The Way You Represent an Insurance Claim Will Decide The Outcome

The way you represent an insurance claim can make a huge difference to whether it will be successful or not. There are some common words that raise suspicion of insurers and you should always avoid them.


We often use the word flood to express any damage caused by a large amount of water. However, insurance contracts use flood in a very narrow way. Flood for insurers only refers to damage from water of a natural water body. Flood damage is usually not covered by general insurance policies and you have to pay more to get the coverage.

It is important to report your claim precisely. Never use the word flood unless the water came from a lake, stream, river or sea. If your house is filled with water because of a burst pipe or a clogged drain, then don’t refer to it as flooding.

Experimental treatment

Words like ‘experimental’, ‘clinical trials’ and ‘investigational’ have a very specific connotation in medical science. Sometimes, doctors say that they wish to experiment with a certain line of treatment, but this does not automatically make it experimental. If the treatment’s efficacy has been proved, then it is not an experimental treatment. Experimental treatments are unlikely to be covered by your health insurance policy. Report your treatment as a medical necessity.

I think it was my fault

You have to be very careful when you are making a claim after a car accident. Do not analyze the facts and give an indication that it was your fault. Even saying ‘I am sorry’ for the sake of politeness can be interpreted as an admission of guilt by your insurance company.

Always stick to the facts. Do not make any guesses about your speed or any other aspect of the accident as your statements can get you into trouble later. Tell them what you know for sure and leave the rest to the insurance company and authorities, who will carry out their own investigation. Unless your fault is apparent to you, you should tell the insurance company that you are not at fault.

It is also important to read your insurance contract carefully before making any claim. You should understand what is covered and what is excluded in your policy. This will ensure that you do not make any statements that make the insurance company suspicious about the claim.

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