Let’s face it. Insurance policies are long and confusing. They’re full of legal terms and fine print. But what they often don’t tell you is what actually happens after you file a claim.

If your home or business has been damaged, you probably have a lot of questions:

• What should I do first?
• Will the insurance company give me money or just fix the damage?
• What if I’m not happy with how the repairs are done?

This article will walk you through the general steps in the property insurance claims process, so you know what to expect and how to protect yourself along the way.

Step 1: Make Sure Everyone is Safe and Prevent More Damage

Your safety comes first. If there’s a fire, flood, or structural damage, make sure everyone is out of harm’s way. Once you’re safe, take reasonable steps to stop things from getting worse:

• Board up broken windows
• Shut off the water if there’s a leak
• Call the fire department or police if necessary

Property owners are expected to try to prevent further damage. If you don’t, it could hurt your claim.

Step 2: Contact Your Insurance Company or Broker

Let your insurer know about the damage as soon as possible. Most have 24/7 hotlines or online forms you can use.

If you have a broker, start there. They can guide you through the process and sometimes help with arranging emergency restoration or cleanup.

**Important** If the insurance company later denies your claim, you may be responsible for paying the emergency service company yourself. Keep that in mind before authorizing any work.

Step 3: Document Everything

Before anything gets cleaned up or repaired, take lots of photos and videos of the damage—from multiple angles if you can.

Make a list of what was damaged or destroyed. If you can, find receipts, warranties, or other proof of ownership for big-ticket items.

If your home is unlivable, ask your insurer or broker about “Additional Living Expenses” (ALE) coverage. That could help pay for a hotel or temporary rental.

Step 4: The Insurance Company Investigates

After your claim is filed, an insurance adjuster will investigate what happened and how much damage there is. This can be a quick phone call, or it might involve:

• Visiting your home
• Speaking to witnesses or first responders
• Consulting with experts (e.g. experts in determining the cause and origin of fires)

If you receive something called a “Reservation of Rights” letter or are asked to sign a “Non-Waiver Agreement,” these could be signs the insurance company is considering denying your claim. Consider speaking with a lawyer at that point.

Some policies allow the insurer to request an “Examination Under Oath,” where you must answer questions under oath in front of a court reporter. If this happens, legal advice is strongly recommended.

Step 5: Coverage Decision

After the investigation, the insurance company will decide whether the damage is covered under your policy. If your claim is denied, they will send you a letter explaining the reason for the denial.

Step 6: Proof of Loss Form

Whether your claim is approved or not, the insurance company will usually ask you to fill out a “Proof of Loss” form. This is form asks you to provide information like:

• What happened
• What was damaged
• How much you’re claiming

You’ll need to get the form notarized before sending it back. You may also be asked to provide backup documents, like photos, receipts, and so on.

For large or complicated claims, it might take a long time to figure out the full cost of repairs. In those cases, you can submit “interim” Proof of Loss forms to get partial payments as the costs come in, and a “final” one when everything is settled.

**Do not lie or exaggerate** Making false statements on this form can void your entire claim.

Step 7: Payment or Repairs

Once you submit your Proof of Loss and all required documents, the insurance company has 60 days to pay you. If they take longer, they have to pay you interest.

The insurer can either:

• Pay you in cash (based on the value of the damaged property), or
• Choose to repair or replace the damage themselves

If they go the repair route, they must notify you within 30 days and begin work within 45 days. They’re also expected to complete the work within a reasonable time.

In most cases, they’ll ask what you prefer – cash or repairs. Be aware that many policies offer more value if you choose to repair or replace instead of taking a payout.

The amount they owe depends on your policy, but it usually comes down to the property owner choosing one of two options:

• Repair or replacement cost (whichever is cheaper), or
• Actual Cash Value (ACV): This is the replacement cost minus depreciation for age and wear

The repair/replace option is almost always more valuable than the ACV payout, unless the property owner has no intention of repairing or replacing the damaged property.

If you choose the repair/replacement option, the insurer will usually pay you the ACV amount first. You will then use that money to start to repair or replace your property. Once the ACV payout is exhausted, the insurer will top you up for the remaining repair/replacement costs. You will have to provide documentation (receipts, quotes, invoices, etc.) that the cost of repairing or replacing your property has exceeded the ACV payout.

Step 8: What If You Disagree?

If there’s a disagreement about the value of your claim or the quality of repairs, there is a mandatory dispute resolution process created by the Insurance Act. This process is designed to be quicker and cheaper than going to court.

If your issue involves a denial of coverage or you feel the insurer is acting in bad faith, those disputes are handled through the courts.

At Slater Vecchio LLP, we represent home and business owners in both types of disputes and can help you understand your rights.

Bonus: Who Does the Repairs?

In most cases, the insurance company will get repair estimates from a few contractors and go with the cheapest option. If you want to hire someone else, the insurer will usually only cover up to the amount of the cheapest quote.

Even if the insurance company coordinates the repairs, you’re still technically the one hiring the contractor. That means you’re responsible for managing the work and dealing with any problems—unless the insurer formally takes over the repair job (which they must do in writing within 30 days).

If they do take over, they’re fully responsible for the repairs, including any issues that come up later.

Need Help With a Claim?

Insurance claims can be stressful and confusing—especially when you’re already dealing with damage to your home. If you’re unsure about your rights, facing delays, or worried your claim might be denied, you’re not alone.

At Slater Vecchio LLP, we regularly help homeowners stand up to insurance companies and get the compensation they deserve. Whether you need advice, help reviewing documents, or full legal representation, we’re here for you.

Contact us today for a free consultation. Let’s talk about your claim and how we can help.