In general, when an insurance claim is “closed”, it means the insurance company, in this case, Progressive Insurance, has finished its review and made a final decision on the claim.
It means that they have reviewed the claim and made a final determination, such as:
- Paying out on the claim (in full or in part)
- Denying the claim
- Offering a settlement amount to resolve the claim
The “closed” status indicates Progressive has completed their adjuster’s review and will not reopen or reconsider the claim without significant new information.
This guide will explain:
- What a closed claim means
- Reasons insurers may close a claim
- Your options once a claim is closed
What Exactly Does A Closed Insurance Claim Mean?
Essentially, having a claim closed by the insurance company is the same as having the claim denied.
Some key things to know about closed claims:
- The insurance company will provide a written explanation for why they closed your claim. They have to outline their reasons for denial.
- Just because a claim is closed does not mean it can never be reopened. You have options to appeal.
- Closing a claim ends the process with that company. You cannot continue claiming more losses or damages on a closed claim. You would have to go through an appeals process to reopen it for further review.
While having a claim denied is disappointing, it does not necessarily mean you are out of options. Understanding why the claim is closed is key to exercising your remaining rights.
Common Reasons Insurance Companies Close Claims
Insurance providers close claims for many reasons. Some reasons are legitimate claim denials, while other situations may present opportunities for appeals or reviews if more information is provided.
Common reasons your claim could be closed or denied include:
- Coverage Limitations:
The loss claimed falls under an excluded peril or category not covered under the policy. For example, flood damage may not be covered by a standard homeowner’s policy.
- Disputes Over Cause of Loss:
The insurer alleges the damage was caused by negligence or improper maintenance rather than a covered risk like storm damage.
- Pre-Existing Conditions:
The insurance company claims the loss stems from a pre-existing issue excluded from coverage. For example, claiming water damage from a rotted pipe they allege should have been repaired earlier.
- Errors or Misrepresentation:
Errors in the information you or your contractors provided could allow insurers to claim misrepresentation and deny the claims. Even unintentional mistakes can lead to problems.
- Lack of Cooperation:
Failing to provide requested claim-related documents in a timely manner may cause the adjuster to close the claim. This could involve anything from proof of repairs to not showing up for inspections.
- Suspicion of Fraud:
If the adjuster believes you made false statements or filed exaggerated or completely fabricated damages, they may suspect fraud. While rare, this can lead to your claim quickly being closed and denied.
The key is understanding the insurance company’s provided reason for closing your claim and what recourse you have. Their written closure statement must outline their justification. This sets the stage for your next steps.
Your Options When An Insurance Claim Is Closed
Receiving notice that your insurance claim has been closed can be gutting after initially expecting coverage. But the combat is not necessarily over yet depending on the situation.
Depending on the reason your claim closed, you may have options including:
- Request A Review
Ask the adjuster to review additional information that may change their decision and lead to reopening your claim. This may include providing estimates or damage photographs you originally failed to include with your claim. Or if they allege pre-existing damages, showing proof of recent repairs.
- File An Appeal
Most insurance providers have a formal appeals process allowing you to dispute the closure of your claim and get it reassessed by an alternative adjuster. Having the case reviewed by someone new provides a fresh set of eyes that may reach an alternative conclusion.
- Submit A Complaint
Every state has an insurance commissioner’s office that oversees insurance companies. You can submit a complaint to the commissioner sharing improper claim handling or denial of valid losses. They may intervene on your behalf forcing the insurer to reconsider your claim. At a minimum, complaints lead to investigations of insurer practices.
- Contact A Lawyer
An experienced insurance denial attorney knows insurance policies inside and out. They can identify if the closure has legal standing or represent you through appeals and even lawsuits against the carrier. Having legal representation often leads to better outcomes getting initially denied claims reopened and properly covered.
No matter what options you pursue, be sure to act quickly. Most insurance policies only provide 12 to 24 months to take action against a claim denial before the matter expires.
Acting rapidly also prevents further damage from the uncovered loss leading to higher claims value over time. The sooner your claim gets reopened and covered, the better.
Using Legal Representation To Dispute A Claim Denial
While you can handle appeals or complaints yourself, complicated claims disputes often benefit from legal representation for best results.
There are a few ways a knowledgeable attorney can assist:
Review Case Details
An attorney experienced fighting insurance denials will review your entire claim file including the policy documents. They can identify if the closure has legal grounds or if the adjuster missed key information supporting your claim.
Insurance companies know working with a lawyer means you are serious. This added gravity results in prompt and thoughtful responses from adjusters often more open to settling or reopening disputed claims.
File Formal Complaints
Your lawyer can utilize their professional industry relationships to submit appeals or complaints triggering regulatory action more effectively than civilians typically could. Their status and knowledge of the appeals system carries more weight.
Take Legal Action
If appeals fail and disputes remain unsettled, attorney representation becomes crucial should you choose to pursue legal action. Only licensed lawyers can represent clients in insurance litigation and lawsuits.
Recovering adequate compensation after an insurance denial often requires in-depth policy knowledge paired with appeals experience that many civilians lack. Hiring professional legal help ensures experienced eyes review your case.
Do not simply accept an unreasonable claim closure or give up fighting because the company said no. Explore every option and get aggressive to get your claim reopened. An attorney fighting on your behalf can turn the denial around opening the door to the claim settlement you deserve.
If your insurance claim has been denied or closed by Progressive, you should reach out to Husain Law + Associates — Houston Accident & Injury Lawyers, P.C. for professional legal representation. With decades of insurance denial litigation expertise, we have helped countless clients successfully dispute improper claim handling, and we can help you too.
Call us at (713) 804-8149) or use our online contact form to discuss your claim denial situation with our legal staff. The sooner we get involved, the faster we expedite getting your critical claim reopened and covered. We are ready to help you recoup the financial support you expected from your policy.