There are numerous grounds for disputing the outcome of an insurance claim. In most cases, claim disputes arise because the awarded amount is significantly lower than it should be or a genuine claim is refused. The longer a commercial property is inoperable or in need of repairs, the greater the strain on its owners, whose business expenses will continue to climb.
Insurance firms advocate arbitration as a means of resolving such issues. Although litigation can be used in specific circumstances, it is typically more time-consuming and expensive. Nonetheless, certain commercial policies mandate arbitration, meaning that if a dispute develops, arbitration is the sole avenue of resolution. Due to the complexities of arbitrating commercial property damage claims, it is essential to understand what occurs when an insurance claim is submitted to arbitration. In most instances, the arbitration procedure includes:
Notification of the Insurance Company and Policy Review
After disagreeing with the assessment of their claim, one of the first steps business policyholders should take to notify the carrier of the issue. Once the insurer is made aware of the issue, both parties must consent to arbitrate for the process to commence (unless arbitration for disputes is already mandated in terms of the policy).
Due to the fact that some plans mandate arbitration, policyholders should check the policy's terms to determine whether arbitration is required. In the event that a policy mandates arbitration, litigation cannot be pursued, and arbitration must be used by both parties to resolve their disputes.
Acquiring Documents
Once both parties have agreed to arbitrate, the policyholder must gather any documents, images, videos, and statements pertaining to the disputed claim. These will be utilized in the arbitrator's examination. Therefore the policyholder must offer as much detail as possible regarding the damage and the event that produced it. So that the arbitrator is aware of the difficulties, the insured must also explain why they are not satisfied with the insurer's conclusions.
Selecting a Neutral Arbiter
When choosing an arbitrator for an insurance dispute, the individual or panel must be impartial, independent, and unaffiliated with either party. The policyholder and the insurer may also appoint a third party, such as the American Arbitration Association, to assist with the provision of arbitration services. Typically, if the parties cannot agree on an arbitrator, each party will choose one arbitrator, and the arbitrators chosen by both parties will appoint a third arbitrator to serve as an umpire.
The arbitrator will evaluate the case facts as given by both parties and render a ruling regarding the outcome of the claim. Throughout this process, both the insurer and the insured have the option of representing themselves or hiring legal counsel.
Examining the Arbitrator's Conclusions
After reviewing the information surrounding the claim as given by both parties, the arbitrator will render a decision or arbitration award. The award contains all pertinent case material as well as the arbitrator's final decision on fees, damages, and/or disciplinary proceedings, if applicable. It is essential to recognize that the arbitrator's decision may be binding or nonbinding.
In binding arbitration, the parties agree that regardless of the circumstances, the award cannot be appealed. Once a binding arbitration award has been rendered, it stands as-is. If either side is dissatisfied with the conclusion of non-binding arbitration, they may appeal the decision in court.
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