Dealing with Insurance Claims

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Dealing With Insurance Claims

I worked for a local government agency in the Risk and Insurance Division.   I have investigated 1000's of claims which had been filed against the agency.   Everything from trees that fell on cars to motor vehicle accidents.   After investigating and reviewing the claims it becomes clear which cliams receive payment and which cliams are denied.

After many years in the Risk Management Business I felt it was time to provide some help to everyone who has been involded in an accident or has a need to file an insurance claim.


Sometimes it helps to know what Insurance Claim Departments are looking for to help resolve a claim.

Keep in mind that the goal of some insurance groups is to lower or reduce the claim you are filing, the claim will be review for the true cost, what is your claim worth on the open market, what is your vehicle worth, what is your house worth etc. Check to See How your Insurance Company Rates Go to: AM Best ambest.com Insure insure.com JD Power jdpower.com Standard and Poors standardandpoors.com

What Information is Needed

Here is a list of the information you should provided to an insurance company in the event of an accident or recovery.
  • Here is what you should include in a claim to an Insurance Company.

    Report the Accident to the Insurance Company or Agency

    Keep Good Records

    Keep notes on who you talk to, phone number, address, title.

    Keep notes on the day and time you call and what was said.

    Write down the date, time, place, location, and weather (sunny, rain, wet, dry, cool, cold, snow etc) of the accident

    Write down the names or people involved, if a vehicle is involved take down make, model, color, year, license number of the vehicle, Driver license number of the person driving.

    Write down the Name of the agency involved, insurance company or business, address and policy number.

    Take photographs of the location and of the vehicles if you can. Take as many photographs as you can. Take 25, 30, 35 or more photographs. Think big and Think small...IE take a photograph of the complete vehicle, the damage of the vehicle, the location of the vehicle, the license of the vehicle, the air bags if they have gone off, take sections of the vehicle front, side, back, right side, left side.

    Take photographs of the street, signs, location of the accident, street lights, stop lights and signs, do a 360 of the location.

    The more photographs the better.

    Write down the name of any police officer with badge number and make sure that he or she provides you with a case number.

    Request copies of any doctor notes or records (most insurance companies will ask for this information they many ask you to sign a medical release).

    Request and Keep a copy of all medical bills, any cost for medication, or co-payments.

    Keep a record of all medical appointments, dates, times and mileage to and from.

    Use maps to show the location of the accident.

    Request a copy of any police reports or fire reports.

    Take photographs of any injuries at the time of the accident, Also take photographs every three months until the injuries have healed. This helps to show what the injury looked like during the healing process.

    Be professional when dealing with Insurance Companies.

    When you file your claim you may file it online, However it is wise to always follow up with a letter and a copy of all of your documents.

    Make several copies two sets for you, and several extra sets just to have them on hand. Insurance companies love to misplace things....well sometimes too many people handle the claim files or sometimes files do not get scanned in the proper manner.

    Keep all of your documents in order of date newest first to oldest last.

    Keep all letters to an insurance company professional, keep it clean and to the point, just the facts.

    Tell a story of what happen and what took place...remember who, what, when, where, why.

    Include all of your cost! Remember to be fair and reasonable.

    The more information the better.

    Don't be in a rush to file a claim IE each state if different, and the law allows any where from six months to 2 years.
    Make sure you do your research! If you file a claim late it may be denied.

    If you run into problems or issues with the insurance company you may in some states request help from the State Department of Insurance or local agency that oversees Insurance Regulations.

    Filing a false claim is against the law.

    Once you have filed a claim remember that it will not get settled over night. The Insurance Company will conduct and investigation into the claim, they will review all of the documents you have provided, but they will also work to receive the same information from your providers IE Doctors, Location, Police Reports etc. They may also go out to the location and see if they can find any hazards or cause of what took place. This may take 10 days or more. They may also request more information from you.

Settlements

Once the insurance company has reviewed your claim they may offer you a settlement for damages and injury. Make sure that you read and understand any settlement offer made. And that in most cases the settlement offer is final and once you sign and return the settle offer and once you have been paid. You can not do back and change your mind. In most cases the claim is closed.

You should consult your Insurance Agent if you have any questions about your insurance coverage and ask about the claim process.

Keep in mind that Third Party Claims may not be handled by your insurance company, You may have to do the work.

Should you have any questions or issues whit a claim or the claims process in a third party accident you may what to consult an Attorney.

Remember that keeping good notes and records helps to make this a easy process.

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Are Insurance Groups fair in Claim Settlements

  • Dec 17, 2009 @ 9:35 pm | delete
    A very informative article on insurance claims.

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