What Is an Insurance Claim?

An insurance claim is a formal request placed by a policyholder to an insurance company for payment as compensation after the policyholder suffers a loss covered by their policy. Take for instance, if a car had an accident and the victim of the accident has car insurance, he or she will file a claim to start the process of the insurance company to pay for the repairs and every other property damage attached to it.

The insurance company can accept or deny the claim. However, it is important that when you want to file a claim you are expected to notify your accident claim lawyer or attorney that can fight for you during the process of the accident or damage. This will enable you get your insurance claim paid faster. Once your claim is approved, the insurance company will issue payment to you or third-party (if any is involved). Third-party usually occurs when you are filing a claim on behalf of an insured person.

How Does an Insurance Claim Works?

When you experience a loss, your insurance company is supposed to pay for as part of your coverage compensation in your policy. Insurance companies are in-charge of protecting millions of customers depending on their coverage policy.

When you file a claim, the insurance company will assign an insurance agent or adjuster to you. This agent or adjuster will give you all the information you need and also get all the information from the accident or damage scene from you necessary for your coverage.

Take for example, you record a loss from a fire or storm for your home. The agent will want to get information of everything that was damaged. Depending on your policy, the insurance company may offer protection for the things in your house and the building while some of the moveable content of your home may not be insured. You have to be aware of the adjuster because they are trained to act in the favor of the insurance company. Normally, insurance company does not want to pay back for damages insured.

The Insurance agent or adjuster uses some claim terms to offer protections to the victims. These terms are used to know the type of policy you purchased, the worth of the policy you purchased. The terms include replacement cost basis, actual cash value, punitive damages, and compensatory damages.

Replacement cost coverage implies that your insurance company will pay for every cost of the item you want replace with a new item.

Actual cash value coverage is when the insurance company pays for the amount of any item that was lost at the time of the accident. This payment agrees with your insurance policy.

Compensatory damages are meant for compensating the victims while punitive damages are used to punish the offenders. For example, home insurance policies do not cover punitive damages.    

If you caused the accident and you file a claim based on damage, your rates will increase but if you are not the one at fault, the rates may or may not increase.

Types of Insurance Claims

There are various kinds of insurance claims. The type of insurance claims you file solely depends on the policies you have and their coverage.

• Health Insurance: this insurance policy claims are usually handled by the doctor. The doctor’s billing department will issue and fill out a health insurance claim form to know if you owe a balance. This claim is filed by the doctor’s office after your visit to the hospital and you may be required to pay a copay.

•  Renters Insurance: this claim is filed for you to receive payment on damage done to your personal property, personal liability for damage or injury, theft, and additional living expenses if you need to relocate out of your old house.

• Car insurance: car insurance claim covers property damage or injury others sustained when you are involved in an accident especially when you are the cause of the accident. You can file for collision coverage in your auto insurance policy coverage for damage of your vehicle involved in the accident irrespective of who is at fault. If you file for comprehensive coverage in your policy, you will get protection for damages caused by theft, natural disasters, falling objects and fire. Car insurance coverage includes uninsured and underinsured motorist coverage. This forms of coverage helps you pay for damage or injuries if the driver that is at fault does not have car insurance or maybe you are the victim of a hit-and-run scenario. 

• Homeowners Insurance: This coverage protects liability for injuries visitors sustained in your home and your personal property. Home insurance coverage has additional living expenses coverage, a coverage that offers you compensation if your home becomes unfit to live in. If damage done to your house is caused by perils like fire, wind or theft and are covered by your policy, you will get reimbursed by your insurance company.

• Life Insurance: this type of claim will require the claimant to provide the death certificate and the claim form before offering the coverage for the person standing in gap for the insured. This type of claim requires in-depth examination to make sure the insured did not die by committing suicide or died while involved in a criminal act. Once all these information is confirmed, the beneficiary can now get the coverage. Beneficiary is usually family of the deceased insured person such that the insurance company will cater for the daily living expenses, college tuition and funeral expenses.

How to File an Insurance Claims

You can file an insurance claim by informing your insurance company about a loss you experience and place a request for compensation to cover the damages. You can file a claim by contacting your insurer on the phone, or online. When you claim process begins, the insurance company will request for relevant information from you and proofs such as photos from the incidents and other supporting documents. The insurance company may also appoint an adjuster or agent to interview you or analyze the merits of your claim.

What is Insurance Claim Process?  

When you want to file your car or homeowner claim, there are claim processes you need to follow. This process is orderly arranged for you to have an easy and successful claim experience.

• Step 1: File a police report

If you are involved in a car accident or any other illegal case such as roadside theft, traffic jam or violations, quickly contact the police with immediate effect. If the situation is urgent, you can call 911 or make use of your police department nonemergency line instead. In some instance, if the accident is not serious you can visit the police station close to you and file your accident claim report before speaking with your adjuster or agent.

• Step 2: Document the Scenario

The next step is to take record of the event by taking pictures and videos of the accident and then send them to your agent or adjuster as evidence for your claim. You can also take photos of any property damage or injury sustained to show your insurer the degree of the damage.

• Step 3: Review your coverage 

It is important you check your policy coverages, deductibles and limits to avoid filing a claim for loss that is not part of your coverage. Or when your deductible is greater than the cost of the repairs.

•  Step 4: Contact your Insurer   

The next thing is to reach out to your insurance company. You can contact your insurer online or by calling your agent directly over the phone for your policy. Before putting a call through, ensure you already have all the information about your claim. You can file a claim using the following insurance companies below;

Step 5: Speak with the insurance adjuster

Once you have filed your claim, your insurer will send an adjuster or agent to you to analyze the damage. From the evaluation, the adjuster will tell how much your insurer will pay you as compensation.

You can also make use of your attorney or lawyer to speak with the adjuster on your behalf to make the claim journey smooth for you. The adjuster will also demand answers after asking some questions about your policy.

What your Adjuster will do:

• Interview you about the incident
• Analyze the report submitted
• Check your policy to ensure the damage is covered
• Ask for the contact information of anyone with the information of the accident or claim such as lawyer, doctors or witnesses at the point of the incident

Step 6: Check the settlement offer

Once the adjuster is done with evaluating you and your claim, he will send the report to your insurer and you will get a settlement offer. When you receive this offer, kindly check carefully to know if you are happy with the settlement but if you are not happy with the settlement offer, you can dispute the claim by asking your insurer for a second review or you can hire a lawyer or attorney. This is because once you accept the offer without careful review; your claim will be closed.

Step 7: Receive the claim payment and repair the damage

Once you have successfully signed the settlement agreement form, the insurance company will pay you the amount in the agreement form without your deductibles.

How Long Does it Take to Get an Insurance Claim check?

To get settlement on your insurance claims can take within few weeks and sometimes within few years. This depends on the amount of damage on your property. In some cases, you are likely to get a multiple checks which include advance on the settlement up front to get repairs fixed. For instance, a home attacked by for could take a few years to complete while a car accident with a minor damage could be fixed within days or weeks.

 How to Dispute an Insurance Claim

You can dispute your auto insurance or homeowner claim settlement if you discover your car was not properly fixed after an accident by reaching out to the State’s insurance department and submit a complaint. You can also hire a lawyer or attorney to represent you.