For most restoration businesses, the bulk of their revenue comes from payouts from insurance carriers. Trying to secure payment from carriers can be frustrating. It’s not uncommon for the period between a job’s completion and payment to drag on for months. So what can restoration contractors do when they’re dealing with an insurance company that’s dragging their feet? Keep reading to learn from One Claim Solution law expert Josh Ehmke about your options.
Understanding your rights as a contractor is key to your success in getting insurers to pay promptly. Familiarize yourself with the laws applicable to contractors and insurers in your state before taking further action. Almost all states have prompt payment laws that dictate payment deadlines for construction projects, including restoration projects. The timeframe allowed and other details specified in prompt payment statutes vary by state. Many states also have prompt response laws that require insurers to respond to contractor communication within a certain time frame. Familiarize yourself with the applicable laws in your state. Make sure you understand the exceptions and exclusions included in these laws that allow carriers to extend the time they have to respond or pay.
So what can you do when an insurer violates prompt payment laws? As Josh sees it, you have four options:
“Your number one recourse is to go to the Department of Insurance,” Josh explains. “It’s the cheapest resource, and it can get some traction.” Each state has a Department of Insurance designed to act as a referee between contractors and carriers. If a carrier violates a prompt payment or prompt response law, you can file a complaint with the Department of Insurance. They are then required to notify the carrier, and the carrier is required to respond. What happens after that point is up to the department’s discretion. While filing a complaint isn’t necessarily a cure-all, it can help get the claim process back on track. Sometimes, even informing a carrier of your intent to file a complaint if action isn’t taken can lead to issue resolution.
The complaint filing process varies by state, but, typically, you can file a complaint online by visiting your state’s Department of Insurance website.
If you’re struggling to get responses from your adjuster, consider escalating the issue to their supervisor. In some cases, this can lead to some momentum in the claims negotiation process.
Getting the homeowner involved is another option restoration contractors have for addressing payment delays. Many restorers are understandably hesitant to get the homeowner involved in any disputes. But, ultimately, the insurer’s customer is the homeowner, and they’re more invested in keeping them satisfied than their contractor. Having the customer reach out to their provider and ask why their contractor isn’t getting paid can be a powerful way to prompt
action from the provider. When determining if involving the homeowner is wise, take into account your relationship with the customer and your knowledge of their relationship with their insurer.
Litigation is always an option available to contractors. Filing a lawsuit against the carrier for not paying in time “gets it out of the adjuster’s hands and into the insurance company’s attorney’s hands,” Josh explains. “[Litigation] can take a long time, but there are times where it’s the only choice.” Litigation is best left as a last resort. Unlike many of the former steps contractors can take, litigation gets expensive quickly. Before filing a lawsuit, consider if the potential payout will be worth the financial and time cost of litigation.
“Being able to know when to push, when to sit back and just wait is important,” Josh says. At OCS, we negotiate thousands of invoices for our contractors. Our dedicated claims team understands the inner workings of each carrier and how to best advocate for our clients to get paid quickly. If you’re a restoration contractor who is tired of how much time and effort it takes just to get paid by insurers in a reasonable amount of time, reach out to OCS to see how we can transform your collections.