Elderly Insurance Claims Tips for Seniors in California (65 and Older)
Seniors are often disadvantaged by insurance agents who don’t take sufficient care to explain policy details or provide them with adequate assistance. As a result, many seniors don’t know or understand what they’re insured for and sometimes struggle to file insurance claims.
In some cases, seniors find out too late that they don’t have the right insurance coverage based on their needs.
The State of California understands that seniors might be more vulnerable and addresses insurance for seniors in California Insurance Code Article 6.3. Section 785 that states:
“(a) All insurers, brokers, agents, and others engaged in the transaction of insurance owe a prospective insured who is 65 years of age or older, a duty of honesty, good faith, and fair dealing. This duty is in addition to any other duty, whether express or implied, that may exist.”
and
“(b) Conduct of an insurer, broker, or agent, or other person engaged in the transaction of insurance, during the offer and sale of a policy or certificate previous to the purchase is relevant to any action alleging a breach of the duty of good faith and fair dealing.”
Based on the above: Seniors 65 years or older are owed a duty of honesty, good faith, and fair dealing in addition to any other duty that may exist.
Should this duty be breached, Section 789 provides for administrative remedies and various penalties for violations that may be enforced by state officials. It states:
“(a) The commissioner shall have the administrative authority to assess penalties against insurers, brokers, agents, and other entities engaged in the transaction of insurance or any other person or entity for violations of this article.”
and
“(b) Upon a showing of a violation of this article in any civil action, a court may also assess the penalties prescribed in this chapter.”
Thanks to Article 6.3. senior citizens are protected from being disadvantaged by unscrupulous insurance companies and insurance agents.
Tips & Advice for Senior Citizens
The Senior Insurance Bill of Rights (SIBOR) and the California Department of Insurance share helpful tips and information on how seniors can better protect themselves. Below are some of these tips and additional advice from Avner Gat, Inc. based on our extensive experience as a public adjuster based in Los Angeles.
Regularly review your homeowners insurance policy.
As we get older, our financial situation, needs, and circumstances often change. For example, you might have made home improvements that are not covered under your existing policy.
Obtain all proposals in writing.
Any discussions or insurance proposals should be reduced to writing. It’s the best proof of what was discussed should a dispute arise.
Don’t be pressured into taking out a policy.
Never allow yourself to be pressured into taking out a policy. Take all the time you need to review the information. Remember, it’s your property, your money, and your decision.
Don’t sign anything you don’t understand.
One of the worst things anyone can do is sign a document they don’t fully understand and fail to read the fine print. If you’re not sure about anything in a homeowners insurance policy, ask the agent to explain it to you, and don’t sign unless you are 100% comfortable.
It’s always a good idea to submit any questions you might have in writing and ask for a written response.
Consider asking a trusted friend, family member or advisor for assistance.
Asking a trusted friend, family member, or advisor to review any insurance documents before you sign them can be a smart idea. They might be able to spot something important that you missed. Two pairs of eyes are better than one.
Make sure you’re dealing with a licensed agent or broker.
Call the California Department of Insurance at 800-927-4357 or run a license status inquiry on their website to see if an agent or company is licensed to sell insurance in California.
Insurance agents are required to print their license number on all business cards, quotations, and advertisements. Never deal with an agent who is unable or unwilling to provide you with his or her license number.
If your insurance application is refused, find out what the reasons are.
Under California Insurance Code Section 791.10, you may request in writing to get a written explanation of the reason(s) your application was unsuccessful.
This might assist you in addressing the reason(s) and help you to obtain insurance elsewhere.
Shop around for the best deal.
You’ll never know if you’re paying too much for your homeowners insurance or if you can find a better deal unless you shop around.
The California Department of Insurance has two helpful tools that can help, namely:
“It is based upon several scenarios, or hypothetical risks, that represent the most common variables applied to homeowners, condominium, renters and earthquake insurance premiums quoted today. It provides you with a general cost comparison between insurers and lists a number of insurers offering the coverage selected.”
Homeowners Coverage Comparison Tool
With this tool, you can compare policies from different companies. It includes the following information:
– Type of Coverage
– Required Minimum Limits of Coverage
– Specific Limits of Coverage on Certain Personal Property
– Coverage Details
– Additional Coverages
– Loss Settlement Provisions
Consider buying your home and car insurance from the same company.
Many insurance companies will offer you special deals if you have more than one insurance policy with them. You might be able to save as much as 5% to 20% on your premiums.
Consider raising your deductible.
In principle, the higher your deductible, the lower your premium. You may be able to save on your insurance premiums by having a higher deductible, but make sure you can afford to pay the deductible should the need arise.
Improving the security of your home might save you money.
Items like smoke detectors, sprinkler systems, monitored alarm systems, and Internet of Things (IoT) technology can help reduce your insurance premiums.
Note that some insurance companies have been slow or reluctant to embrace new technologies such as IoT. However, insurtech companies (combination of the words insurance and technology) are often able to give discounts on premiums to homeowners that invest in technology to better protect their property.
Conclusion
Seniors are often disadvantaged by unscrupulous insurers and insurance agents who don’t take sufficient care to explain policy details or provide them with adequate assistance. And when the need arises to file an insurance claim, they often don’t know or understand what they’re insured for.
In addition, filing and managing an insurance claim can be cumbersome and time-consuming. It can quickly turn into a nightmare if it’s a large or complex claim and you don’t have experience dealing with insurance adjusters and contractors.
Article 6.3 of the California Insurance Code offers some protection to senior citizens, but nothing beats having a public adjuster on your side.
A public adjuster acts in YOUR best interests, not the best interests of your insurance company.
An experienced, reputable, and licensed public adjuster can help you overcome the challenges of managing your property insurance claim and assist you to get the best possible settlement offer.
Avner Gat, Inc. has 17+ years of experience as a public adjuster in Southern California. We protect homeowners from the games and fine print that insurance companies are known for.
Call us at (818) 917-5256 to find out how we can help you.
