Part 1: The Claims Process

A pipe has burst and things are floating in your basement. Or you’ve come home to find your house has been broken into and things are missing. You might have an insurance claim. What happens next?

The first step is to call your insurance company. If you’re a member of South Easthope Mutual, call 1-800-263-9987 or submit a claim online at https://www.southeasthope.com/claims/. (If it’s an urgent claim like a house fire or flood, please call). Your call will be directed to the appropriate member of our claims team who will record all of your relevant information.

Please note – your job as an insured is to do what you can to make sure the damages don’t get any worse; if you can and if it’s safe. For example, if you have water in your basement, get a sump pump going.

An adjuster, (either a staff adjuster or one on our behalf) may visit your property to survey the damage. The adjuster reviews the ‘wordings’ of your policy to determine if you are eligible for coverage and if there are specific limits. If coverage is confirmed the adjuster, with your approval, may call a restoration company to come and start drying and restoring your property. This is to help prevent further damage.

Restoration companies are used when there is severe wind and water damage. For example, a finished basement that has flooded. The restoration company might take down drywall to get the area underneath dry to help prevent mould growth. They might also bring in dehumidifiers and fans to take moisture out of the air.

Every situation is slightly different for claims. We may require a police report for a break in or an estimate from a professional for some other kind of damage that is covered. The adjuster will guide you through this process, explain how your policy works and work out a settlement for the claim with you. Please check out our blog on Claims Settlements: Actual Cash Value vs. Replacement Cost for information on these types of settlements.
When you’ve reached a settlement, you will be asked to complete a legal document called a ‘Proof of Loss’. It describes the loss and dollar values associated with the claim and the settlement. When this is signed, we will send you payment for the value of the settlement.

At this point the claim is considered closed. We try and deal with claims in a very timely fashion, but with very complex claims, they can take some time to come to a final agreement. You do have one year from the date of your loss to complete the Proof of Loss and settle the claim.

As you may or may not know, claims cost us all. Preventing claims through loss prevention, helps us to keep premiums and claims expenses lower. As a mutual insurance company, we provide insurance ‘at-cost’. This means, the premiums you pay cover our costs – operating the business and paying claims. South Easthope Mutual is a financially stable company and when possible, we provide our property policyholder-members (who are our owners) with a premium refund.

All in all, working together to minimize claims in the first place makes us all stronger, but if you have an insurable loss, we will be there to protect you.