Auto Insurance: 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:
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Contact your insurer. Contact your insurance company
as soon as possible, whether you or the other driver is at fault.
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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.
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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.
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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:
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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.
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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).
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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.