6 Steps Insurance Companies Take to Investigate Claims

An accident can result in claims of property damage, personal injury, or a combination of the two. Once you submit your claim, an adjuster will be assigned to your case. The purpose of the adjuster is to investigate your claim to determine exactly who or what is at fault. Here are the steps that insurance companies take to investigate claims.

  1. Initial information gathering

You filed an insurance claim, so your adjuster begins to review your case. At this time, the adjuster might:

  • ask you to send a copy of the police report
  • contact the other party
  • question any witnesses
  • visit the scene of the accident
  • inspect and take photographs of the scene of the accident and/or your injuries
  • ask you to sign a medical release so they can review your medical records
  • contact your medical providers for information about your injuries 
  1. Coverage

Your insurance fully covers repairs and medical bills until fault can be determined for the accident. Right now, the goal is to get whatever was damaged in the accident back to normal. For example, if someone slipped on your property and kicked a hole in your wall while falling, you will get the hole repaired. Your insurance will cover the expenses until it is clear which party is at fault.

If you were injured in the accident, you will want to get a personal injury lawyer. At this stage, your adjuster may want to see your medical records. They might ask you to sign a waiver granting them access to your information. However, this may not be in your best interest. Consult your lawyer before you sign any waivers or forms for the insurance adjuster.

  1. Interview

In order to have the best possible settlement, you will need to speak with your adjuster. There will be standard questions like “What is your insurance policy number?,” “What was the date and location of your accident?,” and “What is the name and insurance information for the other party?” The adjuster will also ask you to describe how the accident occurred. This can be a tricky question to answer, so choose your words carefully. You do not want to lie to your adjuster, but you also may not want to accept full responsibility for what happened.

  1. Determine fault

Once fault is determined, your insurance company will contact the other person’s insurance company and recoup what is owed. For example, if it is determined that you were 60% at fault and the other party was 40% at fault, your insurance company will negotiate to get 40% of your expenses paid.

  1. Review claims

At this stage, your claims have been submitted and fault has been determined. However, before your insurance company finalizes payment, they will want to verify that everything you said is true. They will launch a review of your claims to verify their validity. This will include investigating you through the internet and looking on your Facebook page.

After your accident, it is best if you do not post pictures on Facebook. Or, if you feel like you must, please make sure your privacy settings are such that only friends can see your pictures. Even if you think you pictures will not implicate any wrong-doing on your part, keep them private.

  1. Resolution

Everything has been investigated. Now, the insurance company will issue a statement saying how much of the accident they will cover. If you are unhappy with your settlement amount you may contact your claim adjuster’s supervisor and appeal. However, if that doesn’t help, you should hire a lawyer.

We Can Help

At Barnard Law Offices, we can help you get the settlement for your accident that you deserve. Our attorneys are ready to speak with you and answer any questions you might have. Let us help you get the compensation that you need. Give us a call today at (305) 665-0000 or contact us online to discover what we can do to help.

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Barnard Law Offices

The Barnard Law Offices, L.P. has been protecting the rights of Floridians for four generations. Together our attorneys bring years of insurance claim advocacy and trial experience to the table. We don’t believe in half-hearted measures when it comes to proving your claim: after inspecting the damage to your property, our office will engage or connect you with high-quality third-party professionals to assist you with your claim and assess your property damage. Our talented team is dedicated to serving each client’s needs with a passion and commitment that makes us stand out among our peers.
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