Question

1-3 What procedure is followed when the insured and the insurer disagree on the loss amount under the homeowners policy? What if they disagree as to whether the loss is covered?

Answer 1

Answer: Under this scenario, when the Insured and the Insurer does not agree on the loss amount, the determination is done under the provisions of the appraisal provision in the general conditions of the Homeowners Policy.

A step by step process,Under which both parties can choose appraisers which further choose an umpire and resolve the issues.

Otherwise If they want to avoid litigation process they may go for Alternate dispute resolution where mediation (where mediator listens and brings both parties on the same table) and arbitration ( A group of arbitrators listens both parties and decides what to do) happens.

If they don't agree on whether the loss is covered or not, the insured must sue the insurer(filling a lawsuit) and resolve the dispute through legal ways.