After you report an accident to the insurance company, the claims process begins. This process varies for each insurance company, but the following information can provide you with a general overview of the process.
Assignment of a Claims Adjuster
After your claim is filed, an insurance adjuster will be assigned to the case. He or she will contact you about the accident. In some cases, the adjuster will want to meet in person, but in many cases the entire claim is handled through telephone conversations. Some insurance companies may ask for you to provide a written statement that you sign and sometimes swear to. Your adjuster will describe your insurance coverage and how the insurance company plans to cover the claim.
Indemnification
Generally, your own insurance company will cover injuries and your vehicle’s repairs until your insurance company assesses which party is at fault. After that point, your insurance company negotiates with the other party’s insurance company in order to be reimbursed for any amounts that it initially provided you through indemnification. Then, your insurance company will seek its reimbursement from the other insurance company through the process called subrogation.
Automobile Repairs
Your insurance company may have a certain policy in place for you to get repairs. However, the general options are for you to use an approved body shop for repairs, to get multiple quotes from different shops or to choose your own repair shop. If your chosen shop costs more than the amount that the adjuster determines it should cost to repair your vehicle, you might have to pay the difference. Some insurance companies will issue a check to the insured for the amount that it determines it will take to repair the vehicle, less any deductible.
Medical Expenses
It is important that you provide the claims adjuster with evidence of the medical expenses that you incurred. The claims adjuster might ask you to sign a waiver in order to get your medical records. However, you may first wish to consult with an attorney before signing such a waiver because an adjuster may gain access to records that you may not want him or her to have because of the potential for it to decrease the value of your claim, such as medical information related to a prior injury to the same portion of your body.
Assessment of Fault
The insurance company will determine which party is at fault. In some cases, the covered party may be partially at fault. In other cases, the insurance company will determine that only one party was at fault. If you are 25% at fault and the other diver is 75% at fault, your insurance company might pay 25% of the settlement and the other insurance company might pay the remaining 75%. In order to make this assessment, the insurance company reviews all statements that you have made regarding the accident. If a police report was filed, he or she will also likely evaluate this information. If you were cited by police in the accident, your insurance company may not necessarily find that you were at fault. However, your insurance company will strongly consider this information. If you disagree with the insurance company’s assessment of fault, contact the claims adjuster and ask for an explanation. Provide any new information that you have available, such as an eyewitness’ account of the accident.
Value Determination
Your claims adjuster will determine the approximate value of the claim by considering several factors. For example, he or she will review information regarding the cost for vehicle repairs, your medical records, medical bills and documentation showing your wage loss. If you are claiming permanent disability or a loss of enjoyment of life related to the accident, your insurance claims adjuster might review social media to see if your claims are contradicted by your public messages. If you have retained a personal injury attorney to assist you, your attorney may recommend that you adjust your privacy settings and avoid posting pictures about your accident.
Settlement
After the insurance company completes its investigation, it may contact you or your attorney with a settlement offer. The amount that you receive is based on several components, including the amount of fault that you were responsible for, your insurance policy, the amount of repairs your vehicle needs, your medical expenses and other criteria. If the settlement does not seem fair, you or your attorney may reject it and decide to pursue a civil lawsuit.
