Why most insurance claims are not legal problems, but technical ones

When an insurance company rejects a claim or offers a compensation far below the real cost of repair, the first reaction is often to think about lawyers, lawsuits, or court proceedings.

However, experience shows that most insurance claims do not fail because of a lack of rights, but because of an incorrect or incomplete damage assessment.

In most cases, the problem is not the law.
It is the damage itself.

The most common mistake when claiming against an insurer

Many people start the claim process at the end:

• lawyers
• legal letters
• court actions

The issue is that no legal action can succeed without a solid technical foundation.

A judge cannot determine:

• what damage actually exists
• how much it really costs
• which items were omitted

without a specialized technical assessment beforehand.

The real conflict with insurance companies

In most claims:

• the policy provides coverage
• the loss is acknowledged
• the conflict appears in the valuation

That means:

• damages not included
• underestimated items
• restrictive criteria
• incorrect application of underinsurance

All of this is technical, not legal.

Are you being paid less than the real cost of repair?

If the compensation offered does not cover the actual repair cost, the issue is usually the valuation, not the coverage.

👉 Learn how we handle these situations here:
Denied claims and underpaid settlements

Challenging the valuation: the key point

The most effective way to resolve many disputes with insurers is to challenge the damage valuation, not to argue about legal wording.

This is done through:

• independent technical analysis
• detailed review of items and measurements
• comparison of valuation criteria
• technical negotiation based on real damage

When done correctly, many claims are resolved without going to court.

The role of the policyholder’s appointed loss adjuster

Appointing your own loss adjuster allows you to:

• have a specialist on your side
• review the claim on equal terms
• jointly assess damages with the insurer’s adjuster
• correct omissions and undervaluations

In practice, this approach is:

• faster
• less confrontational
• more effective

And often avoids escalation.

When does a third adjuster come into play?

A third adjuster is the next step when:

• the two appointed adjusters cannot reach an agreement
• there is a persistent technical disagreement

Their role is to:

• analyze both technical positions
• issue an impartial valuation

It is useful, but not always necessary if the case is well structured from the beginning.

What about regulators and legal action?

Other options exist:

• policyholder ombudsman
• insurance supervisory authority
• court proceedings

They can be appropriate in certain situations, but:

• they do not replace a technical assessment
• they do not quantify damages
• they usually come after technical review

Legal action only makes sense once the damage has been clearly assessed and quantified.

Conclusion

Most insurance claims are not lost due to a lack of rights, but due to the absence of a proper technical approach.

Before arguing legal rights, the damage must be proven.
Before going to court, it must be accurately quantified.

Does it make sense to review your claim?

If your claim:

• was rejected
• was closed too quickly
• or the compensation does not cover the real repair cost

an independent technical review can make a real difference.

👉 Discover how we help policyholders with insurance claims:
Our insurance claim services