What Happens During The Auto Insurance Claim Investigation Process

You can typically avoid having your insurance claim denied when your insurer decides to investigate it just by understanding the process. By knowing what to expect, you can give your insurer everything they require to complete their investigation and finalize your claim.

Insurance Public Adjusters of Georgia gathered information about how to get your claim started, what is needed to support it, how to interact with an investigator, and when you should seek professional assistance.

Initiating The Insurance Claim Process

If you’ve been in a fender bender that resulted in damages to your vehicle, your vehicle was stolen, or the accident was severe with physical injuries, your first order of business is to file a claim with your insurer. Keep the following in mind:

• Be forthcoming with information about the accident or theft.
• Answer all of the questions asked of you. Your insurance company is gathering information which it will try to verify before finalizing your claim.
• Do not lie or exaggerate about damages or the value of possessions.

While you are on the phone or meeting with your insurance company’s agent (and for all subsequent conversations or meetings with any representative from the insurance company), take notes that include:

• The day, date, and time of the call or visit
• The representative’s name and identification number
• The reason for the conversation/meeting
• Anything defined, promised, or arranged by the representative

In addition to the notes you take:

• Ask questions about items or details that you do not fully understand
• Repeat back and confirm dates, dollar values, and promises made by the agent

Leave no stone unturned. The agents and adjuster handling your claim are working for the insurance company. They will either pay your claim in a reasonable amount of time for a legitimate claim or void your claim and pay you nothing if it is found to be fraudulent.

Car Insurance Claim Documentation and Support

When accidents occur, they are likely traumatic, and the subsequent events can happen very quickly. The following documentation will help support your claim and preserve your memory to keep your facts straight:

• Date, location, and description of the accident/incident
• Multiple copies of the police report
• Medical documents from any/all injuries sustained in the event
• Photos of your vehicle and all other vehicles involved in the incident
• Photos of your injuries
• Statements from emergency responders (EMT’s), nurses, and your doctor

If your injuries have resulted in substantial medical expenses, your insurer’s adjuster or investigator may interview you, request access to medical records, or interview your family members. All of this is done in an attempt to prove that you were already injured before the accident.

Insurance companies have a vested interest in paying you as little as possible for your claim, and in many instances, the adjuster may initiate an investigation or refer your claim to an investigations department.

Insurance Investigation Interview Tips

As an investigator evaluates your claim, he/she may request an interview with you to straighten out details or uncertainties with the claim. Under these circumstances, you, the policyholder, have the right to request that the interview occur in a neutral location and even notify them that you have a limited amount of time for the interview.

The following tips will help you avoid any pitfalls or traps that may cost you when it’s time for your payout or even void your claim:

• If English is your second language and you wish to have the interview in your native language, you may request an interpreter.
• If you have any doubts or are unsure about doing the interview, seek legal assistance.
• Ask that the interview be recorded and for an unedited copy of it afterward.
• Remain calm and keep your composure.
• Take your time. There is no need to rush through an answer.
• Do not lie. Answer the investigator’s questions to the best of your ability.
• Do not guess an answer. You can say, “I don’t recall,” “I don’t remember,” “I am unsure,” or “I don’t know.”
• When you estimate times or details, clearly communicate that it is an estimation.
• When you need a break, ask for one.
• Only sign documents that you have read and fully understand. If you have hired an attorney or a public adjuster, have them review the document before signing it.

Insurance Claim Settlement

Once the insurance company’s investigation is closed, and the adjuster has processed your case, he/she will likely propose a settlement value. You may even be asked how much you are willing to settle for when your case involves personal injury.

Keep in mind that the adjuster is working for the insurance company and will make every attempt to save them money. In cases involving any injuries, it is highly recommended to hire a qualified personal injury lawyer before settling for any amount.

If you feel the insurance company is trying to lowball your claim or they are purposefully delaying processing your claim, you can hire a public insurance adjuster to go over the details of your insurance policy and fight for the maximum payout value allowed by your policy.

Auto Insurance Claim and Investigation Process

In this article, you discovered how to initiate an insurance claim, the documents, and information needed to support the claim, how to respond to an investigator, and when to seek professional assistance.

By keeping detailed records of your incident and all conversations with your insurer’s representatives, you can significantly increase the chances of your claim being paid promptly.

When your claim is under investigation, your inability to provide consistent information about the incident or subsequent occurrences may result in the denial of your insurance claim.

Sources:
insurance.ca.gov/01-consumers/105-type/95-guides/01-auto/hadaccident.cfm
bls.gov/ooh/business-and-financial/claims-adjusters-appraisers-examiners-and-investigators.htm
insurancelaw.org.au/factsheets/what-can-i-do-if-im-being-investigated-on-a-general-insurance-claim-factsheet/

Insurance Public Adjusters of Georgia
1100 Peachtree St NE Ste 200a Atlanta, Ga 30309
(404) 220-9366

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