File An Auto Insurance Claim: What You Need To Know

If you're unhappy with your insurance company, you can file a complaint. Common reasons for complaints include delays, unsatisfactory settlements, and claim denials. Before filing a complaint, it's recommended that you first try to resolve the issue by talking to your insurance company or agent, as many issues can be resolved this way. If you disagree with the adjuster's estimate, for example, you can tell the company why and send them supporting documents, such as a body shop's estimate for repairs. If this doesn't work, you can ask for an appraisal, which involves hiring an appraiser to review your claim and estimate the damage. If you're still not satisfied, you can file a complaint with your state department of insurance, which regulates insurance activity and insurer compliance with state laws. You can also seek arbitration or file a legal claim against the insurer in court.

Common reasons for insurance complaints

There are several common reasons why people may file a complaint against their auto insurance company. According to the National Association of Insurance Commissioners (NAIC), 68% of complaints are related to claims handling, with unsatisfactory settlements being the single biggest complaint. Other common issues include claim delays and outright claim denial.

In addition to issues with claims, people may also complain about their insurance company's customer service. For example, customers in Nevada reported being unhappy with billing practices and how they were notified about their premiums.

It's important to note that the most common issues can vary by state. While 100% of claims in Vermont were about claims, 79% of complaints in Maryland were related to policy cost and cancellations.

If you are experiencing issues with your auto insurance company, there are several steps you can take to try and resolve the problem. First, try talking to your insurance company or agent, as many issues can be resolved through discussion. If you are still dissatisfied, you may need to file a formal complaint with your state department of insurance (DOI). This typically involves filling out a form and providing supporting documentation. You may also want to consider contacting a third party, such as an ombudsman, to help mediate the dispute.

How to file a complaint

If you're unhappy with your insurance company, there are several steps you can take to file a complaint. Here's a detailed guide on how to do it:

Step 1: Contact Your Insurance Company

Before filing a formal complaint, it's essential to try resolving the issue directly with your insurance company or agent. Most companies have a customer helpline or an appeal process that you can follow. Discuss your concerns, and if necessary, ask for an appraisal to resolve disputes about the amount of damage.

Step 2: Gather Information and Documents

If talking to your insurance company doesn't lead to a resolution, it's time to prepare for filing a formal complaint. Gather all relevant information, such as your policy details, and supporting documents like photographs, email correspondence, and a log of phone calls with the company.

Step 3: Understand Common Complaint Reasons

Understand the most common reasons for filing complaints against insurance companies, which include delays, denials, and unsatisfactory settlements. Knowing the common issues can help you build a strong case and determine the best course of action.

Step 4: File a Complaint with the State Department of Insurance

You can file a complaint with your state department of insurance (DOI). Each state has a dedicated department that takes complaints seriously and is prepared to assist consumers. Visit https://content.naic.org/consumer.htm to select your state and navigate to its consumer complaint page. Be prepared to provide information such as your name, address, type of insurance, and the reason for your complaint.

Step 5: Explore Other Options

In addition to filing a complaint with the DOI, you may consider seeking help from a third party, such as an ombudsman, who can advocate for you in the dispute. Alternatively, you can file a BBB (Better Business Bureau) complaint or even take legal action by suing the insurance company in small claims court.

Remember, each state has its own process for handling insurance complaints, so be sure to review the specific guidelines for your state. By following these steps, you can effectively file a complaint and increase the chances of a positive resolution.

Complain to an ombudsman

If you're dissatisfied with the actions of your insurance company or insurance agent, you can file a complaint with an ombudsman service. The ombudsman will act impartially when reviewing your case and will consider all the facts and circumstances of your individual complaint. They will also take into account any relevant laws, regulations, industry codes of conduct, and best practices, as well as any evidence you can provide, such as medical reports, photos, application forms, and claims forms.

Before submitting your complaint, you should gather all supporting documents and photographs, including email correspondence and a log of phone calls with your insurance agent or company. It is also helpful to write a detailed account of what happened and the reasons for your complaint.

In the UK, you can submit a complaint to the Financial Ombudsman Service, which handles a range of insurance products, including motor insurance. The service is free and easy to use, and they will inform you of their findings. If they find that the business has treated you unfairly, they will tell them to compensate you and may ask for an additional award to be made for any distress and inconvenience caused.

In Australia, you can submit a complaint to the Australian Financial Complaints Authority (AFCA), which considers a wide range of insurance products, including car insurance. AFCA provides fair, free, and independent dispute resolution for financial complaints. You can make a complaint to AFCA online, by letter, email, or phone.

In the United States, you can file a complaint with your state department of insurance (DOI). Each state's DOI takes complaints seriously and is prepared to help consumers. You can typically file a complaint through their website by filling out a form with your information and the details of your complaint.

File a legal claim

If you are dissatisfied with the actions of your insurance company, you can file a legal claim against them in court. Delays, unsatisfactory settlements, and claim denials are among the most common reasons people file complaints against their insurers.

Before filing a legal claim, there are a few steps you can take to try and resolve the issue. Firstly, try talking to your insurance company or agent. Most companies have a toll-free customer helpline, and you can also contact them online or by phone. If you disagree with the adjuster's estimate, explain your reasoning to the company, as they may raise it if they find they have overlooked something or receive new information. You can also ask for an appraisal, where you and the company each hire an appraiser who then chooses a third appraiser as an umpire. However, this can only be used to resolve disputes about the amount of damage claimed, not about whether something is covered.

If talking to your insurance company does not resolve the issue, you can file a complaint with your state department of insurance, which regulates insurance activity and insurer compliance with state laws and regulations. You can also seek arbitration if that is an option in your policy.

If you are still not satisfied with the outcome of your claim, you can take the issue to court and sue your insurance company for failing to meet its legal obligations under the terms of the insurance policy. Common violations include wrongful claim denial, untimely and incomplete claim processes, untimely payments, inadequate payments, and failure to pay valid claims.

What to do if your complaint is unsuccessful

If your complaint is unsuccessful, there are a few options available to you. It is important to remember that you can always escalate your complaint to a higher authority for further investigation and resolution. Here are the steps you can take:

Step 1: Re-evaluate your complaint:

First, take the time to understand why your initial complaint was unsuccessful. Review the response you received and identify any areas of concern or disagreement. This will help you address these points more effectively in your next steps.

Step 2: Gather additional evidence:

Strengthen your case by gathering any new or additional evidence that supports your complaint. This could include documents, photographs, emails, or any other relevant information that may not have been considered previously. This additional evidence can help build a stronger case and address any gaps in your initial complaint.

Step 3: Contact the insurance company again:

After re-evaluating your complaint and gathering additional evidence, reach out to the insurance company once more. Communicate your concerns clearly and provide the additional evidence you have collected. This demonstrates your commitment to resolving the issue and may prompt a more favourable response from the company.

Step 4: Seek external assistance:

If your complaint still remains unresolved, consider seeking assistance from external sources. Contact your state department of insurance (DOI) or a similar regulatory body, as they are equipped to handle such disputes and can provide guidance or mediation services. They will take your complaint seriously and work with you to find a resolution.

Step 5: Legal recourse:

As a last resort, if all other attempts to resolve your complaint have been exhausted, you may need to seek legal advice. Consult with a legal professional who specialises in insurance disputes to discuss your options for taking legal action against the insurance company. Remember to carefully consider the costs and potential benefits of pursuing legal recourse.

Remember to keep detailed records of all communication, responses, and actions taken throughout the process. This will help support your case and demonstrate your efforts to resolve the issue if you need to pursue further avenues for redress.

Frequently asked questions