An insurance claim lawyer can help you if your claims were denied or rejected. We can also help if the insurer is unreasonably delaying payment on an approved claim.
Insurance adjusters often delay or refuse claim based upon an origin and cause investigation.
You need an experienced attorney on your side when this happens.
What is an Origin and Cause Investigation?
For many property insurance claims, the insurance company will want an investigation as to the source and cause of the damage.
The purpose is to determine both the cause and origin of the loss being claimed by the policyholder. The results can have an effect on whether a damage claim is covered under the policy.
The origin of damage refers to where the damage began. For instance, in a fire loss, the origin might be in the stove or in a bedroom. The origin is used as the starting point to better understand how and why the fired occurred.
Once the origin is determined, the next step is to determine the cause.
Using a house fire as an example again, the cause could be a grease fire, faulty electrical wiring, or a cigarette that caught a bed on fire in the middle of the night.
Understanding the origin and cause helps insurance companies determine whether the damage is covered under your policy.
Some losses might be covered and others may be not. If a loss was intentionally created, it may not be covered under the policy.
Common Origin and Cause Investigations
The insurance company conducts investigations on all types of losses. The most common ones include:
- Fire loss claims
- Smoke damage claims
- Gas explosions
- Appliance fires
- Electrical fires
- Ice and snow damage
- Water leaks
Many times, the insurer is investigating whether a fire was intentionally set by the insured or someone else. Arson may be a basis for denying a claim.
Who Performs the Origin and Cause Investigation?
The insurance adjuster will likely hire an investigator to determine both the origin and cause of a loss.
On some occasions, an in-house employee will perform it. The type of investigator largely depends on the type of damage.
For example, the adjuster will hire a fire investigator for a case involving fire damage.
Another type of investigator may be hired for a water damage claim or a gas explosion claim. There are certified investigators for most types of insurance claims.
Many times, the insured will want to hire a private origin and cause investigator to assess the loss.
The insurance company investigator may have opinions that are bias to the insurer, and these can be used to deny or reject a claim.
It is wise to have your own investigative experts evaluate the loss to best protect your interests.
Do I Get a Copy of the Report?
You will be provided a copy of the report. The report should detail the findings of the investigator as to both cause and origin of the loss.
You can review it and decide if you agree or disagree with the findings.
If you hired your own investigator, you should provide that person a copy of that report. It is interested to compare findings to determine any differences in opinions.
If the insurance company denies your claims based upon the findings, then you can sue the insurer in a lawsuit to demand payment for your losses.
What is an Insurance Subrogation Claim?
Many times, the insurance company will seek reimbursement from another party that may have caused the loss.
For example, if your home burns down due to an electrical fire, the insurer may sue a contractor that negligently installed circuitry that caused the fire.
Or, it can sue a product manufacturer for an appliance fire.
The insurance company will pay your loss and then pursue subrogation claims against the at fault party. This does not affect your right to payment under the policy.
How Do I File an Insurance Claim Lawsuit?
In most circumstances, you will need an experienced insurance lawyer to file your lawsuit.
There are many legal requirements and technicalities in these cases that make them more difficult than a simple matter.
If the loss is very small, you may be able to handle it yourself in small claims court. However, most losses are substantial so it is advisable to have skilled legal counsel on your side.
The insurance company will have a team of lawyers to fight you.
Get Help After an Origin and Cause Investigation
If you are getting the runaround from your insurance company, you need an experienced team of insurance lawyers on your side.
For most claims, we charge no fees unless you receive an insurance company settlement. And, we only get paid our fees at the end of the case.
Call us today to get started on your case.
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