What Is an Insurance Claim?

Insurance claims begin when you file a claim. Then, the insurer investigates that claim to see if your policy covers it and to determine who was at fault. You may have to pay a deductible before the insurer contributes to your expenses if the claim falls under collision or comprehensive insurance. Otherwise, insurance companies will pay covered claims up to your limit. If the claim isn’t covered, you’ll have to pay for the costs out of pocket.

Different types of insurance claims that apply to different car insurance coverage types. While this isn’t a complete list, here are the most common types of insurance claims based on coverage options.

• Bodily injury claims: Bodily injury coverage would mean filing a claim with another party’s insurance company for your injuries they caused as the result of a collision.
• Property damage claims: Property damage coverage also applies to the other party’s insurance company in accidents you didn’t cause. The damage could have been to your car or to another piece of personal property, like a mailbox.
• Medical payments claims: If you get into an at-fault accident and your health insurance isn’t sufficient to pay for your medical costs, medical payments coverage or personal injury protection can cover your bills.
• Uninsured motorist claims: Did you get into an accident with someone that drives without insurance, or doesn’t have high enough limits to cover your losses? Uninsured/underinsured motorist coverage claims could reimburse you for your property damages and/or bodily injuries.
• Comprehensive claims: If your car is damaged in incidents other than collisions, like car theft or a weather-related incident, you can use comprehensive coverage to pay for its damages.
• Collision claims: If you caused an accident that damaged your car, collision coverage would pay for its damages.

Claim types also break down into first-party claims that you file with your own insurance company, third-party claims that you file with someone else’s insurance company, and subrogation claims, which try to retrieve compensation for losses you didn’t cause.

To receive compensation on time, file your claim ASAP, after you’ve collected all the evidence you need (more on this below).

Legally, it’s important that you file a claim within your state’s statute of limitations for property damage or personal injury claims. Otherwise, your insurance company will deny your claim.

In some cases, the statute of limitations may be shorter than the above data, such as if the accident involved …

• A government entity.
• Drunk driving after drinking at a bar. For example, in every state except Virginia, South Dakota, Nevada, California, Maryland, and Washington, D.C., bars are responsible if they allow visibly drunk people to drive. If the bar is held responsible, the statute of limitations for claims is only 60 days following the accident.

Filing an insurance claim form is a straightforward process.

1. Gather evidence. Gather as much evidence as you can about the accident, including the make, model, year, and Vehicle Identification Number of each car involved; the insurance and contact information of all parties; details about the day the accident occurred; photos of the damage; and a copy of the police report. Write down the names and badge numbers of any police officers you dealt with as well.
2. Contact your insurance provider. Get in touch with your agent, or submit your claim online or through the mail. Refer to your company’s claims contact information.

3. Get your damage assessed. Once you have filed a claim, your insurance company will send an adjuster to assess the damage and determine fault.
4. Get repair estimates. If you prefer, obtain several repair estimates from different shops and give this information to your insurance provider.
5. Pay your deductible. If the claim fell under comprehensive or collision coverage and your provider covered it, pay your deductible.
6. Wait for compensation. Wait for your compensation to arrive, either over the mail or through a direct deposit, assuming the claim was covered.⁴ Read on for more information on what to do if your provider denied your claim

The claims process looks different based on whether you are filing a claim against someone else, or someone else is filing a claim against you.

Filing Against Someone Else

If you are filing a claim against someone else, you’re filing a third-party claim with their insurance company. Their insurer will investigate the claim and offer a settlement accordingly. To settle the claim, you’ll need to sign a release for damages. The amount you’ll receive also depends on your state’s negligence laws.

What do these negligence laws mean?

• Contributory negligence: The plaintiff can’t receive compensation if they were at fault in the accident at all.
• Pure comparative negligence: The plaintiff can receive money even if they were partially at fault; however, the amount of money is reduced by the amount of fault, so if they were found to be 15 percent at fault, they’ll receive 15 percent less compensation.
• Modified comparative negligence: In modified comparative negligence states, the plaintiff can only receive money if they are less than 50 percent at fault.
• Slight-gross negligence comparative: Plaintiffs can only recover if they displayed “slight” negligence and the other party displayed “gross” negligence.⁵

Any insurance company has certain responsibilities when it comes to claims; they can’t just ignore claims or not investigate them. They are required to take the following actions:

• Act in good faith, not assuming the claim is fraudulent and discounting it immediately.
• Investigate the claim thoroughly.
• Respond to claims in a reasonable time period.
• Pay or deny claims in a reasonable time period.
• If they deny the claim, explain in writing the reason for the denial.⁷

One of the biggest car insurance FAQs we get is “How long will an insurance claim take?” Unfortunately, we don’t have a direct answer to that, as the length of time depends on the type and severity of the claim. Expect to wait anywhere from a few weeks to a few months for a settlement.⁸

Companies can pay claims either by paying a repair shop directly or by reimbursing you for your losses. This could be in the form of a check or direct deposit.

Did your insurance company deny your claim completely, or refuse to compensate you for all of your losses? If so, you can appeal their decision:

1. Read your policy. Read your car insurance policy, including the declarations page, to see if you deserve coverage or not. If you think you deserve coverage, begin the appeal process.
2. Contact your company. Contact your company’s claims department or customer claims department and explain the situation.
3. Send evidence. Send in any additional evidence that demonstrates why you deserve full compensation.
4. Try to settle the dispute internally. Your company can provide you with appraisal or arbitration services to settle your dispute without involving any third parties.
5. Contact a third party. If that doesn’t work, you can contact a third party, such as a car insurance attorney, an independent arbitrator from the American Arbitration Association, or your state’s insurance department.⁹ Find your state’s insurance department below.

Will filing a car insurance claim make your car insurance rates go up? That depends on whether it’s a first- or third-party claim. If you weren’t at fault for an accident and filed a third-party claim, your insurance rates won’t increase. However, most of the time, first-party claims will increase your car insurance premiums, even if the accident or incident wasn’t your fault.

Although claims may increase your car insurance rates, they won’t impact your credit score directly. That being said, claims could affect your credit score indirectly if you can’t pay a deductible or premium and fall behind on your bills. But as long as you pay on time, claims won’t harm your credit score.

We’ve outlined three basic types of claims with real-world examples.

At-Fault Claims

Let’s say you hit someone and cause property damage to their car. In that case, the other party would file a third-party property damage claim with your insurance company, while you would file a first-party collision claim with your provider.

No matter which state you live in, you’d be liable for the other car’s property damages as well as your own. Your car insurance rates would increase unless the accident fell under an accident-forgiveness policy.

No-Fault Claims

If you’re pulling out of a parking spot when another car sideswipes you, injuring your shoulder, you could file a bodily injury claim with their provider. If you live in a no-fault state like Florida, you’d file a personal injury protection claim to pay for your medical bills, lost wages, and childcare.

Subrogation Claims

Imagine you’re the victim of a hit-and-run, but your insurance company uses surveillance footage to find the perpetrator who hit your car. It turns out that the perpetrator lacks car insurance, which might have been the reason they drove off so quickly.

In that case, your insurance company would file a subrogation claim, suing the driver directly in order to retrieve your compensation. The other option is to file an uninsured motorist, collision, medical payment, or personal injury protection claim to pay for your damages and injuries.

To be a savvy car insurance customer, you should understand insurance claims. For more information, read our complete guide to car insurance. If you’re looking to save money (maybe your teen driver just got their license), get an auto insurance quote or free car insurance quote, or bundle your car insurance with your homeowners insurance or life insurance.