Common claims questions

It’s important to note that it’s difficult to provide answers to scenario-based questions. The reason is that the right answer often depends on the actual claim, and the circumstances and facts related to that claim.

For example, you may wonder if you’d be covered if your TV was damaged. The short answer is most likely yes. But it will depend on your policy type, how the TV was damaged, what your limits and deductibles are, among other things. For example, if you intentionally threw a glass at the TV because you were mad that your hockey team lost, you would not be covered as your policy excludes loss or damage you intentionally cause.

The best approach to determine what is and is not covered is to review your policy wordings. These wordings should explicitly indicate what is covered, what is not covered, what your limits of insurance are, and what your deductibles are. That said, your home insurance agent will do his or her best to answer your questions related to coverage and claims.

Provided below are some answers to common questions relating to home insurance claims.

What’s the difference between an agent and an adjuster?

An agent helps you with your policy while an adjuster helps you with your claim. More information is provided below.

Agent’s role Adjuster’s role
Review the home insurance application with you and help you complete it. Review the claims process with you and help you submit the required information.
Explain to you what is and isn’t covered under your home insurance policy. Determine whether your specific claim is or isn’t covered and explain why.
Assist you in selecting policy covers, limits and deductibles based on your needs. Assist you in repairing or replacing lost or damaged property.
Issue your policy and arrange for policy premiums to be collected from you. Finalize your claim and arrange for claim payments to be made.
Record and report any potential claims you may need to make under your policy. Secure feedback from you on your claim and share it with your agent.

We’ve had a break-in. What should we do?

First, you need to call the police. Don’t touch anything, but do an initial visual inspection and try to make a list of what is missing – the police will need it and so will your insurance adjuster. Call us to report the claim – we will take all the details and assign an adjuster to help you. If there is damage to one of the entries to your home, we will arrange for necessary repairs to keep your home safe.

If something is stolen from my car, is that a home insurance claim or an auto insurance claim?

This would be a claim on your home insurance policy, assuming the item that was stolen from your car was not permanently installed and that it was something that you have covered under your home insurance policy. For example, some insurance policies limit the amount of coverage for CDs and DVDs while they are in your car.

Should I be worried about reporting a claim?

You should never be reluctant to contact Square One to report a potential claim. That’s why you have home insurance and why we’re here. It’s best that you contact us even if you ultimately decide not to proceed with the claim. That way we can help assess the situation and determine your best course of action.

Can I change my mind on filing a claim?

Absolutely. You can withdraw your claim at any time. If you do, it will not affect your claims history. You can also decide to reopen your claim within 2 years from the date of loss.

How do I know if my claim is covered?

The adjuster will review your claim to determine if it’s covered. Coverage can’t be confirmed, nor can lost or damaged property be repaired or replaced, until the adjuster has received all required information from you. You can, however, get a good sense of whether your claim is likely to be covered by reviewing your policy document. This document details the covers, limits and deductibles that apply. It also describes what is and isn’t covered.

How long will it take to settle my claim?

As you would expect, it will take longer to settle a claim for a house fire than it will for a stolen laptop. Even for relatively straightforward claims, settlement is often delayed because the adjuster hasn’t received all the required information. The faster you submit the required information, the faster your claim will be settled. In fact, claims can be settled in as little as 2 to 3 days if all information is provided promptly.

What type of information will be required?

Your adjuster will provide you with a claims package outlining the information needed. Usually, you will be required to:

  • Review and sign the Personal Information Protection and Electronic Document Act Consent Form.
  • Prepare a written statement of loss, describing what happened in your own words.
  • Complete the schedule of loss form, providing details about the lost or damaged property.
  • Attach proof of ownership for lost or damaged items.
  • Secure and provide quotes for replacement of lost or damaged items.

What if I can’t provide all required information?

Speak with your adjuster if you’re unable to provide all required information. For example, if you don’t have original receipts or invoices as proof of ownership, the adjuster may accept product manuals or photos.

What is a deductible?

A deductible is the amount you have to pay out-of-pocket before your policy will pay any remaining claims costs. For example, if it’s going to cost $1,525 to replace your stolen laptop and you have a $1,000 deductible, your policy will reimburse you $525 after the laptop is replaced. You will be responsible for the first $1,000.

Does a deductible apply to my claim?

To determine the amount, you will need to refer to your policy declaration. It specifies what amounts you selected by loss type.

On what basis will my claim be settled?

In most situations, claims are settled on a “replacement cost” basis. That means the actual cost to repair, replace, or rebuild, whichever is less, with like kind and quality. If the exact item is no longer available, it would be replaced with a comparable item of similar kind and quality. If you’d like to upgrade an item, you can do so, but you would need to pay the difference.

Do I have to replace all lost or damaged items?

If you decide not to replace all the items, most policies will offer you the “actual cash value” for those items. “Actual cash value” is calculated as the replacement cost less depreciation. For older items, substantial depreciation will result in a low settlement. Square One policies, on the other hand, will apply “limited depreciation” of no more than 50% to most items that you choose not to replace.

Do I have to use the contractor that the adjuster brings in or can I choose my own?

You are generally free to choose your own contractor, provided your adjuster is satisfied with the pricing that is offered and the ability of the contractor to perform the work that needs to be done.

Should I make a claim for a small loss?

Your policy has a deductible, which is the portion of the loss you pay any time you make a claim. If your claim is less than your deductible, which is noted on the first page of your Policy Declaration, it likely doesn’t make sense to make a claim. When you apply for insurance, your claims history has an impact on the premium you are charged, so again, making small claims may not be in your best interest. That said, insurance is designed to protect you, so it’s up to you.

Will a claim affect my policy in any way?

Virtually all policies offer a “claims free” discount, which can range from 5% to 25%. After a claim, you will no longer be considered “claims free” and you will see a premium increase at your anniversary date. You will qualify for the discount again once you’ve been “claims free” for 3 years.

Before filing a small claim, do a little bit of math. Make sure the amount of the claim is more than the total of your deductible plus the 3 years of forgone savings from the claims free discount. If it’s not, you might be better paying out of your own pocket.

What happens if I have multiple claims?

Home insurance premiums are based on the assumption that the average person will have no more than one claim every 5 to 7 years. If you have more frequent claims, you will likely experience one or more of the following:

  • A substantial increase to your policy premiums.
  • A change to your policy terms and conditions.
  • A notice of cancellation or non-renewal.

If you receive a notice of cancellation or non-renewal, you will have the difficult task of finding a new provider. You may end up having to insure with a specialty company at much higher rates.

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What you really want to know

How are claims handled?

The insurance industry doesn't have the greatest reputation when it comes to claims. Many people fear their insurer will go to any length possible to avoid paying claims. At Square One, we’re different. We're there when you need us most.

How different? Legal jargon can be confusing, so we've created a transparency page to translate the legal language of your policy into plain English.

We're committed to changing how you think of insurance. We'll make sure your claim is handled quickly and fairly.

See Our Transparency Page
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