Things You Need to Know Before Filing an Insurance Claim

When something bad happens to you that involves damages, your instincts will have you impelled towards seeking compensation. This will drive you to make a formal request from your insurance company, seeing as you are covered by insurance, which hopes to have you receive money in exchange for the repair costs, or any other expenses. After you are approved, you are sent a check in your mail for the losses. The process includes copious paperwork, but the check makes the effort tolerable. However, getting approved is difficult, since insurance companies can reject your claim, even if liability is reasonably clear. That said, in order to make sure your claim is successful, there are a few things you need to know.

According to the Insurance Information Institute, 6% of all drivers filed a car insurance claim in 2017. Even homeowner claims have surged, with almost one in every twenty filings for a claim each year. However, you do not always need to file for a claim. 

When to file an insurance claim

Generally, if your deductibles are more than your damages, or if they are just a little under, you should reconsider filing an insurance claim. Going through the insurance claim process may not be worth it, and so it will depend on the circumstances. However, there are instances that strongly call for an insurance claim, and they are:

When You Cannot Pay For the Damages

Should you find yourself unable to pay for the damages, either you or your asset have suffered from, begin looking to file for an insurance claim.

When Someone is Injured

Filing an insurance claim is important in instances where someone gets injured, like in a car accident.

When You are Figuring Out Who is at Fault

If you get into an accident, and you cannot figure out who is at fault, file for an insurance claim. 

File an Insurance Claim

Before you file an insurance claim, you need to make sure that you are following through correctly. This will include everything from the moment the damage occurred. Here is what you need to know:

Call the Police

Whether it is a crime, an accident or something else, getting the police involved will make the insurance claim process move by easier. A police report will paint a definitive picture of what happened, and while it is not needed, having one does not hurt. 

Make a Document of Everything

After the damage takes place, make sure to document everything that happened. Include a detailed report of events that had unraveled, names, addresses and phone numbers of the other party involved, as well as a photo of their license. Make sure you have included photos from the accident site and detailed documentation of the conversations you had with the people involved in the accident. 

Whether you have injuries or not, make sure to have received medical attention. The doctor’s report and medical fees will play a key role in having your claim approved. Also, make sure to include any stolen items and the receipts or pictures of your belongings. Do not forget to mention any costs that resulted from the damages.

File an Insurance Claim

After gathering detailed information about everything that is connected to the accident, you will be asked to give an estimate of the costs for the damage. You will also need to fill out a Proof of Loss statement. Also, it is important to be aware of who to report your claim to, as it could be the at-fault party’s insurance provider. Make sure to ask how long you have to file your claim, as you can be denied after the period of contestability has passed. After doing so, you can file your claim. Some insurance companies offer online alternatives, such as mobile apps and websites, however, some will work with antiquated gear, as you will need to send them an email or fax.

What Happens Next?

After filing an insurance claim, you will either be approved or denied. If you are approved, then you will need to check your mail. However, if you are denied, here is what you need to know:

Check Your Policy

You will need to check your policy to identify why your claim has been denied. Start at the beginning and read through it carefully. Your claim can be denied for any number of reasons. They include:

  • Incomplete or Inaccurate Information, which includes omitting information concerning the claim’s diagnosis. 
  • Violating the terms and conditions of the agreement.
  • Filing a claim after the period of contestability has passed. 
  • Lack of prior authorization, since the service could be a non-emergency

Go to Court

If after checking your policy, you believe to have been wrongfully denied, you may take the insurers to court. Though there are conditions, and they are:

  • If they did not provide an explanation since they are legally bound to do so
  • If they refuse to pay compensation, even if liability is clear
  • If they do not respond to the claim within a specified period of time
  • If they deny your claim after the period of contestability has past

Any of these conditions will allow you to sue the insurance company. However, it is important to have a skilled lawyer by your side, especially in cases where it is difficult to figure out who is at fault, such as with car accidents. If you or a family member were hurt in a car crash, getting legal help with a car accident claim can have you secured the financial compensation you deserve. The legal help you hire will contest the case brought by the insurance company’s lawyers. Your lawyer will gather the evidence and the statements made, as well as any paperwork involved, in order to lift the legal burden off your shoulders.

Third-Party Assessment

If you hope to avoid going to court first and wish to seek a quieter solution, getting a third party assessment can be an option. No matter the outcome of the assessment, it will act as evidence, and so it is important that you get it. It is carried out by a loss assessor, who is an independent entity. So, expect to get charged for the report.

Financial Ombudsman Service

You will need to make a complaint at the Financial Ombudsman Service. Go to their website and download the complaint form. The Financial Ombudsman Service ruling is final and cannot be challenged by the insurance company. The only way to contest the ruling will be to go to court. They have the power to influence the insurance company into issuing an apology, offer an explanation as to why you were denied and pay compensation. 

Filing an insurance claim can be long and arduous. However, with the appropriate preparations and mindful considerations, you can avoid many of the issues that can come with a claim. Always make sure to have included everything the insurance company asks for. Remember, if they deny your claim, and the other outlets, such as the Financial Ombudsman Service and Loss Assessor, let you down, you can always lawyer up and take them to court.

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