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Claims & Disputes

Choosing an insurer, not just a price

The policy is a promise to pay in circumstances you cannot predict, and who makes the promise matters as much as what it costs.

Close-up of a handshake between colleagues in a professional office setting, emphasizing teamwork and agreement.
Close-up of a handshake between colleagues in a professional office setting, emphasizing teamwork and agreement. · Photo via Pexels
Financial information notice. Analysis and education — not personalised financial advice. Read the full disclaimer.

People choose insurers on price, which is understandable given that the product is invisible until a claim.

Several things about the insurer are knowable in advance and are worth checking.

Financial strength

Several agencies rate insurer financial strength, assessing the ability to meet obligations.

Ratings use different scales, so compare within an agency rather than across them.

This matters most for long-duration promises: life insurance that may be claimed in forty years, annuities paying for decades, and long-term care policies.

It matters less for annually renewable property and auto coverage, where you can move if a carrier weakens.

State guaranty associations provide a backstop if an insurer fails, up to limits that vary by state and by product type. Those limits are meaningful and are frequently below the amounts people insure.

Note that surplus lines insurers are generally not covered by guaranty associations, which raises the importance of their financial strength.

Complaint data

The most useful and least used public information.

State insurance departments publish complaint data, and a national database aggregates it into a complaint index comparing an insurer's complaint volume to its market share.

An index above the median means more complaints than expected for the company's size.

Look at the trend and at the categories — delays, denials, unsatisfactory settlement offers.

This is genuine information about how a company behaves at claim time, published free, and almost nobody looks at it before buying.

Claims satisfaction research

Independent surveys measure claim satisfaction across insurers.

Treat these as one input. Survey methodologies vary and satisfaction correlates with expectations as well as with performance.

Still, consistent poor performance across several years and several surveys is a signal.

Market conduct examinations

Regulators periodically examine insurers' claim handling practices, and reports are frequently public.

Enforcement actions and consent orders are also published by state departments.

A pattern of regulatory action on claims practices is meaningful information.

What to ask before buying

How are claims handled? In-house adjusters or contracted independents? Is there a local presence?

What is the process after a catastrophe? Capacity matters enormously when thousands of claims arrive at once.

What are the policy's distinguishing provisions? Roof settlement basis, replacement cost on contents, extended replacement cost, water damage terms.

Coverage differences between insurers at the same price point are frequently larger than the price differences.

How long have they written in this state? Recent entrants may exit.

The agent question

An independent agent who knows the market is a genuine asset.

What a good agent provides: knowledge of which carriers are writing and which are competitive for your situation; advocacy at claim time; and a review of coverage rather than only of price.

What to look for: independence across multiple carriers; experience with your type of risk; willingness to explain coverage differences rather than only quoting; and responsiveness.

Direct purchase is efficient for simple standard risks. For anything with complexity — a business, a rental property, valuable items, a difficult market — an agent earns their place.

Price is still real

None of this means paying more is better.

The most expensive insurer is not necessarily the best, and price differences of thirty or forty percent for identical coverage are common and worth acting on.

The point is to compare on coverage, complaint history and financial strength alongside price, rather than on price alone.

A modest premium saving is not worth a company with a poor claims record on a policy you are buying precisely for the claim.

The practical routine

Shortlist three or four insurers on price for identical coverage.

Check financial strength ratings for each.

Check the complaint index for each in your state.

Compare the actual policy provisions on the coverages most likely to matter.

Then choose.

Twenty minutes of research, on a decision you will live with for years.

And afterward

Read the policy when it arrives, during any free look period.

Keep the declarations page and the full policy where you can find them.

Review annually.

The best insurer for your circumstances changes over time, and so do your circumstances.

General information about insurance selection, not insurance advice. Ratings, complaint data and guaranty association protections vary. Consult your state insurance department and a licensed agent.

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Grace Mbeki
Editor, Premium Policy Plans

Grace worked as a claims adjuster for eight years. She writes the article she wishes policyholders had read before they called her.

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