For those who have ever been involved in an accident before, whether it be a vehicle collision or simply personal injury, navigating the ins and outs of the world of insurance is a challenge. Naturally, the point of insurance is to keep you covered financially in the event of an accident, but the process of actually getting a claim on file is easier said than done.
Once a claim has been submitted, however, you may think that everything is done and nothing more is required on your part. Unfortunately, there are many cases of insurance claims that don’t end how a person expected, whether that be more needing to come out-of-pocket or the entire thing turning into a bad faith claim. To that end, learn everything there is to know about insurance claims, including how monetary calculations are determined, so that you can navigate your insurance process better.
What Are the Different Types of Insurance?
First and foremost, there are a number of different types of insurance that a person may have. Understanding these different types can help a person learn which types will kick in during which situations. For the most part, a person will likely have the following types of insurance:
- Auto Insurance: For accidents that occur on the road, auto insurance is where a claim would be warranted. There are a variety of different types of auto insurance, but liability coverage is the form that is required in the country. This insurance offers insurance which will pay for damages to another person’s vehicle or body if you are found at fault.
- Health Insurance: For general health matters, such as visiting a doctor’s office, or when there is bodily injury such as an assault, health insurance will kick in.
- Homeowners Insurance: This form of insurance protects people who own a home from a number of instances that may occur including weather related accidents, theft, vandalism, personal property coverage, and much more.
- Renters Insurance: For those who don’t own a home but are renting a home or apartment, this form of insurance offers everything homeowners’ insurance does.
- Life Insurance: Nobody wants to think about themselves dying, but life insurance is a helpful form of insurance that offers financial compensation to those who rely on you financially if you die.
How Does Filing an Insurance Claim Work?
Regardless of the type of insurance coverage you have, filing a claim is always for the same purpose. The process of filing an insurance claim simply means a request to the insurance company for financial compensation after the person who has the policy was injured or involved in an accident covered under their policy. Not all forms of the above will require a formal claims process, but for those that do there are six primary steps involved in the claims process:
- A police report may need to be filed for proof of the incident
- Any and all applicable damage must be documents
- Your coverage must be reviewed to ensure its applicable to the current situation
- You will need to contact your insurance company
- An adjuster will be sent to talk with you regarding the incident to determine the value
- You will receive a settlement offer
Determining the Cost of an Accident: The Different Components
As mentioned above, the part of the claims process where the insurance company determines the cost of the accident occurs around halfway through. In most cases, auto insurance is one of the only types which will use an adjuster to evaluate what you may potentially be owed. Therefore, it’s worth covering what the job duties of this person entail:
What is an Adjuster?
An insurance adjuster is a person who is sent to investigate an incident that the insurance company has been made aware of. Their job is to determine whether the insurer or the insured should pay for damages, and how much each part should be paying. They will review the details of the claim, as well as your policy, interview everyone who was involved, and make a final determination.
What is a Claim of Bad Faith?
At some point during the claims process, you may believe that your or another person’s insurance company isn’t acting truthfully or honestly. If this is true, it’s a form of bad faith from the insurance company and could result in an additional claim. Bad faith simply refers to any event in which an insurance company attempts to take away its obligation to its clients by refusing to pay what a personal is rightfully owed or another similar situation. For those trying to identify bad faith tactics used by insurance companies, here are a few commonly seen examples:
- Misrepresentation of contract terms as outlined by the insurance company at the time of signing the contract
- Nondisclosure of policy provisions or exclusions
- Avoiding paying claims in the amount that a person is rightfully owed
- Denying a claim without giving any valid reason whatsoever
- Making threatening statements towards the clientele of the insurance company
- Failing to conduct a quick and complete investigation into the incident in question
- Offering significantly less money that the claim is actually worth
- Continually delaying decisions on claims or various requests for approvals for medical treatment related to that claim
Common Examples of Bad Faith
The Bottom Line
The last thing anybody needs after a major accident has occurred is to have issues with their insurance covering medical expenses or repair costs. While the valuation processes most insurance companies use is extremely accurate in the majority of situations, it’s still possible that a mistake has been made or an intentional oversight has occurred. If you believe you have a bad faith claim on your hands, it may be worth reaching out to an accredited bad faith attorney in your area who can evaluate your case. Don’t settle for receiving less than you deserve following an accident.
