Approach in resolving Insurance Disputes

SoftSettle Support

As careful as we are, there is the possibility of being involved in an accident while you’re driving.   Or having damage occur to your home due to circumstances you can’t control.   While carrying car insurance and home insurance minimizes the financial risks and responsibilities of the aftermath of an accident, there is a possibility that you and your insurance company could disagree about the benefits you’re entitled to in the event that you have to file a claim.

What can you do in the case of a dispute with your insurance company?   The best scenario is that you and your insurance provider can come to an agreement that works for both of you, but in the case that it isn’t possible to resolve the disagreement between both parties, there are other options available to you.

SoftSettle Support shapes online platforms for insurance claim settlement.

There is, of course, a range of options available to disputing parties who do not wish to proceed to formal litigation (litigation Is typically costly, time consuming. Uncertain and ultimately unsatisfying regardless of the outcome.) A number of processes, of varying degrees of formality, are available to assist the parties to resolve their dispute themselves, or in some cases, to impose a settlement regime on the parties. These resolution processes can be divided into two broad categories.

First are consensual processes such as conciliation and mediation, where the parties to the dispute typically meet with an independent third party to explore settlement options. The third party is not supposed to impose any unilateral decision but to assist and persuade the parties to generate and refine their own settlement options.

Second are adjudicative processes such as arbitration, appraisal, early  neutral evaluation or mini trial. The parties are given the opportunity to make submissions to an independent umpire. Each parties’ submissions are weighed by the umpire and a decision is made. This third party must them review that material before formulating an appropriate settlement regime.

SoftSettle Support facilitates an environment for both insurers and insured as insurer will gain more credibility to canvass more clients as he is not inclined to constantly battling with customers in court and insured will get sigh of relief so far as insurer used to be conciliatory and attractive to their existing and prospective customers

SoftSettle Support provides a portal or application to insurer and insured where they can submit their disputes to get it resolved by means of online mediation and online arbitration presided by experienced neutral and arbitrators. These advantages are being built and integrated in the virtual court powered by SoftSettle Support in www.odrsupport.com. Apart from regular disputes used to occur in the negotiation (resolution) process to reach an accepted claim settlement is being integrated in www.softsettle.com. These opportunities allows the insured more time in mediation sessions to articulate his or her position. The insurer would also get an opportunity to reconcile to go with a win-win strategy rather than preserving an attitude of obstinacy in the process of litigation.

Hence SoftSettle Support strikes the conscious of the parties  as the conciliatory nature of processes like online mediation ensures that the parties are given every chance to preserve their existing relationships. Consensual processes encourage the parties to work together to generate settlement options.

Hope these suggestions might be some of the analytical answers to the questions posed by the scenario described in the top paragraphs.

 

 

SoftSettle Support manages Disputes in respect of value of the insured property

The Dispute Resolution Process

When you cannot reach an agreement about the value of the insured property, the value of the property saved, the nature and extent of the repairs or replacements required, or the amount of the loss or damage, those questions must be determined using the Dispute Resolution Process. The Dispute Resolution Process by means of Online Arbitration or Online Mediation are being integrated in the ODR portal www.odrsupport.com using the platform MEDIATOR AFFAIR powered by SoftSettle Support.

The dispute resolution process must be used in settling the amount of a loss with your own insurer. Rather the insurance company is supposed to send you a statement determining that there is dispute in respect to the amount of a loss.

Alternatively, as an insured, you can initiate the dispute resolution process in respect to the amount of a loss at any time, through the following process by resorting to the concerned services of SoftSettle Support. SoftSettle Support facilitates online conferencing which could bring the insured and insurer confronting over video so that the following steps can be carried out without further delays.

  • You must file a proof of loss form with the insurer and make a written request to start the dispute resolution process. A proof of loss form is available from your adjuster by online.
  • Within seven days, you and your insurer must each appoint, at your own cost, someone to represent your interests. Neither party can represent themselves, nor can appoint employees.
  • There is no requirement to appoint an appraiser to represent you. You may appoint anyone of your own choosing, although it is highly recommended you appoint a representative with expertise in the subject matter being disputed.
  • If the two representatives cannot agree on the amount of the loss, they will appoint an umpire to assist in establishing the amount of the loss. If the representatives cannot agree on an umpire, they can seek the assistance of the selected ODR provider to provide an umpire/neutral to decide the case.
  • Selection of an umpire/neutral to decide the case
  • The umpire will issue a written decision based on information provided by the representatives.
  • The outcome of the dispute resolution process is final and binding for both the insured and the insurer on the issue of the amount of the loss.
  • It is important to note that the dispute resolution cannot be used to resolve contractual disagreements, such as whether there is coverage under the policy.  The interpretation of what is covered by your policy is a matter for the courts to decide or resort to online dispute resolution facilitated by the platform MEDIATOR AFFAIR integrated in www.odrsupport.com.

Soft Settle discharges this service as a special effort to help both claimant and insurance company to sort their differences over the determination of the loss. As such, the insurance company can make an analytical study which could lead to a perfect way of dealing the settlement

 

Dealing the Insurance Claim Settlement Offer or Denial

SoftSettle Support

If you filed an insurance claim (in general) and feel your insurer should pay more than they estimated, or wrongfully denied your claim, you aren’t helpless. This guide will walk you through the process to dispute a claim offer or claim denial, and help make sure your settlement is fair.

Discrepancies over the cost of damages or a loss are common between insurance companies and policyholders. Policyholders pay premiums and expect all of their claims to be paid in-full. It is in insurance companies’ best financial interests to pay as little as possible in claims, which directly affect their profit and ultimately affect the cost of premiums. But that doesn’t mean companies automatically try to lowball their policyholders. Both parties often just need to share more information with one another to come to an agreement, or at least an understanding behind a settlement.

Then there is room for disputing. Exactly what you shall do is to contact your insurer or company. But you should review the claim you filed earlier. Consider if there is any way you can improve it. The quality of evidence showing damage or a loss can have a significant impact on the claim settlement. You have to refresh the claims with evidences potentially with materials such as photos, videos, repair estimates and receipts for items; you should organize before reconnecting with your insurer or company. It must be borne in mind that these materials should not have evidenced in the initial claim. Remember that an adjuster from the company calculated the estimate, not your agent or the person you’ll speak to. Be polite, listen to what they have to say and follow any instruction they might give you regarding a claim dispute. It has to be learnt whether the adjuster can reexamine the property damaged or loss of particular assets against which you have made the claims as mistakes happen and it is possible that the adjustor might have succumbed to miscalculations. A company might review it again but that doesn’t mean that settlement offer might change.

As the insurer or company is reluctant to make any amends, you may be forced to resort to certain private appraiser. SoftSettle Support is there to assist you in accepting the role of an appraiser with their expertise in assessing or appraising the loss suffered by you. It is a special service that SoftSettle Support intends to provide to their clients. On the other hand you will be pleased to enjoy the services of SoftSettle Support rather than seeking the assistance of a private appraiser so far as their services demands heavy pounds or fees. The extension of the special services provided by SoftSettle Support is by means of MEDIATOR AFFAIR integrated in the portal www.odrsupport.com powered by SoftSettle Support.

Claim disputes rarely make it to this stage. If you are unable to reach an agreement on a claim with your insurance company, and have exhausted all of the above options, there are certain options to be worked out which includes reporting the mistreatment or bad business practices to concerned authorities and facing the investigation to evaluate whether your complaint is justified or not along with the second option of hiring an attorney to pursue the case dragging it to court litigation and bear the heavy litigation expenses.

Rather ignoring the above two options, as the first gesture, you can reliably seek the assistance of SS-Equity (Insurance Claim Settlement) using the Soft Settle platform in deciding the disputes over the insurance claim which is more convenient in settling your case may also be acceptable by your insurance company to be justifiably delivered with a win-win outcome.

Denial of Insurance Claims

By SoftSettle Support

There may be delay in settling claims, ok the delay is delay but if the claims are denied it is truly unjustifiable. But the insurance companies have justifications. But we will find difficult to digest such arguments deemed to be the reasons for denial of claims.

We can assess the situation. Let me serve you with some hypothetical scenario.

A gentleman met with an accident. The accident is disastrous. He is seriously injured and left in a coma. When he wake nine days later, he has multiple broken bones, collapsed lungs, and are destined to spend the next few agonizing months under constant care. He regularly pays his insurance premiums. But unfortunately the insurance company denies his claim. They claim the driver who caused the crash acted negligently, and so the accident was not an “accident.” His hospital bills pile up, He is too injured to go back to work, and his insurance company has deserted him. The irony is that when the policy holder needs the insurer most, they do something like this.

So it is that. The policyholder is at fault. It is assessed and certified that the accident could have avoided.

Okay then the reasons steps up one by one. Then the claim is not covered by policy. Insurance policies are contract that define each party’s obligations. The insurer agrees to cover only certain claims as outlined in the contract.

Then again, the coverage has lapsed. If an accident occurs during gap in coverage, if the policy holder did not pay his insurance premium in correct date.

Then something most unfortunate. The policy holder’s doctor may use the wrong coder for a procedure causing the insurance company to believe that the procedure fails outside his policy coverage.

Then how can you overcome such awkward situations:

You have to read your policy carefully/ You should know exactly what is covered and how to appeal a denial by your insurance company.

Be very careful in filling the forms. Even if you make an honest mistake your insurance company may seize on that as a reason to retroactively deny your coverage.

If anytime your insurer rescinds your insurance by sending you refund for the premiums you paid, you never accept or cash them which might lead to make the court believe or may be interpreted as accepting their decision.

Talking to insurers or their representatives over telephones or directly is desperately a frustrating experience and you will fail to prove anything during litigation and it is better you insist the insurance company to put everything in writing. So that you can keep records of all bills and correspondence such as mails and other communications.

It is going to be  a mental test, sometimes even your persuasive attitude would not help you to not to abandon further attempts. Knocking at the doors and if it keeps on turning dear ear to you, never give up.

Soft Settle is there to support you. They can help you from your first knock at the door or even at your frustrated knock before you have decided to give up. As such Soft Settle with its mediation outfit (www.odrsupport.com) Mediator Affair can resolve the issues and further if everything goes well,you can also negotiate with your insurance company to make a get through in settling your insurance claims. Soft Settle and Mediator Affair can put you in a safe resort and releasing all agonies against your insurer.

 

 

Low Insurance Settlement Offer – A source for Concern & Source of Conflict.

By SoftSettle Support

Do not be surprised if the initial settlement offer is a low figure. There are many reasons why you might receive a “low” offer. The claims adjuster may have concluded that you are partially at fault for your injuries, or that your injuries were not serious enough to justify the amount of damages you included in your demand letter. He may also produce concerns about your pain and suffering demand.

Consider this a test from the claims adjuster. The insurance company has nothing to lose and everything to gain by making you a low bid settlement offers. Many people are struggling financially after an accident and are desperate to jump at the first settlement offer that comes their way. Even though it may be difficult to pass up a settlement offer, you should not accept the initial offer unless it is fair. How to evaluate and deal with a fair settlement offer is discussed at the conclusion of this article.

Do not panic over a low settlement offer. Remember, the insurance company is running a business and must maintain its profits. The claims adjuster does not expect you to accept the first offer, but rather hopes that you will. Naive personal injury claimants accept lowball offers all the time.

As soon as you receive the initial settlement offer in writing, carefully evaluate the stated reasons for the low settlement amount. You should respond to each of the points made by the claims adjuster in a written letter that includes a counteroffer. In this letter, you will reassert your position (this is the same position you carefully described in your demand letter). Focus on the extreme pain and suffering you endured. Never personally attack the claims adjuster. Be professional yet firm in explaining why you deserve more money for your injuries and other losses.

Rejecting the Low Offer

 In order to reject the initial settlement from the insurance company, you should send a details  to the claims adjuster through  the medium of Soft Settle that:

States you do not find the initial settlement offer acceptable;

Lists the reasons why you deserve a higher settlement offer; and

Includes a demand for a higher settlement offer stating reasons.

In this case you can invite the Insurance Company for negotiation so that you can tell them Soft Settle Platform offers a potential zone of agreement where they can reach a settlement acceptable to both.

In the meanwhile you can serve a letter rejecting the initial settlement offer and include your personal information about your loss or damages where applicable. This record will help you in case you are heading for court litigation if any.

The initial or later low offer from the part of the insurance company is the cause of the dispute and usually the claimants may consider entrusting lawyers to contest for them to claim and earn more which could be settle their loss.

Soft Settle thus helps both claimant and insurance company by judiciously settling their claims which could bring a harmony in respect of their relationships, otherwise would have been in peril in case the claimant proceeds to court litigation

Set Limits on Conversations

SoftSettle Support narrates the following hypothetical situation over a personal injury – auto accident insurance case as cautioning notice to the parties who will find rather difficult time with the insurance company on the occasion of an event – injury or accident.

In your first contact with an insurance adjuster (which usually comes via a phone call) make it clear that you will not be discussing much.

Let the adjuster know that, until you have finished investigating the accident, have completed medical treatment, and have fully recovered from your injuries, you do not want to discuss anything related to:

  • how the accident happened
  • what your injuries are (or how serious they are, or whether your condition is improving), or
  • what a settlement amount should be

In this first discussion with insurance adjuster, set boundaries. Ask that the adjuster communicate with you in writing until you present your written demand for compensation and actual settlement negotiations begin.

In some situations, however, it may not be practical to stop all phone conversations. For example, if you have been in an auto accident, you may need to discuss repairs to your car. If you do need to speak to the adjuster again, set whatever limits you want on the place and times — home or work, morning, evening, weekends — for telephone contact.

There are good reasons to limit your phone conversations with insurance adjusters. Some will call frequently in an attempt to get you to settle quickly, and they can become a real nuisance. It’s good to nip this in the bud.

More important, until you have had a full opportunity to investigate and think about the accident, to determine the nature and extent of your injuries, and to recover (or reach “maximum medical improvement” in insurance parlance), you will not have accurate information to provide. And, if you give incomplete or inaccurate information on the phone, the insurance company may try to make you stick to it later on. Some insurance adjusters are good at getting you to say something which could be considered an admission of some fault on your part, or which limits the seriousness of your injuries. It is therefore much better to have no discussions at all until you have made your compensation demand in writing and you are fully prepared to discuss a settlement.

 

How can Soft Settle support the parties in settling the insurance issues?

By SoftSettle Support

SoftSettle is a web-based application and it has integrated the software SS-Equity (Insurance Claim Settlement or ICS) in which fast and fair criteria (FFC) has been incorporated, could provide an efficient and result oriented resolution procedure. SoftSettle Support provides a web-based and mobile-accessible platform that offers 24/7 assistance to claimants and insurance companies to facilitate the claim settlement process.

Fortunately, the integration of element of Artificial Intelligence aided by service technology facilitating the alleviation of Case Management Procedure in the interactive portal www.softsettle.com and Soft Settle mobile application, is bent on creating new pattern of insurance claim settlement process.  Further the service technology developed by SoftSettle Support enables and expedites virtual communications so as to reach result oriented resolutions leading to win-win propositions between or among the parties.

The space is being provided for 24/7 by SoftSettle Support through portal or mobile phone application at the convenience of the parties so that they can interact or participate in the resolution process synchronous or asynchronous. SoftSettle allows you to conveniently negotiate with your disputing adversaries in a secure virtual environment.

Soft Settle channelizing the services through the product SS-Equity (ICS) enable Insurance Claim Settlement process facilitating the easy access to justice through web portals and mobile applications, without any snags. The parties can have a full control over the process and they are left with the freedom to make exchanges to the effect of their issues through virtual interactions and further accept, reject or appeal in respect of settlement of claims.

The web-portal along with mobile application provides awareness and promotions through the resource tools could make the people or consumers assimilate the procedure in respect of case management and make use of the software SS-Equity (ICS) ultimately keeps their life relieved off all soft look alike intimidating approaches from the opposite parties.

Other professional services apart from the above technical services are the following:

  1. Dealing with the claimant, insurance company, adjuster and related parties
  2. Managing the Dispute Resolution Process
  3. Legal Advice
  4. Tips for the resolving a complaint
  5. Provide or facilitate with the significant process like authentic and bona-fide Negotiation to the effect of Insurance Claim Settlement between claimant and insurance company.
  6. An Agreement is built up with reasonable clauses cause to manage settling the issues cropped up between or among the parties
  7. Facilitate the Mediation and Arbitration which ultimately keeps away the harrowing experiences and exorbitant expenditure resulting out of court litigation.
  8. An award at any stage (after the negotiation settling the claims or after the final mediation or arbitration process) is ensured which make the way for enforcement of the agreements thus generated.

Software platform provided by SoftSettle is definitely a blessing for those who have been undergoing the confusion over the settlements offer on the claimant’s part essentially and avoiding the expensive litigation would be ad added advantage for the insurance companies while settling the insurance issues under the auspices of Soft Settle.

What you need to do when you defaulted on a Debt?

SoftSettle Support

Everybody knows that defaulting debt is certainly an offense. But it is unavoidable and applicable to all kinds of people. We know as a matter of fact it is not going to finish you but it will tarnish your financial image.

The primary concern is that your credit score will get dropped and you will not entertained for any further loans against you submissions. May be it is not going to affect your breath, but low credit score causes difficulties in your life.

Further the creditors will start haunting you once you defaulted payment by means of their recovery as well as collection agents who are all the more ruthless in their approach and thus pressurizing you to an extent where you may feel like ending your life.

In most cases, once you have missed a payment with the original creditor (i.e. Banks, NBFCa etc.), the company will attempt to work with you for six months to establish a repayment program.  Failing that, the creditor will most likely sell or consign your debt to a collection agency – and the game may change dramatically

If collateral is assigned to the loan on which you have defaulted (e.g. mortgage or auto loan), repossession is a distinct possibility.  Banks generally utilize home foreclosure as a last resort, since they would prefer to keep you as a customer and avoid the cost and hassle of the foreclosure process.

Now it is the time to get in touch with Soft Settle. Soft Settle is a shrewd interactive debt resolution software platform that leads you to communicate with your creditor in a secure virtual environment. The software is accessible 24/7  by means of the portal and mobile applications.

As a result the torture of the collection agencies will get stopped and you will be invited to participate in the debt resolution process in the e-Court powered by Soft Settle after complying with the case management procedure integrated.

You can see you are entering the easy and less complicated negotiation process where you have to be more collaborative and accommodative so as to reach a decision in your favour.

Apart from the above, you will not be charged for signing up and the e-Resolution process. So it is everything FREE for you unlike  other debt settlement agencies

To learn more about the Case Management Procedure and e-Resolution process kindly make a visit to www.softsettle.com

Lawyers and Access to Justice

SoftSettle Support

According to the American Bar Association’s (A.B.A.) Model Rules of Professional Conduct, “[a] lawyer is a representative of clients, an officer of the legal system and a public citizen having special responsibility for the quality of justice.”

A lawyer’s varied roles include advisor, advocate, negotiator, intermediary, and evaluator. Lawyers are generally concerned only with legal issues and conditions that directly affect a specific case. In addition, the legal profession commonly reflects an individualistic and non-collaborative view. Finally, social justice is not an explicit goal of the legal profession. Lawyers see justice as the efficient result of an adversarial system; as long as they serve their clients well, justice is served in that process.

Attorneys have a central commitment to serve their clients. They act as advocates for their clients, help their clients determine what their needs are, and then, help them to meet those needs. Advocates use a problem-solving approach to address their clients’ needs and resolve issues. Hence these professionals could be deemed to be social workers considering the public interest and so far as focussing the life of the people with direct services which could facilitate their clients with conveniences like short period for attaining justice at most reasonable expenses and at the most stimulating vision in respect of scheming win-win propositions for the contesting parties.

So far as the lawyers are infected with the judicial system resulting out of heavy, tardy and tedious court litigation, there may be remote possibility on their part of the lawyers to get inclined towards low volume remunerated automated online dispute resolutions. Lawyers are aware of the fact that they involve in the conflict areas taken to court trials include expense, which a common client finds it difficult to co-ordinate or afford along with other discomforts like time pressure and other related legal hindrances. The lawyers may be probably in the process of realising the issues of their existing as well as prospective clients.

A lawyer’s goal is to win the case for his client, and in order to do so, it is usually necessary and appropriate to give advice to the client. Hence there is a chance for a lawyer taking the baton of a social worker rather helping his clients than merely advising them. The introduction of the platform Soft Settle could cater to the requirements of the lawyer to play the role of a social worker. He is not confined to mere advising the clients but helps the clients to come out of the troubles he has been confronted with.

Legal community is going to be encountered with certain challenges as a result of many functions traditionally performed by lawyers will be soon replaced by software systems. The integration of technology into the practice of law has been advantageous for the clients so far the basic legal activities to the effect of dispute resolution would be carried out with ease, flexibility, cost reduction, fast, fair and efficient.

SoftSettle Support has evolved research methods to create technologies, which are needed for realizing the promise of effective software support for resolving complex disputes coming under certain categorized areas. SoftSettle Support avoids human intervention to an extent to conduct the dispute resolution procedure and activities on their own. At the same time other significant issue taken into consideration while designing these devices is about the role of human dispute resolution agent or expert neutral in the online resolution system and the job better to be left over to automated (software) solutions. The execution of the justice has entered a revolutionized phase.

The access to justice has become very easy, fast, fair and efficient with the introduction of Artificial intelligence in the area of dispute resolution and www.softsettle.com has been organized with more stability and consistency so as to counter certain challenges likely to be posed by the conflicting situations in different areas.

Hence the lawyers are invited to test the automation in respect of accessing the justice straight forwardly and effortlessly. Realising the fact that litigation is adversarial, which means less regard to fair solution, court decisions might not be acceptable to either party and further adjudication of court results in win-lose scenario and not a mutually acceptable decision, it is time for the lawyers to ponder over a new means for accessing fast and fair justice.  Let the hope rests with the new beginning in the area of justice ignited with the help of artificial intelligence being promoted by SoftSettle Support.

 

Your insurance settlement effort is being supported !

SoftSettle Support

The car insurance company should already have a list of your demands from your claim prior to the negotiation process. This includes facts surrounding the accident such as who was at fault, injuries to yourself or staff members, profit loss and/or damages to vehicles or property. After receiving your request for compensation or demand letter, the claims adjuster will contact you to discuss your demands and offer a settlement. Usually phone works as the media for this negotiation and here we are introducing an unique method for settling claims.

Support your claim with documents that confirm the extent of your loss. Have a specific settlement amount in mind that you feel your case is worth but do not request an amount that the evidence can not support. Back up your argument with an organized list of damages suffered. For example, if you paid for a rental car for several weeks to ensure business obligations were still met, show the adjuster the receipts and also explain how being out of the vehicle has affected your business. The insurance company must compensate you for actual damages including medical bills, expenses and lost income as well as perceived damages such as business interruption and damaged customer relationships

The new method calls for a negotiation or resolution where the insurance company extends an initial offer, which will be less than the amount you requested. The insurance company will likely offer a very low settlement amount initially regardless of how strong your case is. They often do this to see if you know what your case is worth.

To negotiate successfully, you must counter with an amount less than what you originally requested but higher than what the insurance company offered. After several negotiation deliberations with the adjuster or Company’s  representative, negotiations, with the collaborative attitudes of the parties along with the parties’ interests overtaking their positions would be measured so that the virtual neutral SS-EQUITY (ICS) decides the case providing a relaxing time for both parties with a beyond win-win proposition. (It is just as the insurance company used to  be more keen to negotiate a favourable settlement if you are flexible and realistic with your counter offer in a direct or face to face negotiation in some cases where the company is qualitatively just and right in extending their services).

But usually insurance companies adopts a tough attitude under the pretension of building their business profits, the claimants might undergo the trauma of the difficulties in attaining the deserved results. This situation calls for the intervention of a different platform like SOFT SETTLE and virtual neutral like SS-EQUITY (ICS or Insurance Claim Settlement)

 

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