How do car insurance companies investigate claims?

How car insurance companies investigate claims is through insurance adjusters who are assigned to each claim on an individual basis. Insurance adjusters investigate the accident, speak with witnesses and other drivers, and will look at the police report to determine fault and settlement amounts. Your coverage limits will also be considered when auto insurance companies investigate claims.

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Tonya Sisler has a Bachelor’s Degree from the University of South Carolina in Journalism and has worked for 15+ years in management. She has also completed a proofreading certification and is currently a professional writer.

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Brad Larson has been in the insurance industry for more than a dozen years. He started out as a claims adjuster for a national carrier. He has since switched to the agency side of the business. Brad is licensed in all P&C lines.

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Reviewed by Brad Larsen
Licensed Auto Insurance Agent

UPDATED: Oct 29, 2020

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Here's what you need to know...

  • Car insurance companies investigate claims by using insurance adjusters to survey the damage and estimate costs.
  • Insurance adjusters make the final recommendations to the insurance provider on how much to pay.
  • If they suspect insurance fraud, they may take more aggressive measures to investigate claims.
  • If you feel the insurer has not paid out enough, you may file a settlement insurance claim or seek the advice of an attorney.

When shopping for car insurance, it’s important to know the claims process and how insurance companies investigate claims. This is information that the insurance company will likely never volunteer to tell you unless you specifically ask this question.

In this post, we will look at the process of claims investigation and illustrate what happens at each stage so you’ll know what to expect.

Keep in mind that not all insurance companies follow the same order to complete the requirements for issuing claim money in the same way. The time that it takes to file and receive an application may be different also between the various companies.

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The Insurance Claims Process

To understand how insurance companies investigate claims, it is first important to understand the claims process itself. Here is the claims process for a car insurance claim.

You call and report the claim immediately after the accident

It is important to call your insurer immediately after the accident. This is because you need to get your story to your insurance company and tell your side as soon as possible. If you wait, you also run the risk of having another fender-bender later, which can get confusing because it would involve two separate claims.

The insurance company will get the police report

They need to determine what happened and who was at fault. The police report will have the causation of the incident as the police officer recorded it, any external events that may have influenced the event, and other factors that may have contributed to the event.

The insurance company may call you back for any follow-up information regarding your claims

This may involve other expenses such as medical costs, injuries, and damage.You should answer any calls you get from your insurer after they talk to you about your wreck and be prepared to answer any questions.

The insurer will send an insurance adjuster to your location

The adjuster will check over the vehicle and analyze the damage.

The job of the insurance adjuster is to assess the damage that was caused by the accident and estimate what the insurer should pay to fix it.

They will report this information back to the insurance provider, and a decision will be made on how much they will pay to cover it

If you feel the insurer was too conservative in their estimate, or if you have additional costs that were not initially expected, you should call your insurer and report this as soon as possible before they issue your claims check.

They will ask you to get two or three estimates of cost for damage repair

They will take the lowest estimate for repairs. But don’t settle for too low an amount. You can always file a motion for an insurance settlement if necessary.

They send a check to you or the body shop that plans to fix your car

The amount that they send should be enough to cover all repairs, as well as any other expenses that you suffered as a result of the accident. You should keep a careful record of any additional expenses that you incur as a result of your accident. Sometimes you do not know the entire cost until later. Keep careful documentation and records of every step of your claim and accident so that you can report it.

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When should I get more help?

The insurance claims and investigation process usually goes smoothly. But if an insurance provider thinks you have been dishonest with them about your claims, they may get more aggressive about their claims investigation process. They will use their adjuster in the same way as with any case, but they may have them scrutinize the situation more carefully or spend more time asking questions about the accident if they suspect insurance fraud.

In some cases, you may want to seek the advice of an attorney or insurance settlement expert to help you handle a claim. The insurance settlement process involves getting a representative from your insurance company together with your negotiator or other parties to decide what would be considered a fair settlement.

Insurance solutions are ultimately decided by the insurer, but you may have a lawyer present if you wish to represent your best interests.

Personal Injury Protection

If someone has been injured in an accident in which you were involved, you may need to seek legal help. Personal injury protection (PIP) is a type of insurance that pays for injuries to others that you caused due to negligence. When shopping for insurance, you may want to consider getting this type of insurance to cover accidents that result in injuries. Ideally, your insurance policy will cover this. But if the injuries are substantial, it may not be enough. Ask your online agent to advise you on how much personal injury protection you might need.

If you have already been involved in an accident involving personal injury, you will want to consult with an attorney to get advice on how to proceed.

How to Find the Best Insurance

It can be confusing shopping for car insurance. You want to get as much coverage as you can afford, while not taking on more expense on premiums than you can afford. It’s best to compare rates side-by-side with the help of an independent online site like ours  that you find unbiased information.

If you deal directly with one insurance company, they will almost always tell you that their insurance is the best for your needs. This is why comparison shopping and researching companies through reviews is so important. You can check ratings with agencies like AM Best and the Better Business Bureau to make sure that a company is in good financial standing and its customer satisfaction level.

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Replacing Car Insurance

If you are not happy with your current auto coverage and wish to change to another company, that is a smart move on your part. You have realized that your current coverage is not sufficient to cover your risk. Perhaps you also have not been happy with the claims process of your current provider. Whatever the case, changing companies can be a good decision. However, you always want to follow the use guidelines when switching insurance providers so that you will not experience a gap in coverage.

  • Make sure your premiums are paid up so that you will not have a lapse in coverage while you are shopping for another policy.
  • Do not cancel your current insurance until you have been issued a new policy from your new company.
  • Call your previous company to make them aware that your plan to switch and see if they offer any discounts to keep you on.
  • Only stay with your current carrier if they truly have the best insurance for your needs.
  • Shop our site and compare to look at the benefits of switching before you replace your current insurance.

This law firm has some other sound advice on how to handle switching or canceling an insurance policy. These tips will remind you to be careful during the process of switching companies so that you have no lapse in coverage. You may also qualify for a refund from your previous company since you are not renewing your policy with them. Contact your old insurer but only once you have decided you want to switch. They should help you make the transition without objection.

It is an insurance company’s ethical responsibility to help you phase out of their system if you wish to do so, while also warning you not to let your policy lapse in the transition.

Insurance companies, by law, are viewed as a representative of you. This means that they should care just as much about you and your best interests as you do. They are acting on your behalf in all matter involving your coverage, policy, and legal aspects and they must conduct themselves accordingly.

If you believe that an insurance company is not conducting themselves in an ethical, legal manner with your best interests at heart, you may report them to the insurance commissioner’s office in your state of residence.

The key to having confidence in your insurance company is in choosing a good company, to begin with. We can help with that.

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