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Mar 05

A Quick Look at How Insurance Claim Works

Reading Time: 3 mins

Dealing with your insurance provider can often prove to be a complex and arduous process. Be that as it may, every responsible policyholder should be aware of their own duties, benefits, and rights upon subscribing to any insurance policy package. This will avoid costly mix-ups and misunderstandings down the line. So, before putting your signature on this contract or that document, it’s essential to make sure you select the right coverage, and that you know exactly what you’re insured for. It will also make the process easier to handle when you’re called to file an insurance claim after a personal loss or property damage.

In that spirit, we’ve put together a useful overview to help you gain more insight into the world and practices of insurance claims. You’ll become familiar with how the process takes place, what it involves, and how to deal with your insurance company in cases of policy disputes.


What Is an Insurance Claim?

In simple terms, an insurance claim involves making a formal request to your insurance provider in order to get full coverage or compensation whenever you’ve suffered a loss or property damage (called ‘policy event’). Once the insurer investigates, validates, and approves the claim, they will issue any due payments to the insured beneficiary, or to any affiliated interest party (family members, associates, etc.).


When Should I File an Insurance Claim?

Essentially, depending on factors such as what your coverage includes and other premiums, an insurance claim will indemnify you if you’ve suffered any sort of financial loss. Among the most common reasons for filing a claim to your insurer are health-related expenses (medical bills, goods, and services), damages to your vehicle after a car accident, property damages after a natural disaster (storms, hurricanes, earthquakes), and liability policies for landlords and renters against late payments from tenants. In the event of loss of life, a spouse or a legally designated relative will receive financial compensation if you’ve purchased life insurance prior to death.

A Quick Look at How Insurance Claim Works

How Does the Process Work?

It’s important to know that the claim that you’ve just filed, irrespective of its nature, will not be automatically accepted and processed by your insurer. The company will first conduct the necessary investigations and checks to ensure it is a valid one, and that it is grounds for reimbursement. Now, when that’s been established, and before proceeding with any repayments on their end, the insurance company will request that you pay a deductible—consider this the upfront amount you’ll have to put up to get your compensation. This amount or percentage is determined by a variety of factors, such as insurance package policies or your personal credit score. Higher deductibles usually entail lower insurance costs, but you’ll benefit the most from a low deductible.


Dealing with Disputes

In the United States, every year, thousands of policyholders file formal complaints against their insurers on the grounds that they have been operating in bad faith. This is known as insurance bad faith. 

As insurance companies ought to protect themselves against abuses and widespread insurance fraud, this can lead to potential mismanagements on their ends. If you live in Oakland, California, the team of experts over at Kerley Schaffer LLP will be an invaluable asset to have by your side for matters of settling disputes with your insurance provider. As a general principle, calling on the services of a team of qualified lawyers to represent you and your interests is bound to maximize your chances of obtaining a settlement and adequate compensation for your hardship, thus avoiding lengthy and complicated litigation procedures.


Always Read the Fine Prints

To avoid finding yourself in these types of unfortunate scenarios, we suggest that you always conduct your own research, explore your options, or consult with an expert to select the most fitting packages to insure yourself, your health, as well as your home and personal property against potential risks. Also, be sure to thoroughly review the insurer’s declaration page to be aware of your coverage. This will help you decide whether or not you are eligible to file an insurance claim after an accident or disaster.

It’s understandable that navigating the world of insurance can seriously put your patience and judgment to the test. Between choosing the right insurer, selecting the most adequate coverage, finding out your deductible, and filing an insurance claim after a loss, it is easy for anyone who’s not contract-oriented to feel lost and realize they may be getting ripped off by their insurer. If that’s ever the case, prepare to lawyer up!


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