Auto Accident Insurance Claims Process

An auto accident insurance claim always begins with an accident. If you are involved in a car accident, there are some very important things you should do at the accident site to the extent you can. At the first opportunity, you should report the accident with your insurance carrier and begin the process of filing a claim. After you have submitted your claim, a claims adjuster (someone who works for the insurance company and deals exclusively with claims) will either call, write or email you regarding your claim. He or she will then look at your policy to determine the types of coverage you have, deductibles, and any coverage limits that may affect your claim.

If your claim is simple (i.e., fault is not at issue, the damage was minimal, and little or no medical treatment was necessary), the adjuster may have you get an estimate for repairs and then send you a check. You will have to fill out some paperwork, but you may not have to meet with the adjuster in person. If your claim is more complicated (for example, liability is unclear, you do not have enough coverage in your policy, or you do not agree with your adjuster’s settlement offer), then the negotiation process will take longer.

Investigating Your Automobile Accident Claim

In relatively complicated injury accident claims, adjusters typically must do some investigation in order to adequately assess the insurance company’s liability. The adjuster will comb through your policy and possibly contact witnesses to the accident, the other party to the accident, look at the police report if there is one, take photographs of the damages and scene of the accident and generally investigate your medical expenses by sending out requests to your medical providers for information regarding your treatment. If you are seeking to have medical bills covered, the adjuster will send you a medical authorization form for the release of your medical records.

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The Settlement Offer

Once the adjuster has investigated your claim and looked at your policy, he or she will typically send you a settlement offer. The settlement offer will tell you what the insurance company is willing to pay on your claim. It could be all, it could be part, it could be none. This opening offer is typically on the low side. After all, the adjuster’s job is to save his or her employer money. But the adjuster also wants to close a case and thus is typically allowed a settlement range that offers room for negotiation. Read How Insurance Companies Calculate Car Accident Settlements for more.

The Demand Letter

If you are confident about how much you think your claim is worth, you can preempt the adjuster’s settlement offer with your own settlement proposal (demand letter). Your demand letter would outline fault (if an issue), damages and ask for a certain amount to settle your claim.

Negotiating with the Claims Adjuster

If you’ve already received an opening offer from the adjuster, keep in mind that opening offers for settlement are almost always on the low side. Then, unless you’re willing to go with that opening offer (knowing that it’s too low) without an argument, you will ultimately need to negotiate with the adjuster for a higher settlement. See Getting the Best Car Accident Settlement.

If Your Auto Accident Claim Is Denied

If your claim is denied in whole or in part, there could be many legitimate and reasonable reasons. Most have to do with limits in your coverage. You can check the denial letter against your policy to see if the denial seems legitimate or not. But whatever you decide to do, don’t wait too long to do it. If you sit on your claim for too long, you may lose the right to sue in court to get your recovery. Each state has a statute of limitations (a time limit for filing a lawsuit in court). In most states, the statute of limitations for personal injury claims is 2 or 3 years, but could be shorter or longer. An attorney will be able to advise you.