Insurance Claims Process and What to Expect
By: Kathleen Murray, Capstone Brokerage Client Advocate, June 2014
Many years ago an insurance claims adjuster would get into a company vehicle with their Polaroid camera, calculator, note pad and perhaps Dictaphone in hand. They would visit the scene of the claim and survey it. Boy, have things changed. With technology forever evolving so has the process of processing claims. In fact many claims adjusters never even leave the office. They can estimate damages and allocate funds on an insurance claim right from the comfort of their cubicle.
Many businesses owners when faced with a loss don’t know what to except in the claims process. There is a standard procedure that takes place for most types of claims. It is very beneficial to have a knowledgeable broker help guide the situation. A broker can help ensure proper documentation is obtained and will help ease the filing process. A broker can also ensure a settlement and payment is received as quickly as possible by having knowledge of the claims process.
The following is the standard procedure used to process claims:
-The broker or insured report the incident to the insurance company. The two most essential procedures on the part of the broker are to ask the insured if they have their permission to report the claim on their behalf and when reporting the claim, to tell the insurance company they are reporting the claim with the permission of the insured. We recommended calling your broker immediately when a loss occurs.
– A claim number or reference number will be assigned in most cases by the insurance company at the time of report. This will be used on all future documents and submissions.
– The claims adjuster usually takes 24-48 hours to contact the insured directly. The adjuster then must obtain a narrative report directly from insured.
- Note: The insured must provide the narrative directly, If not, the claim will not proceed from this point. The insurance policy is a contract between the named insured and the carrier and the adjuster is bound by rules and regulations to obtain the narrative report directly.
– The insured should start gathering information during this time that will be needed to process the claim. A broker can assist to make the process easier. A few examples of information that may be needed during the investigation stage:
- Photographs of all of the damaged property. This can include structural objects, property and all objects –nothing should be thrown out until the adjuster has received and reviewed all the submitted documents or until an independent adjuster is assigned to perform a physical inspection of the damaged property.
- Make a list of damaged or lost items.
- include items date of purchase, value, and receipts, if possible.
- Provide invoices for work performed by out sourced company
- Estimates to repair or replace damages.
– After the insured is contacted by the insurance company the investigation stage begins. The insured and the broker will help to provide all information that is being requested by the adjuster.
– The claim is reviewed and a claim amount is assigned. The insured will be notified of the claim amount, minus applicable deductible, and then they must agree to the terms of the claim. Once confirmed all parties are in agreement a check will be issued. This can take approximately 2 weeks to be issued and a week to be received.
Behind the scenes there are so many advancements in the claims process there are even apps to help calculate liability, report losses and provide estimates for the consumer. The broker remains the best tool for businesses. A broker has been through the claims process and knows what to expect. Look for my future insights into the Workers Compensation Claims process and how to handle an Automobile claim.
