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Watch What You Say to Insurers


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Apologizing after an auto incident, and other key phrases during incidents, can make processing your insurance claim a major struggle.

When Melissa Cruz's car hit a pickup truck coming to a screeching halt at a busy intersection, she says she did everything right.

She stayed at the accident scene and took out her documents. But Ms. Cruz did one thing wrong, according to insurance experts: She apologized to the other driver.

For people who get into a car accident and file insurance claims, apologizing is a habit that should be avoided, insurance experts say. There are words that people should avoid, they say, because what you say can mean the difference between an insurance check arriving smoothly and a drawn out battle with an insurer.

"I thought apologizing was the right thing to do no matter whose fault it was," says Ms. Cruz, 27 years old. "It turned against me, though."

While the police report stated that the pickup truck was clearly speeding, Ms. Cruz says, her apology was seen by the other driver as taking blame for the accident. And that slowed down the entire claims process, she says.

No Need to Apologize

Amy Danise, editor of Insure.com, a site that provides advice on shopping for insurance, recently compiled a list of what people like Ms. Cruz should and shouldn't say to avoid sparring with insurers over a claim.

"A few words can make a big difference," she says.

Saying "I'm sorry" or "It's my fault" after an auto accident can be seen as an admission of fault, Ms. Danise says. Instead, she says drivers should stick to the facts and speak as plainly as they can.

A simple mix-up in terms can confuse insurance companies and possibly delay a claim, she says.

If you're not sure about what occurred, let the authorities and insurance agents figure it out. "The last thing you want to do is backtrack to explain what happened," she says.

Ms. Cruz says because she apologized, it turned into a blame game with the other driver, which was documented in the police report. "It was like I got penalized for being nice or honest."

She says it took four months to get a check for nearly $1,100 from her insurer -- a time frame that is longer than average, insurance experts say. "I learned to be careful with what I say," Ms. Cruz says.

When Is It a Flood?

Homeowners often misuse the word "flood" when filing a homeowners insurance claim, Ms. Danise says.

Insurance companies have a narrow definition of flood. Unless the water reaches a home because a lake, stream or river overflows, it's not a flood -- at least to insurance companies -- she says. Flooding from a hurricane does count, though.

Damage from a pipe that burst in your basement and caused water to rise knee-high would likely be covered in most homeowners policies. But calling it a flood -- which it may very well seem like to you -- could delay a claim because the insurer must investigate whether it actually was a flood.

Pain in the Neck

Another area where language can be murky is health insurance. Ms. Danise says patients should be careful when using words like "experimental," "investigational" or "clinical trial" when submitting a claim to their health insurer.

Misuse of these words could lead to claims delays, or even refusals, she says.

Drivers involved in a car accident shouldn't use the word "whiplash" to describe neck pain, unless it has been medically diagnosed as such, Ms. Danise says.

Insurance companies often deem the term whiplash an exaggeration or part of fraudulent claims, she says.

"People are being denied or compromised all the time simply because they use the wrong lingo," says J.D. Howard, founder of the Insurance Consumer Advocate Network in Springfield, Mo., which advises consumers shopping for insurance.

Jeanne Salvatore, a spokeswoman for the Insurance Information Institute, says filing claims in an organized manner helps expedite the process. "The realty is, someone is going to look at the loss and it's going to be based on facts."

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Andrea Luoni
FiLifer
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Great article and very true. I work as a consultant to businesses and individuals and now teach many of my clients what to say or "not" say. Agents can not do this due to who actually pays their bills - insurance carriers - they are acting as agents to the carriers. Many agents can lead a client down the path they should go but if the client says the wrong thing like "flood" then many times the claim can get thrown out or away from their favor. Insurance is a bit of a "less is more" - let the carriers ask the questions and only answer what is asked. I have often told clients I can create ANY reason for an insurance carrier not to want you as a client - it is all in the wording. On any given day you can be a desirable client or an undesirable client.

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