How Insurance Companies Investigate Car Accident Claims

What happens with your claim after you file it? Find out how the insurance company investigates car accident claims.

While the insurance company investigates the accident by the nature and severity of it, the policies the company have and whether the accident involved injuries, property damage or both, we will review the steps that are common to most claims investigations.

Immediately after you file your claim, the company will assign to your case a claims adjustor. The adjuster’s job is to review your policy and make sure that you are covered. If she/he need more details about the accident, the adjuster may contact you after. The adjuster may do the following (during the investigation):

  • Contact the other driver involved in the accident.
  • Take photos of your car and the other car involved, if any.
  • Inspect your car for damages
  • The adjuster can visit the scene of the accident
  • He/She can also talk to any listed witnesses to the accident
  • Can request from you to send a copy of the police report for review
  • The adjuster can ask you to sign a medical release form, in order to view your medical records.
  • The adjuster can contact your medical providers and request information regarding the expenses related to your injuries.

When it comes to vehicle repairs, you’ll have several options. Your adjuster may request repairs to your car to be done at one of  the insurance company’s approved body shops for an estimate. The adjuster can also ask you to obtain multiple quotes from several shops to compare. However, you may choose to get the repairs done at any location you choose, but, you might pay from your own pocket the difference between that shop’s estimate and the amount the insurer determines is a fair price.

Regarding the medical care, your insurance company will cover the injuries until fault is determined, this initial payment being called “indemnification” (meaning compensation for damages and losses). After that will negotiate with the other driver’s insurance company to decide who pays in the end.
In case the other driver is to be at fault, your insurance company will seek payment from his insurance company.

If your claim includes medical expenses as a result of the accident, your claims adjuster will want to see evidence of your medical bills. In order to access your medical records, the adjuster will ask you to sign a waiver to grant permission for your insurance company to access your medical records. It is very important that before signing this document to talk to a personal injury attorney to see if it is in your best interest to sign such a document, because the information in your medical records can be used to lower your claim.

Your Story – adjuster will ask for your recollection of the event and you will need to provide as much information as you can.

Additionally, you may need to provide the following:

  • Policy number (it is written on your insurance card).
  • Date and location of the accident.
  • Description of how the accident occurred.
  • Name and insurance information for the other party involved.
  • Name of the police department involved and the police report number (if applicable).

The adjuster will also try to determine fault and based on that the company may only pay a part of the settlement and the other driver’s insurance company to pay the rest. In some cases, the settlement is paid entirely by the insurance company of the driver who has the majority of the fault. You can find out more by speaking with your auto insurance agent.

During the reviewing of the claims, the adjuster will look at evidence such as medical records, bills, proof of income loss, evidence of property damage.

The insurance companies are also likely to look you up online, on Facebook, Twitter or other social media websites to check if you are lying or not. So, claiming you had an accident on Saturday but on Sunday you post a picture with your car, not having a scratch, they will treat it as a fraud.

The insurance companies have special investigation units to investigate frauds but you can protect your privacy on social media by setting the privacy settings so that only approved people can see your photos, by avoiding posting photos or anything about your accident and, of course, by not filing a fraudulent claim.

If you are unhappy with the settlement offer, you have some options: You can take the claim to the adjuster’s supervisor, Mediation, Arbitration, Small claims court, hiring an attorney.

Honestly, hiring an attorney from the beginning is the best option. This way you make sure you get the settlement you want, you don’t get “adjusted” too much, you avoid being found at fault even if you are not and so on. In this type of situation, an attorney is your shield and your weapon.

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