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When the Smoke Clears

Last month's article offered an overview of the provisions found in 19 states' versions of the Unfair Claims Practices Regulations.

By Tim Lynch | Updated on October 30, 2008

Last month’s article offered an overview of the provisions found in 19 states’ versions of the Unfair Claims Practices Regulations. These regulations extend the deadlines to accept or reject a claim and/or waive the requirement for providing the claimant reasons as to why the insurer is seeking a time extension for the investigation, should evidence of fraud or arson be found. In this article, we will discuss claim handling in states where no such protections appear to exist. We will also discuss some general concepts regarding handling arson or fraud claims in both types of jurisdictions.

Certain basic guidelines, some of which will be outlined in detail, should assist an adjuster who is confronted with a suspicious loss — such as fire, theft, and vandalism — or a damage claim that appears to be intentionally exaggerated. In the states listed in the sidebar “Waiving Regulations,” these become particularly important, given the tight time frames under which the adjuster must operate.

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