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It can be a pain to pay your insurance premiums every month. But you’re doing it with the knowledge that if you ever need to file a claim, your insurance company will pay your claim promptly. Right?

According to an unpublished survey conducted by Harris Interactive in September 2011, most American policyholders don’t think that’s the case. Fifty-nine percent of adults questioned in the survey believed that insurance companies intentionally delay the settlement of claims for auto accident victims. Nearly the same number (58 percent) thought auto insurance companies take advantage of accident victims who are struggling financially while waiting for settlements. However, only 16 percent of those surveyed said that they or someone they knew had experienced financial hardship as a result of waiting for an insurance settlement.

So are consumers just distrustful by nature, or do they have good reason to believe that insurance companies are holding out on them?

Delay and deny

According to Jay Feinman, a law professor at Rutgers University and author of the book “Delay, Deny, Defend,” consumers are right to be suspicious of the claims process. “A large number of companies have figured out that they can make money by delaying claims, which gives them more investment income,” he says.

In 2003, Harold Chandler, CEO of disability insurer Unum, was forced out amid a controversy over how the company handled claims. In internal memos that were leaked, executives wrote that they wanted to move from “a claims-payment to a claim-management approach,” and claimed that “a 1% decrease in benefit cost … translates into approximately $ 6 million in annual savings,” according to a 2005 report by the Los Angeles Times.

It’s been reported that offering low-ball claim amounts is a common tactic as well. An American Association for Justice report, “Tricks of the Trade: How Insurance Companies Deny, Delay, Confuse and Refuse,” cites a Farmers Insurance employee incentive program, “Quest for Gold,” which provided rewards such as gift certificates and pizza parties to adjusters who met low payout goals.

The North Dakota Insurance Department took Farmers to task in 2007 after a three-year investigation into its payout practices. As a result of the investigation, Farmers’ North Dakota branch was fined $ 750,000 for violation of state law in encouraging employees to limit claim reimbursements.

Farmers spokesman Jerry Davies objected to the ruling, telling Bloomberg in 2007 that “Farmers Insurance denies and strongly disagrees with the North Dakota Department of Insurance allegations. ” Another Farmers spokesman, Mark Toohey, says the program at issue was discontinued in 2002.

On the other side

Of course, there are legitimate reasons for delays in claim approvals and payments. “Adjusters can be overwhelmed with work,” says Mark Romano, the Consumer Federation of America’s director of insurance claims projects. “They have many cases to deal with and may be doing the best they can.”

Peter Foley, vice president of claims administration at American Insurance Association trade group, doesn’t believe that it’s in insurers’ best interests to delay paying claims. “The company wants to investigate the claim as quickly as possible and resolve it as quickly as possible,” he says. “The cost in keeping that claim open is high. You can’t be sitting on claims or it will sink you as an organization.”

The fallout from Hurricane Katrina in 2005 offers a case study. A year after the disaster, nearly 95 percent of all hurricane-related home insurance claims had been settled in Louisiana and Mississippi, and four out of five people said they were satisfied with how their insurance companies had handled their claims, according to the Insurance Information Institute.

Dealing with delayed payments

When it comes to delayed insurance payments, many states have laws requiring that a payment must happen within 30 days of a claim being approved.

The problem is that companies are free to take as much time as they want in determining the claim amount, says Feinman, the law professor. “Sometimes, claims are delayed because it takes a long time for the policyholder to get the necessary information, or the insurer takes a long time to decide what is owed,” he says.

Delaying or denying claim payments can prove particularly lucrative for insurance companies in cases involving long-term care insurance. The New York Times found that in California, nearly one in every four long-term care claims was denied in 2005. Such policyholders often are elderly and ill, and they may not be prepared to fight denied or insufficient claim payments. Often, a policyholder will die before the case can be resolved.

According to The New York Times, employees for one large long-term care insurance provider, Conseco, testified in depositions that they were told to deliberately mail the wrong types of claim forms to policyholders and then withhold payments because of the paperwork problems.

What you can do

If you’ve filed an insurance claim and your insurer is taking months to respond to the claim or pay it — or has denied the claim for a reason that you don’t think is valid — it’s time to take action.

“Keep pressing the insurance company,” Feinman says. “Don’t take no for an answer. If they say you’re not covered, you don’t have to assume they’re right.”

In addition to contacting the insurer on your own, ask others involved with the claim to advocate for you.

After an auto accident, “if your car’s in the shop and you’re waiting for an insurance payment, ask the body shop to call on your behalf,” says Romano, the Consumer Federation of America official. “They may deal with the carrier on a frequent basis.” If you have a loan on your car, Romano suggests contacting the lender for help in dealing with the insurer.

If calling and sending letters to the insurance company doesn’t get you anywhere, send a complaint to your state’s insurance department. “They won’t negotiate on your behalf, but they may make an inquiry to the insurer which will push the process along,” Feinman says.

And if the money at stake is a substantial amount, it may be worth consulting an expert. Feinman recommends calling an insurance or personal injury attorney for assistance, which may include filing a lawsuit against your insurer.

Hiring an insurance adjuster directly — rather than using one who works for an insurance agency — also may be an option in dealing with difficult claims, Feinman says. A public adjuster, who advocates for policyholders in insurance claims, can help you with paperwork, arrange for inspections and negotiate prompt payments. He or she typically will charge a commission, equivalent to about 15 percent of the claim amount, according to the Insurance Information Institute.

Don’t settle for less

It’s a common for insurers to delay payment when an injury is involved, Romano says. If you press your insurer to approve your claim for medical coverage, the insurer’s in-house adjuster often will offer to pay a lower amount on the spot to settle the claim.

“Never allow them to pressure you into a settlement that you don’t want to take,” Romano says. “Demand that they pay the bill they’re obligated to pay.”

Terri Huggins

Not sure how to protect your heart and wallet if an engagement ring — a common Valentine’s Day surprise — is damaged, lost or stolen? We can’t help you with the heart part, but we can help you with the wallet part. Here are seven tips to simplify the process of insuring an engagement ring or other pieces of jewelry.

1. Home insurance isn’t always adequate.

If you have a home insurance policy, chances are your jewelry is covered by it. The problem is it might not be enough coverage.

“When it comes to expensive jewelry, stand-alone policies are best,” says David Hendry, chief underwriter of the Jewelry Insurance Brokerage of North America.

Although personal property not itemized on your home insurance policy includes jewelry, it may not be sufficient coverage for jewelry valued at $ 1,000 or more.

Home insurance is great for replacing jewelry that’s been stolen. However, it won’t be much help if jewelry is damaged or misplaced. The solution? Buy a separate policy for your jewelry. A stand-alone policy usually offers broader coverage, Hendry says. Home insurance policies don’t cover things such as a chipped diamond or a ring that gets flushed down the drain; stand-alone policies may cover them, however.

2. Not all jewelry insurers are on the up-and-up.

With so many jewelry insurance companies out there, it’s hard to tell which one is right for you. And just because the jeweler recommends a policy doesn’t mean it’s good. In fact, you may want to avoid a jeweler-recommended policy altogether. Why? Some jewelers may get a cut of the deal for referrals to certain insurers, according to Hendry. To find out whether this is the case, ask the jeweler.

3. Cash is not always an option.

A cash option may be your payout preference, but it’s not always available to you. When buying insurance, ask how a ring or another piece of jewelry would be replaced. Some insurers may write you a check, while others may demand you get a replacement at a specified jeweler.

4. Prices vary.

Premiums vary from state to state, but if you live in a big city such as Miami or Los Angeles, you may be getting the short end of the stick. Residents of big cities can expect their jewelry insurance rates to be higher than average because of the higher risk of theft, Hendry says. However, stashing your jewelry in a safe or vault may help lower your premiums. Generally, you can expect to pay a premium of 1 percent to 1.5 percent for a stand-alone jewelry policy. This means that if a ring cost $ 3,000, you’d pay about $ 300 a year to insure it.

5. Appraisals count.

In most cases, you must get jewelry checked out by an appraiser before you can get coverage from a jewelry insurance company. Factors considered in appraisals include the type of metal and the number of diamonds or gemstones.

Certified appraisers determine the retail value of an item as opposed to an inflated value. Why does it matter? Barbara Nevius, a trained appraiser and gemologist in New Jersey, says that giving an inflated value is unethical. An inflated value typically is provided by a jeweler or unqualified appraiser to boost a customer’s ego, Hendry says. Settlements of insurance claims are based on the retail replacement value of a piece of jewelry, not on its inflated value.

To get a proper evaluation, you should use an appraiser who has received training from an accredited, reputable organization like the National Association of Jewelry Appraisers, the Gemological Institute of America or the International Society of Appraisers.

Once the assessment is done, you’ll receive an appraisal report, a photo of the jewelry and a description of the jewelry — all of which you can hand over to your insurance company.

6. Up-to-date records are critical.

Without up-to-date records, your insurance policy may do you no good. Make sure appraisals are done regularly; some insurers require it every 18 months, as the value of jewelry may rise over time. Also, be sure to give the insurance company your new address if you’ve moved.

Here’s another wrinkle to keep in mind, courtesy of Hendry: “If a guy buys insurance for an engagement ring under his name, that ring no longer has coverage once he proposes and his girlfriend says ‘yes.’ From the moment the girlfriend says ‘yes,’ he is no longer the property owner and has no insurable interest.”

To remedy this situation, Hendry suggests notifying your insurance company of the change as soon as possible. Better yet, put the future bride’s and future groom’s names on the jewelry policy when it’s purchased.

7. Sentimental value is not insurable.

Your attachment to Grandma’s heirloom ring may prompt you to shop for insurance, but Hendry warns that “sentimental value is not a valued asset.” So you’ve got to insure that ring for its actual value, not its sentimental value.

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