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What Happens When My Car Insurance Claim Is Under Investigation

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Created by Stacey C, WriterAccess talent

Stacey C
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**Native US English Speaker **Also Studied Latin Stacey C. has a Master's Degree in Human Resources Development from Indiana State University, a Bachelor's Degree in Aviation and a Computer Science Minor. Her past work experience includes flight instruction and flight shop manager...

Have you recently been told that your car insurance claim is under investigation? While this may seem concerning, it’s an important part of the claims process. To process your claim, your insurance company must collect details. This helps determine who was at fault and the amount of damages that should be awarded. Of course, there is the possibility that they suspect your claim is fraudulent. Let’s take a look at what happens during a car insurance claim investigation.

The Initial Car Accident Claim

When you get into a car accident with another vehicle or hit another person’s property with your car, you should file a car accident claim as soon as possible with your insurance company. The process starts when you call your insurance agent or start a claim online. To complete the claim, your car insurance carrier will want specific details about the accident, including any witness statements and pictures, along with the accident report taken by the police officer. Once your insurance company has all the details, they will examine your claim and either approve the claim or deny it.

Your Claim Is Approved

If your car insurance claim is approved, it means that your car will either be repaired or replaced, and your pay your medical expenses in accordance with the terms of the insurance policy.

Your Claim Is Denied

Getting a claims denial means that the insurance company will not pay any money for your claim, and you will either have to repair or replace your car and pay for your medical expenses from your own pocket. It’s important to note that there are things you can do if your claim is denied to potentially get it approved.

The Car Accident Claims Process With an Insurance Company

It’s important to understand that every car accident claim is investigated. This is done to determine if the claim is valid, who is at fault, and how much money should be paid for the accident and any injuries.

Step 1 – Your Insurance Policy Is Reviewed

The first thing your car insurance company will do is investigate your claim to make sure the accident and the way the accident happened are covered under your auto insurance policy.

Step 2 – The Accident and Its Details Are Investigated

After reviewing your insurance coverage and policy, your car insurance company will review the specific details of the accident to determine who might be at fault and if either driver received any citations from the accident, like running a red light or speeding. If either driver committed a traffic infraction or is found to be driving under the influence, there’s a good chance that the driver will be held liable.

Step 3 – Contacting the Other Insurance Company

In some instances, your insurance company may contact the other insurance company to get more details and hear their side of the story as it was presented to them to determine the monetary value of the car insurance claim.

Step 4 – The Insurance Companies Determine Who the At-Fault Driver Is

When it’s determined which party caused the accident or which was responsible for the accident is determined. The exact determination depends on your state. Some states have tort liability. Others have comparative negligence, while other states have contributory negligence.

  • Tort Liability – In tort liability states, the driver who is found to be at fault for an accident is responsible for paying for all damages and injuries that are a result of the accident.
  • Comparative Negligence – In comparative negligence states, each driver is assigned a percentage of fault for an accident based on their actions leading up to the accident. For states with modified comparative negligence, the driver who is less than 51 percent responsible for the accident can file a personal injury claim.
  • Contributory Negligence – In contributory negligence states, if a driver is found to be any percentage at fault for an accident, they may not be able to recover any damages from the other driver.

A Claims Approval or Denial Is Sent

Once the insurance company has made a determination, a letter of approval or denial will be mailed to you. If your claim is approved, the insurance company will pay your accident-related expenses up to the policy limitations. If your claim is denied, your insurance company will not send you a payment, and you’ll be responsible for covering any damages or medical bills from your own finances.

What Steps Should You Take if You Get a Car Insurance Claim’s Denial?

If your car insurance claim is denied, you can accept the result of your car insurance company’s determination for the claim, or you can appeal the decision. If you choose to appeal, you should read the letter to determine why the claim was denied. If you think the claim was unfairly denied, you can send more information about the accident in an effort to get the decision repealed and your claim approved. This generally involves writing a letting of appeal and sending more evidence along with your reasons as to why the outcome was not correct.

You still have options if the appeal doesn’t correct the situation that you believe you are being unfairly denied. You can hire an attorney to represent you, effectively suing the insurance company. You can also report the insurance carrier to your state insurance commission if you believe the claim was denied in bad faith. Faith faith denials occur when an insurance carrier fails to investigate a claim in a timely manner and/or denies a legitimate claim.

Getting a Trustworthy Car Insurance Carrier

If you’ve had a claim denied by your insurance carrier either in good faith or bad faith, you are probably thinking about switching to an insurance carrier with better customer service and better rates. Our insurance company takes the time to thoroughly investigate each claim in order to make a fair determination of who was at fault and what types of monetary damages should be paid.

To get a quote for car insurance, call us today or fill out our online form.

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