Gain knowledge of and take the steps you need to take to file a successful auto insurance claim.
An insurance claim is a request to an insurance company to pay for a loss. After an insurance claim is requested or filed an evaluation process will begin to determine if the loss is the responsibility of the requested insurance company
Below are some tips to help you when filing a claim to your insurance company:
- Read your policy well and familiarize yourself with what's covered and what's not covered.
- Call your insurance agent as soon as possible, regardless of who is at fault. Find out whether you're covered for this loss. Even if the accident appears minor, it is important that you let your insurance company know about the incident. Ask your agent or company representative how to proceed and what forms or documents are needed to support your claim. Your insurance company will require a “proof of claim” form and, if there is one, a copy of the police report. Increasingly, companies allow you to monitor the progress of your claim on their web site.
- Supply the information your insurer requests. Fill out the claim form carefully. Keep good records. Get the names and phone numbers of everyone you speak with and copies of any bills related to the accident.
- Ask your insurance agent or company representative the following:
- Does my policy contain a time limit for filing claims and submitting bills?
- Is there a time limit for resolving claims disputes?
- If I need to submit additional information, is there a time limit?
- When can I expect the insurance company to contact me?
- Do I need to get repair estimates for the damage to my car?
- Will my policy pay for a rental car while my car is being repaired? If so, how much?
5. Be consistent. Remember, it will be awkward if you want to change your story later on. Keep all documents that are relevant to the claim. Make sure the staff of the insurance company can get in touch with you.
6. Stay on top of things. If the insurance represenitive does not seem up to speed or doesn't give you a satisfactory response, ask to speak with a supervisor. If that person doesn't help, get the name of his or her boss. If you're told someone will get back to you with an answer, ask when. Write down the person's name, extension, and the date you spoke. If you don't receive an answer by the promised date, call the rep back. Take detailed notes on each conversation so you can refer to them in later discussions.
- What if the claim is rejected? There are circumstances where you may in fact have the legal right to be reimbursed for your loss even though the insurer refused to pay the claim. Although you can sometimes make this judgment yourself, it is sometimes a good idea to get legal advice. If you don't get the response you want, the next step is to file a written complaint. Basically, this includes your name, address, policy number, and doctor's name, along with a description of what wasn't covered and why it should have been. A note from your doctor supporting your case can be helpful. Check with your plan to find out what information is required for a written appeal and where it should be sent. Get the names of people in charge of patient complaints and appeals, and address your letters or emails directly to them.
- Check the policy. If the claim is rejected ask your insurer to identify specifically the clause of the contract on which they rely. If you do not have a current policy make sure they supply one.
- What caused the loss? If the insurer claims that you caused the loss, and this is in breach of the policy, make sure that this is so. For instance, if you were smoking in bed at the time of a fire, and a fire caused this way is a breach of your policy, you may not in fact be in breach if the fire was caused by an electrical fault. In this case the fact that you were smoking in bed would be coincidental and not the cause of the fire.
- Pre-existing conditions - The policy may stipulate that a known pre-existing situation or condition is not covered. For instance, if you have disability insurance but at the time you signed the policy you had a tumor. However, under the law it would be crucial whether you actually knew you had this condition. If you were unaware of it you should still be covered.
- Ignorance of the terms - Under the law the insurer has a legal obligation to inform you about the restrictions in the insurance policy. This must be done before you sign the application and the policy is issued. This means (in part) that:
· You must be given a copy of the policy; and the wording of the policy must be clear and unambiguous. If these pre-conditions were not met it may be possible to retain your coverage for your loss. Again, it may be necessary to obtain legal advice.
12. Is it worth the claim? Many types of insurance contracts will have an excess. This is common in a car insurance contract, or similarly you may lose part of the no-claims bonus. Some companies now reward rating one drivers with a lifetime rating one guarantee. At times you will have to decide whether the amount of the claim is worth the long term loss that results from the effect on rating or no-claims bonuses, especially after taking into account the amount of the excess.
13. Keep copies of all of your paperwork. Store all your copies of your paperwork in your own personal files. You may need to refer to them later.