Virginia Property Insurance Claims

Virginia has specific requirements for handling property insurance claims to protect policyholders.

Claims Timeline Requirements

Virginia establishes specific timelines for claims handling:

Required Timeframes

Communication Requirements

Insurers must:

• Acknowledge receipt of claims in writing
• Keep claimants informed of investigation status
• Explain reasons for claim denials in writing
• Provide claim file information upon request

Unfair Claims Settlement Practices

Virginia prohibits unfair claims practices:

Prohibited Practices

• Misrepresenting policy provisions to claimants
• Failing to acknowledge claims promptly
• Failing to communicate claim decisions
• Denying claims without reasonable investigation
• Offering substantially less than reasonable value
• Delaying investigation or payment without reason
• Compelling litigation through low offers
• Failing to provide forms necessary to process claims

Penalties

Violations can result in:

• Administrative penalties
• License suspension or revocation
• Civil liability to policyholders
• Bad faith damages in some cases

Appraisal Rights

Most Virginia property policies include appraisal provisions:

Appraisal Process

1. Demand: Either party can demand appraisal
2. Appraisers: Each party selects an appraiser
3. Umpire: Appraisers select an umpire
4. Agreement: Agreement by any two is binding
5. Cost: Each party pays their appraiser; umpire cost split

Note: Appraisal addresses the amount of loss, not coverage disputes.

Public Adjusters

Virginia regulates public adjusters who represent policyholders:

Licensing Requirements

• Must hold Virginia public adjuster license
• Separate from producer license
• Must pass examination
• Continuing education required

Conduct Requirements

Fee Limitations

• Fees must be disclosed in writing
• Typically 10% of claim settlement
• May not pay referral fees to contractors
• Cannot solicit within certain period after loss

Proof of Loss

Virginia property policies typically require:

Proof of Loss Contents

• Date and cause of loss
• Interest of insured and others
• Actual cash value or replacement cost
• Inventory of damaged property
• Receipts, canceled checks
• Sworn statement (if required)

Timeframes

• Submit within time specified in policy
• Usually 60 days from loss
• Insurer may extend if reasonable
• Failure to submit may jeopardize claim

Recovery and Subrogation

After paying a claim:

• Insurer has subrogation rights
• Can pursue responsible third parties
• Policyholder must cooperate
• Recovery reduces insurer's loss