Filing an insurance claim is a necessity if you want to receive payment after a covered incident. But many people don’t understand how an insurance company evaluates a claim or what factors can influence the final settlement they provide. Understanding these issues can help policyholders file claims with greater confidence, and ensure that they’re receiving fair compensation for their losses.
The process of filing an insurance claim begins when the policyholder reports an unforeseen incident to their insurer. This can be done in person or through a variety of digital platforms, including online forms and mobile apps. Most policies require prompt reporting of incidents to prevent fraud or other problems.
Once the insurer has received a claim, they’ll initiate an investigation to determine its validity and assess the value of the loss or damage that occurred. This can include examining the property, reviewing medical records or interviewing witnesses. The insurance company may also request documentation to support the claim, such as police reports or photographs. Depending on the type of claim, an investigator from the insurance company may even visit the scene of the accident.
In addition to conducting investigations into the validity of a claim, insurance companies must also decide whether or not they will approve or deny the claim. This can be complicated, as it’s not uncommon for the insurance provider to discover information that could skew their evaluation of the claim. In such cases, they may issue a partial or full denial of the claim.
Ultimately, the ultimate decision to approve or deny a claim comes down to the insurer’s view of the risk and their ability to mitigate it in the long run. This view is informed by the claims history of individual policies, and a large part of this is determined by their collective cost to resolve a line of coverage (TCOR).
As such, while it’s important to be proactive about preventing accidents from occurring, it’s equally important to know how to navigate insurance claims. If you’re concerned about the impact a claim will have on your rates, it’s best to talk to a trusted insurance professional before the accident occurs. They can help you better understand your policy, including any first accidents that are forgiven or previous claims that won’t count against you.
The number of insurance claims you make has a direct impact on the rate that you pay to gain coverage (typically through installment payments called insurance premiums). For this reason, it’s critical to understand how insurance companies assess the merits of a claim before making one. By being aware of the key factors that impact the final payout for your claim, you can prepare yourself to negotiate effectively with insurance adjusters and maximize the value of your claim.