Here are our top Insurance Claims Frequently Asked Questions – FAQ: 

What is an insurance adjuster and why isn’t my agent handling the claims process? 

An Insurance Adjuster is a person who investigates claims and tells your insurance company how much they should pay for the damage. They will also determine if the claim should be denied. This position requires an Adjuster License, 960+ hours of training and continued education. Your insurance agent is not usually trained, and licensed, as a claims adjuster. 

What is the insurance claims process? 

There are usually four steps in the claims process:

Step 1 – Report the claim to the insurance company, and they will assign a claims adjuster. The adjuster will typically contact you within 3 business days.   

Step 2 – Provide any requested documentation to the adjuster.  This may include photos of the damage, itemized list of the issues or an estimate to repair the damage. 

Step 3 – The adjuster will review the documents, review your coverage and make a settlement offer – or deny the claim if there is not coverage available.

Step 4 – Settlement of the claim. 

What is a deductible?

This is a common Insurance Claims FAQ.  The amount of money the policy holder must pay out of pocket, as their portion of an overall claim amount, is a deductible.

How do I dispute a settlement offer? 

To dispute a settlement offer, start by reviewing the documentation you had submitted (photos, repair estimates, receipts). Then determine if you can provide any other evidence or improved documentation.

The settlement offer was calculated by your assigned adjuster.  However, we encourage you to contact your insurance agent. Your insurance agent can review the details and ask the adjuster to reexamine the evidence and calculations. 

If the adjuster is unwilling to reconsider the offer, you can contact a public insurance adjuster for an independent appraisal.  The cost for this appraisal will be your responsibility.  If the appraisal is helpful, submit this documentation to your adjuster (and/or claims manager) to reevaluate your claim. 

The last resort in disputing a claim settlement is to contact an attorney to review your case. 

Can I use my own repair company? 

Yes, you can use your own auto body repair company, or construction company.  That being said, if the cost of labor, cost of material or warranties are outside of the State’s standard rates, the insurance company can decline to pay the difference.  Your insurance company might also choose to pay the repair company directly. 

How much will a car claim impact my insurance rates? 

When deciding how much your car insurance rates will go up, after filing a claim, your insurance company will consider:

The final payout amount;

Your claims history;

Any claims-free discounts that were on your policy;

Other factors related to the insurance carrier specifically. 

If this is your first claim in 5-7 years, the average premium increase is 10% to 30%.

Why is the claim going through my insurance when it was the other person’s fault? 

The job of your insurance company is to “make you whole” as quickly as possible.  If the claim was reported to your insurance company, they will follow the claims process. They will repair the damage to your property (provided it is a covered loss).  Part of the adjuster’s job is to investigate the claim and determine who is at-fault. If the other party was at-fault, your insurance company has the option to “subrogate” and pursue reimbursement from the other party’s insurance company. 

What do I do right after I get into an accident?

Most importantly, pull to a safe location, turn off your car, turn on your hazard lights and make sure no one is hurt.  If someone is hurt, call 911 and do not attempt to move them. 

If there are no injuries, connect with the other party to exchange information.  Collect: Name, address, phone number of driver and any witnesses.  Driver’s license number, license plate numbers, insurance company details.  Take photos of the vehicles and damage, if possible. 

You can report the claim to the police, but in Washington State they generally will not send an officer unless property damage exceeds $1,000, there are injuries, or involves a pedestrian, bicyclist or motorcyclist. 

Why are aftermarket parts being used to repair my vehicle? 

After market parts or “generic parts” are brand new parts, and generally made by a third-party manufacturer.  They are as safe as Original Equipment Manufacturer (OEM) parts, but cost less.  In most cases, the insurance company will use after market parts as the standard.  With some insurance companies, you can pay the difference for OEM parts or request that coverage added to your insurance policy. 

Why do I have to pay my deductible if a loss wasn’t my fault? 

If the at-fault person’s insurance is handling the claim, you do not have to pay your deductible.

If you choose to file the claim with your insurance, you will be required to pay your deductible.  The good news is that your insurance company will likely attempt to recoup your costs by pursuing reimbursement from the at-fault driver’s insurance company. 

However, if an investigation determines that you are partially at fault, that will impact the reimbursement.  

Why doesn’t the settlement offer include the value of the custom parts on my car?

In most cases, the insurance company will undervalue (or not include) the value of your custom or aftermarket parts in a settlement offer.  

Aftermarket or Custom parts are upgrades you do to your vehicle after purchase.  These updates include customized wheels and rims, special tires, stereo, custom paint jobs, specialty seats, running boards, bed liners, hitches, etc.  

To avoid these issues, it is important to tell your insurance agent about your custom parts.  Consider purchasing Custom or Aftermarket Part coverage, if it’s available. 

How much will a home claim impact my insurance rates? 

When deciding how much your home insurance rates will go up, after filing a claim, your insurance company will consider:

The final payout amount;

Your claims history;

Other factors related to the insurance carrier specifically. 

If this is your first claim in 5-7 years, the average premium increase is 10% to 20%.

If you’re not sure whether you should file a claim, contact your agent. 

Upcoming Insurance Claims FAQs:

What do I do when I discover a potential home claim?

Can I start doing repairs on my house before the adjuster or repair company contacts me? 

If you have any other Insurance Claims FAQ questions that we can answer, or clarify, please share with us!  You can reach Lisa via email: info@northtowninsurance.com  

Disclaimer: This is a general overview, with the intention of bringing awareness to coverages, options, policy information.  However, coverage varies between carriers and states.  Please check your policy for specifics.