Jane Dotson
Car insurance is designed to protect you against financial losses if you're involved in an accident or your vehicle is damaged. When you file a claim, the insurance company will investigate to determine who is responsible and to protect themselves from fraud. This process can be stressful and take anywhere from a few weeks to several months. The investigation will involve an adjuster asking you for information, such as how the accident occurred, medical records, and details of any losses or damages. They may also contact the other driver and witnesses, as well as visit the accident scene. While the investigation is ongoing, you can begin making repairs to your vehicle. It's important to cooperate with the insurance company's investigation to ensure your claim is not denied.
| Characteristics | Values |
|---|---|
| Reason for investigation | To find out who is responsible and to protect themselves from fraud |
| Who investigates | Claims adjusters |
| Information requested | Details of the incident, police report, medical records, photos, etc. |
| Red flags | Financial trouble, social media presence contradicting the claim, etc. |
| Outcome | Approval for payment, adjustment, or denial of the claim |
What You'll Learn
Adjuster assigned to the case
Once a claim has been filed, an adjuster will be assigned to the case. The adjuster will be the person that the claimant deals with most often and will be responsible for handling the claim. The adjuster will ask the claimant for a summary of how the accident occurred, and may ask follow-up questions. They will also ask for additional information, such as:
- The police accident investigation report
- Photos taken at the scene
- Medical records and bills
- Authorization to obtain accident-related medical records
The adjuster will then review the information provided and may ask the claimant for more details. They will also investigate the accident by examining any police reports, inspecting the damage, and talking to witnesses. This may include visiting the accident scene, especially if fault isn't apparent or it was a severe accident.
The adjuster will then place a dollar value on the claimant's damages and handle the personal injury claim settlement negotiation process with the claimant or their attorney. Adjusters are judged by how little of the company's money they spend in settlements and how quickly they settle claims. They have the authority to agree on a final settlement amount and send the paperwork to finalise the settlement. However, they may need approval from a supervisor if the settlement amount exceeds a certain limit.
If the claimant disagrees with the adjuster's estimate, they should tell the insurance company why. The company may adjust the offer, or the claimant may need to provide more information or ask for a different adjuster.
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Adjuster asks for information
When an insurance claim is filed, the company assigns an adjuster to the case to investigate and assess the damage. The adjuster will contact the claimant to ask for more information. The adjuster will ask for a summary of how the accident occurred and may ask follow-up questions. They may also request additional information, such as:
- The police accident investigation report
- Photos taken at the scene
- To view the vehicle
- Copies of medical records and bills
- A release to look at medical records
The adjuster will also want to know what damages are being claimed, including damage to the vehicle or other property, and any personal injuries. The claimant should be as clear and straightforward as possible when providing this information, focusing on the facts and avoiding opinions or assumptions. It is also important to limit the information shared to only what is directly relevant to the crash and the claim.
The adjuster may also contact the other driver and witnesses to get their version of the accident. They may also visit the accident scene, especially if fault isn't apparent or it was a severe accident.
The investigation process can vary in length, depending on the type of claim and the facts surrounding the crash. It can range from a few days to several months. While the claimant is not legally obligated to provide the information requested, failing to cooperate with the investigation will likely result in the claim being denied.
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Adjuster may contact other driver and witnesses
When you file a car insurance claim, the insurance company will assign an adjuster to your case. The adjuster will contact you to ask for more information about the accident, such as how it occurred and may ask for additional information like the police report, photos from the scene, medical records, etc. The adjuster may also want to look at your vehicle and determine if repairs have begun.
The adjuster may also contact the other driver and any witnesses to get their version of the accident. This helps the adjuster verify the information provided by you and understand the accident's cause and severity. Usually, an adjuster will only visit the accident scene if fault isn't apparent or it's a severe accident.
The adjuster will then make a preliminary determination of fault and payment. If there is an insurance policy covering the damages, the adjuster will approve payment up to the policy limits. If you disagree with the adjuster's decision, you can provide more information, ask a supervisor to review the decision, send a formal demand letter, or begin formal litigation proceedings.
It's important to note that you are not legally obligated to speak with the other driver's insurance company or adjuster. If you do choose to speak with them, it's crucial to be cautious about what you say, as their goal is to protect their company's interests and minimize payouts.
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Adjuster may visit the accident scene
When you make a claim to your insurance company, they will assign an adjuster to your case. The adjuster will contact you to ask for more information about the accident, including a summary of how the accident occurred, and any follow-up questions they may have. They may also ask for additional information, such as a police report (if one exists), photos of the scene, and medical records.
If the adjuster believes it would be helpful, they may visit the accident scene. This usually happens if fault isn't apparent or if the accident was severe. By visiting the scene, the adjuster can gain a clear picture of the case and answer any questions about how the accident occurred. They can also collect physical evidence and take their own photos of the scene.
The adjuster will also interview you and any witnesses to verify the credibility of your claim. They will gather information such as the insurance details of the involved parties, the time, date, and location of the accident, and the names and badge numbers of responding officers.
The adjuster's job is to investigate your claim to protect the insurance company from potential fraud and determine the validity and value of your claim. They are working to protect the best interests of the insurance company, so the settlement package recommended is usually on the lower side.
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Adjuster makes a preliminary determination of fault and payment
When an insurance claim is filed, the insurance company assigns an adjuster to the case to investigate the claim. The adjuster collects information from the claimant, including a summary of the accident, the police report, photos from the scene, medical records, and details of the losses incurred. The adjuster may also contact the other driver and witnesses to gather their statements and visit the accident scene.
Once the adjuster has gathered all the relevant information, they make a preliminary determination of fault and payment. They review the information, taking into account modified comparative negligence, and complete a report. The adjuster then examines the applicable insurance policies to determine if the damages are covered based on the circumstances of the accident. If there is a valid insurance policy, the adjuster approves payment up to the policy limits.
The preliminary determination of fault is a crucial step in the insurance claim process, as it sets the foundation for the subsequent actions of the insurance company. It is important to note that the adjuster's initial decision is not final, and if the claimant disagrees, they can provide additional information or seek a review from a supervisor.
The investigation process can vary in duration, depending on the complexity of the case and the severity of the accident. While simple cases may be resolved in a few weeks, more intricate cases can take several months to investigate.
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Frequently asked questions
When an insurance company investigates a claim, they are essentially verifying the details of the claim to ensure it aligns with the policy terms and isn't fraudulent. This process is standard for all claims and is done to protect the insurance company from fraud and false claims.
The insurance company will assign an adjuster to your case who will contact you and ask for information about the accident, including how it occurred, the time and date, road conditions, and any subsequent damage or injuries. They may also ask for additional information, such as a police report, photos of the scene, and medical records.
While you are under no legal obligation to provide the information requested by the insurance company, failing to cooperate with the investigation will almost certainly result in your claim being denied. The insurance company is contractually obligated to pay a valid claim, but this hinges on your cooperation with their investigation.
The length of an investigation depends on the type of claim and any potential red flags. A simple case may be resolved in a few weeks, while a more complicated case could take several months. An investigation usually takes an average of 30 to 45 days.
