How does an insurance company decide to pay a claim?

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Question:

How does an insurance company decide to pay a claim?

Answer:

In most car accident scenarios, it isn’t a matter of a car insurance company deciding whether or not to pay a claim; it’s more a question of how much the carrier is willing to pay in order to settle the matter and avoid costly litigation. Much depends on the specifics of the claim, including whether you’re dealing with your own car insurance carrier, or the other driver’s.

Vehicle damage claims you make under your own car insurance policy. These could include a collision coverage claim when your vehicle is damaged in an accident. You can file a claim under your collision coverage (or comprehensive coverage if you have it) whether or not the crash was your own fault or the fault of another driver.

When you make a collision coverage claim, it isn’t usually a matter of whether or not your insurance carrier will pay, but how much. You’ll need to get repair estimates, and the insurer will probably want to do its own inspection of the vehicle. If the car is deemed a “total loss,” a valuation of the vehicle will need to be made.

Learn more about Vehicle Damage Claims After a Car Accident.       

No-Fault car accident injury claims you make under your own car insurance policy. In the dozen or so states that follow no-fault rules, you’ll need to turn first to your own car insurance coverage to make a claim for injury after a car accident. Typically, your own personal injury protection coverage will pay compensation for your medical expenses and lost income, up to a certain amount.

Get more specifics on No-Fault Car Insurance Claims.

Third-party liability claims you make with the other driver’s insurance company. This is when things can get contentious, when you’re trying to put the other driver’s car insurance company on the financial hook for your losses stemming from a car accident.

You may or may not be involved in the back-and-forth haggling (the polite term is “negotiation”); that may be handled by your own insurance adjuster or your attorney. But when you’re claiming significant injury, you can expect the insurance adjuster to ask you to submit to an independent medical examination, and you’ll need to have documentation and other evidence to support every component of damages you’re claiming.

Take a look Inside the Car Accident Settlement Process.   

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