This week's most asked questions deal with business interruption insurance coverage and losses resulting from tropical storm Irene. The first question that is asked is "Am I covered?" for a particular loss and the answer is always the same: "What does your contract of insurance state as far as your coverage?"
If you have suffered a loss of some type, the first thing you should do is locate or obtain a copy of your current insurance policy, with all applicable riders, and read what is covered. After you have read through the policy and know what is covered you should then call your insurance agent or company to report the loss and get a claim number.
You should amass all necessary documentation to prove each individual loss and its value. Get estimates if needed, take pictures and use all reasonable efforts to get as much documentation together as possible to verify and substantiate your loss(es). If you are in doubt as to what to get, the rule of thumb is the more information you can obtain the better off you will be.
You need to record all information regarding your communications with the insurance company (i.e. the date and time of each call, the phone number called, the name of the person you spoke with and that person's extension number, what exactly was said and what follow up action will be taken). If you are sending or receiving letters or emails, save copies of those as well.
Typically, losses or expenses that would be covered under a business insurance policy could be:
- Lost profits or loss of income that would have been earned had the covered peril not occurred;
- Operating expenses that were incurred during the time the business was not opened as a result of the covered peril;
- Reasonable expenses incurred, in addition to the customary expenses of the business that resulted from the covered peril; and
- Inventory that could not be sold, due to spoilage, at either the cost basis or retail value depending upon your policy coverage.
A typical homeowner's policy might cover you for losses including damage to property, the cost to repair or replace personal property, reasonable and necessary expenses related to the covered peril and alternative living expenses.
If you are told your loss is not covered, ask where it is excluded in your policy. In other words, the page and paragraph number where it states that so you can read it while you are on with the company representative. If it does not state in the policy that your loss is not covered, politely but forcefully point out that the policy does not exclude your loss. If necessary, ask to speak with the adjuster's supervisor. As a last resort, if you are still not satisfied, indicate that you will be speaking with your lawyer or that you will file a complaint with the CT Insurance Commissioner's Office.
The insurance company owes each of its policyholders the duty of good faith and fair dealing, which is implied in every contract of insurance. If you feel that you are not being treated fairly by your insurance company then you should contact a lawyer, and get a free telephone consultation, or file a complaint with the Connecticut Insurance Commissioner's Office by visitingwww.ct.gov/cid/.