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6 Questions to Help Determine If Your Claim is Covered

December 5, 2005 by Jonathan Stein

These six questions were taught to me when I was a young adjuster. I do not recommend you try to get into complex coverage issues without speaking to someone who has done this. But, if you want to know the process, here are the six questions:

  1. Is there a policy in effect? If no, your analysis is done. If yes, go to question 2.
  2. Did the loss occur to an insured party who has an insurable interest? Read the policy and determine if the person damaged is insured AND then determine if the person has an interest in the loss. If no, you are done. If yes, go to question 3.
  3. Are there policy conditions that effect the loss?
  4. Has an insured event occurred? If no, you are done. If yes, go to question 5.
  5. What dollar amount, if any, is payable?
  6. Is there anything else that may effect the claim?

I admit that these six questions are not the easiest in the world. It takes practice to read the policy, answer these questions, and determine if a claim is covered.

Categories: Claims

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