How Car Insurance Companies Investigate Accident Claims

The Role of the Insurance Adjuster

After you've filed your claim with an insurance company, a representative of the company will contact you - likely by phone - for more detailed information. In most cases, it will be an insurance or claims adjuster. This person investigates claims on behalf of the carrier.

The auto insurance adjuster may ask you to clarify the initial information you gave, or just probe deeper to gain a fuller understanding of what happened with the accident.

As part of the investigation, the adjuster may:

• Request you send a copy of the police report for review.

• Contact the other driver.

• Talk to any listed witnesses to the accident.

• Visit the accident scene.

• Inspect your car for damages.

• Take photos of your car.

• Ask you to sign a medical release form so your records may be viewed.

• Contact your medical providers for information regarding your injury expenses.

Again, so much of this hinges on the accident, as well as how easy it is for the claims adjuster to determine what happened and who was at fault. But, no matter what, the claims adjuster will review your policy to make sure your claim is covered, and see if the possible expenses exceed your coverage limits.

Depending on the accident and the insurer, the adjuster may request you take your car to one of its approved body shops for an estimate. Or, the adjuster may ask you to go a shop (or two) of your choice and obtain some quotes. Keep in mind you have the freedom to perform the repairs at any shop you want, but you may have to pay the difference between that shop's estimate and the amount the insurer feels is a fair price.

The Settlement Offer

After evaluating all the pertinent information, the adjuster determines if you have a valid claim and how much the insurer will pay.

If your claim only involves property damage and you're going to have the repairs completed at an insurer-approved shop, the shop may bill the insurance company. In that case, you won't receive any payment directly from the carrier. (Remember, though, you'll need to pay the applicable deductibles.)

In other cases, the claims adjuster will send you a settlement offer that indicates a breakdown - by type and amount - of what the insurance company will pay.

If you're fortunate, the carrier will cover the full amount of your expenses. If you're not, be aware the claims adjuster usually has a dollar range to work with, and may be willing to negotiate with you and increase the amount.

If you can't reach an agreement with the adjuster, you may have other options, such as:

• Taking your appeal to the adjuster's supervisor.

• Mediation.

• Arbitration.

• Small claims court.

Ask Questions

It's easy to get confused by the investigation, and normal to wonder why certain questions are being raised.

If this applies to you, don't be shy about asking your own questions to determine what's going on and why. And, that's especially so when dealing with your own car insurance company; after all, you pay those premiums throughout the year for moments like these. If you are unhappy with your insurance company's handling of the situation, maybe it's time to get some quotes from a new insurance carrier.