After you file a claim with your car insurance company, the claim goes through a process that leads to a settlement. The exact way that your car insurance company investigates accident claims can vary depending on the following:
However, certain steps are common to most claims investigations. We’ll review these steps here.
Immediately After the Claim Is Filed
After you file your claim, a claims adjustor will be assigned to your case. The adjustor will review your policy to make sure that you are covered. He or she may contact you to ask for more details about the accident.
During the investigation, the adjustor may:
Medical Care and Vehicle Repair
Your insurance company will cover your injuries and repairs until fault is determined and then will negotiate with the other driver's insurance company to decide who pays in the end.
The process of initial payment is “indemnification,” which means coverage for damages and losses.
If the other driver is found to be at fault, your insurance company will seek payment from his insurance company through the process of “subrogation.”
Typically, you have several options when it comes to getting repairs for your vehicle:
If your claim includes medical expenses from injuries from the accident, your claims adjuster will need to see evidence of your medical bills.
He or she may request that you sign a waiver to grant permission for your car insurance company to access your medical records. Before signing this document, you may wish to speak to a personal injury attorney about whether signing it is in your best interest. Once she has access to your records, information in your medical history may be used to lower your claim.
Review of Your Side of the Story
You will need to provide as much information as you can to get the best possible settlement. The adjuster will ask for your recollection of the events.
In addition, you may need to submit the following to your car insurance company.
Review of Official Records
During the investigation phase, the adjuster reviews the case. Your rep may review the following information:
Determination of Fault
One of the roles of your insurance adjuster is to determine fault. In most states, a driver does not need to be 0% or 100% at fault.
Your adjuster may decide that you are partially at fault (e.g., 70% responsible for the accident). If you are 70% responsible and the other driver is 30% responsible, your company may pay 70% of the settlement and the other driver’s car insurance company may pay the remaining 30%.
In some cases, the settlement is entirely paid by the car insurance company of the driver who has the majority of fault. Speak to your auto insurance agent to learn more.
Review of Claims
While reviewing claims, the claims adjuster may look at evidence such as:
The Role of Social Media
The adjuster will investigate the claimant (you). In addition to reviewing your claims history, car insurance companies are also likely to look you up online.
They may go to Facebook, Twitter, or other social media sites to make sure that you are not lying. For example, if you are claiming car damage for an accident Tuesday morning, and you post a picture of you with your car intact on Wednesday, your company will recognize the fraud.
Your car insurance company has a special investigations unit (SIU) to investigate suspected fraud. You can protect yourself on social media by:
Options to Resolve Claim Disputes
If you are unhappy with the settlement offer, you have some options: