What Happens When You File An Insurance Claim? | Berger and Green (2024)

On This Page

  1. Submitting an Insurance Claim
  2. Investigating the Claim
  3. Learning About Your Offer
  4. Challenging the Insurance Company
  5. Talk to an Attorney About Your Case Today

What Happens When You File An Insurance Claim? | Berger and Green (1)

LEGALLY REVIEWED BY

C. William Kenny

February 02, 2024

Board certified by National Board of Trial Advocacy

What Happens When You File An Insurance Claim? | Berger and Green (2)

When you file an insurance claim, there are several steps your claim goes through before you learn the insurer’s decision. They may approve your claim, in which case you will receive the listed amount of compensation. If the insurance company denies your claim or approves an insufficient amount of compensation, you may need to file a lawsuit in pursuit of a fair payout for your injuries, losses, and expenses.

Having an attorney review your case, handle your claim, and negotiate a settlement can make it easier to navigate this process and help protect your rights.

Submitting an Insurance Claim

An insurance claim is a formal request for compensation based on an insurance policy. This could be a policy you took out to protect your own investments or a liability policy to protect you from accidental injuries.

You will need to submit basic information about the incident or accident and your damages to the insurance company. A representative from the insurer will likely want to ask you a series of questions and learn as much as they can about your incident and what happened. This is usually done over the phone.

It is important to be careful what you say. The insurance company is a business and is motivated to distribute as little compensation as possible, so its representatives will look for reasons to deny your claim or reduce your offer. An attorney can help you understand what to expect and collect the information you will need to make a compelling argument for compensation. If you have a lawyer, you may not need to talk to the insurance company yourself.

For a free legal consultation, call 412-661-1400

Investigating the Claim

The insurance company will assign an adjuster to your case. This adjuster will investigate what happened and determine if they believe you suffered a covered event. In the case of a liability claim, they will also decide who they believe is liable for the accident that caused your injuries.

They will obtain a copy of the police report, medical bills and records, and other documentation of your injuries. If there is a claim for property damages, they may send someone to assess the cost of repairs or replacement.

You have the right to collect your own evidence about these and other details in support of your claim. If you are unsure of how to proceed, a personal injury lawyer may be able to help.

Learning About Your Offer

Once the insurance adjuster completes their investigation, they will contact you or your attorney with an offer. It is imperative that you do not agree to this offer unless you have a good idea of the value of your expenses and losses.

Every case is unique, but for many liability claims, the insurance company’s offer should cover:

See Also
claim

  • Medical bills
  • Ongoing care costs
  • Property damages
  • Lost wages
  • Diminished earning capacity
  • Out-of-pocket expenses
  • Pain and suffering
  • Mental anguish

The best way to understand the value of your case is to have an attorney familiar with the applicable laws review it and help you calculate a fair settlement value. They can determine the value of your full range of economic damages, as well as pain and suffering damages in a liability case.

Click to contact our personal injury lawyers today

Challenging the Insurance Company

If the insurance company’s offer does not cover your losses and expenses, you have the right to pursue a larger payout. A lawyer can help you hold out against the insurance company for a maximum settlement. They can review your case, investigate your accident, and help you understand the damages that may be available to you.

If you are unable to reach a satisfactory settlement with the insurance company, your attorney can pursue legal action and take your case to court to argue for the compensation you deserve.

Complete a Free Case Evaluation form now

Talk to an Attorney About Your Case Today

If you or a loved one suffered injuries in a personal injury accident, car accident, fall, or another incident, Berger and Green can help you pursue compensation. Let us file an insurance claim or file a civil suit on your behalf.

We handle these cases on a contingency basis. You do not owe us any attorney’s fees until we recover a payout in your case. Call Berger and Green’s office today at 412-661-1400 for a free case evaluation with a member of our team.

Call or text 412-661-1400 or complete a Free Case Evaluation form

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What Happens When You File An Insurance Claim? | Berger and Green (2024)

FAQs

What is the downside of filing an insurance claim? ›

It could increase your premiums

When determining your premiums, insurance companies consider your likelihood of filing a future claim — which could cost them money. The higher your perceived risk, the more likely you are to pay more in premiums. Your claims history tends to play a direct role.

Is it better to not file an insurance claim? ›

It's crucial to file a claim for major property damage and bodily injuries. A claim might not be worth it for one-car accidents when nobody is hurt. A bad driving record could increase your auto insurance premiums for three years.

What happens after a claim is filed? ›

The insurance company will assign an adjuster to your case. This adjuster will investigate what happened and determine if they believe you suffered a covered event. In the case of a liability claim, they will also decide who they believe is liable for the accident that caused your injuries.

What happens if someone doesn t respond to an insurance claim? ›

If the other driver never calls their insurance company back to answer their questions about the accident, many insurance companies will eventually deny insurance coverage. This turns your insurance claim into an Uninsured Motorist Claim.

What is one of the most common reasons for a claim being rejected by an insurance company? ›

Process Errors
  • The claim has missing or incorrect information. Whether by accident or intentionally, medical billing and coding errors are common reasons that claims are rejected or denied. ...
  • The claim was not filed in a timely manner. ...
  • Failure to respond to communication. ...
  • Policy cancelled for lack of premium payment.

Is it worth making an insurance claim? ›

You should consider filing a car insurance claim whenever your out-of-pocket costs would extend past your deductible. Reminder: your deductible is the amount you'll pay for certain auto insurance coverage types to kick in.

Should I get an estimate before filing a claim? ›

Getting a repair estimate is the key first step toward resolving your vehicle damage claim after an accident. When you're making an insurance claim after any kind of traffic accident, getting a trustworthy repair estimate (or two) is a necessary first step toward getting your vehicle fixed and back on the road.

Will an insurance claim affect my insurance? ›

Even if you've been considered a safe driver in the past, your insurer may re-evaluate your driving record and decide to raise your premium if new claims indicate you've become a riskier driver. However, filing a claim doesn't mean your insurance premium will automatically increase.

Does making a claim affect my insurance? ›

Will my car insurance go up after an accident? Unfortunately, the simple answer to this is yes. Whether the accident was your fault or not, making a claim will usually lead to an increase in your car insurance premium the next year and you could see an increase even if you don't make a claim.

Does your insurance go up after a claim that is not your fault? ›

Under California law, an insurer cannot increase your premiums when you aren't at fault.

How long can a claim take to settle? ›

The length of time a case takes to settle a personal injury claim can vary significantly, simple cases where liability is admitted can be settled in around 12 months or so. Large, more complex, high-value cases can take longer to settle.

How to value items for an insurance claim? ›

When it comes to the value of specific items, condition is more important than age. An older item that's in excellent condition should be depreciated less than a newer item that's frequently used or one that's regularly exposed to water, sun, wind, etc.

Can you sue an insurance company for ignoring you? ›

You may be able to sue your insurance company for bad faith if they intentionally neglect to perform the duties necessary according to your policy. If the insurance company knows that the claim is valid but they deny it anyway, you may be able to sue for bad faith.

What happens if you don't tell your insurance about a claim? ›

While many people avoid telling their personal insurance providers about accidents in a company or rental car to protect their no-claims, doing so could be viewed as non-disclosure. If providers' checks find you've withheld information, your policy could be invalidated.

What happens if an insurance company rejects a claim? ›

If an insurance company denies a request or claim for medical treatment, insureds have the right to appeal to the company and also to then ask the Department of Insurance to review the denial. These actions often succeed in obtaining needed medical treatment, so a denial by an insurer is not the final word.

How does an insurance claim affect you? ›

The greater the number of claims filed, the greater the likelihood of a rate hike. File too many claims—especially in a very short amount of time—and the insurance company may not renew your policy. If the claim is based on the damage you caused, your rates will almost surely rise.

Should you file an insurance claim before or after repair? ›

Report the Claim Before Making Repairs

Because it could not accurately calculate the damage due to the repairs, the insurance company was not required to pay anything on the claim. Do not let this happen to you.

What is one benefit of submitting a claim to an insurance company? ›

Submitting a claim to an insurance company helps cover expenses incurred due to a loss, which is a primary benefit of insurance. Insurance companies mitigate costs through negotiation and risk spreading, and policies are often structured to encourage prevention of losses.

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