Filing a Claim
You're likely to eventually be involved in a fender-bender or other accident that results in you filing a claim.
A claim is a request that you make to your insurer to pay for damages sustained in an accident. After you pay any deductibles, the insurer pays your claim up to the amount that you are covered.
If your insurer contests your claim, first double-check your policy to see if it has a legitimate case for denying your claim. If you feel the insurer is shirking a legitimate claim, you can contact your state insurance commission. The National Association of Insurance Commissioners maintains a directory of state offices at its Web site.
When you have an accident, you may want to follow these steps, according to the Insurance Information Institute:
Contact your insurer. Contact your insurance company as soon as possible, whether you or the other driver is at fault.
Determine if coverage is applicable. Ask your insurer to check whether or not the accident will be covered. Double-check your policy for an explanation of coverage.
Documentation. Ask your insurer what documentation you will need to support your claim. At a minimum, you will need to submit an accident report filed by police. You will also want to keep records of all conversations -- when they occurred and with whom -- and receipts of all accident-related expenses.
Monitor the progress of your claim. Ask your insurer about the timetable in which it expects to investigate and pay your claim. The insurer is likely to use a claims adjuster who investigates the incident surrounding your claim. You will want to be in regular contact with the claims adjuster.
Insurance companies make money by taking in more in premiums than they pay in claims. An insurer wants to minimize its loss ratio, which is the percentage of premiums it pays out in claims. As a result, insurers have a fiduciary duty to shareholders or other policyholders (in the case of mutual insurance companies) to carefully investigate claims to avoid fraud.
Not all insurers use stall tactics to slow down your claim, but some unscrupulous insurers may. If you feel you're getting the run-around, contact your state insurance regulator. According to the Insurance Information Institute, other avenues of recourse include:
Contact the National Insurance Consumer Helpline. You can reach the consumer helpline between the hours of 8 a.m. and 8 p.m. The toll-free number is 800-942-4242.
Seek arbitration. Your insurer may suggest an arbitrator to work with you and your insurer over a disputed claim. If you prefer, you may also obtain your own arbitrator from the American Arbitration Association (www.adr.org).
Hire an attorney. You may want to consider hiring an attorney to represent your claim but probably only as a last resort. Hiring an attorney is the most expensive approach. It may not even be necessary if you pursue either of the above courses of action instead.