How car insurance claims and denial works?

Further reading

How Do Auto Insurance Claims Work?

Making a claim on your insurance after an automobile accident can be very nerve-wracking and confusing. For many people, doing so never occurs because they’re safe drivers who do their best avoid collisions. However, not everyone can be so lucky. Understanding how auto insurance claims work is very important, especially if you’re the kind of person who likes to know what’s going on at all times.

The Basic 5-Step Timeline of an Auto Insurance Claim

Although each auto insurance provider operates different, they all use some basic guidelines to ensure the proper reporting and adjustment of a policy after a collision or accident which requires a claim to be made. Here is how it usually goes:

Step One: You call and make the claim.

When you initiate your policy, you are typically given a toll-free phone number to contact in the event of an accident. Once you call and make a claim, the bulk of the process begins.

Step Two: An adjuster makes his or her report.

A licensed insurance adjuster will then come out to inspect your vehicle, either at your home or wherever it ends up being towed. They will use a combination of site evidence, police reports, and witness statements to determine what happened.

Step Three: The adjuster works with the provider to determine pay out.

Working with the provider, the investigation launched by the adjuster will then determine what is paid for and what is not. The pay out is typically determined using an algorithm that calculates policy holder needs, insurance coverage limits, applicable deductibles, accident fault evidence, and the provider’s bottom line. Keeping in contact with the adjuster may help you get the best compensation available.

Step Four: You may need to haggle.

An initial offer will then be sent to you from the insurance provider via the adjuster. You can either take the offer or haggle for more (or less, depending on the situation). Sometimes, however, you will not get this opportunity and will have to take what you can get.

Step Five: Your premium changes.

As a result of the claim made, your car insurance premium may change a bit afterwards. Do not be upset by this, as it’s only used to offset the cost of your claim and is not a permanent modification. Future safe driving records, on-time premium payments, and a lack of claims made will eventually bring things back to their original state.

How long will it take for my car insurance company to pay out?

It’s impossible to know exactly how long it’s going to take for your car insurance company to pay out on a claim that has been filed, though there are some rules, regulations, and laws that protect you as a consumer with a timeframe that requires them to have taken action on your claim or they could be in for some pretty stiff penalties.

Most states require that claims are paid out within “a reasonable time”, a nebulous definition that isn’t all that verifiable, but in Florida you can expect your insurance company to pay out on a claim within 30 days or you can begin legal proceedings against them to accelerate the timeline and may even be entitled to some kind of monetary compensation on top of the money for your actual claim.

Thankfully, by working with one of the best insurance companies in the state of Florida, one like Florida Insurance Now, you won’t have to worry about sitting around and waiting a month for your claim to be processed and taken care of.

This insurance company has a sterling silver reputation in the state for providing fast payouts and quick action for all of their clients, and that’s a big part of why they have been so successful and why they are so often recommended.

Of course, there are some things you can do to accelerate the timeline as far as how your claim will be processed and when you will receive payment. Here are some tips you’ll want to remember.

File your claim as quickly as possible

Initially, the ball is going to be very much in your court when it comes time to file the insurance claim in the first place. You’ll want to make sure that you file the claim as quickly as possible so that you can accelerate the timeline on your own and get quick service from your insurance company.

Provide as much documentation as possible

Your insurance company is going to do the majority of the “heavy lifting” regarding your claim, but any research and any documentation you can provide will help cut down on the time that they have to spend fiddling with logistics and can accelerate your claims timeline as well.

Keep on their case

At the end of the day, it’s important to remember that all of the insurance companies in Florida have a tremendous amount of customers and clients and receive claims each and every single day. If you want quick service you’re going to have to make sure that you keep in constant communication with your insurance company, remaining in their ear and on their case so that you can be sure that you aren’t being shuttled to the back of the line or ignored.

How car insurance companies investigate accident claims?

If you have been unfortunate enough to be involved in a motor vehicle accident, and actually need to reach out to your car insurance company, you’ll need to understand the process of how all car insurance companies – including Florida Insurance Now – navigate the accident claims process and go through their investigations.

Some insurance companies are going to have different steps that they take, different paperwork that they need to file come in different investigative strategies, but as a general rule all insurance companies are going to follow the same “framework”.

Understanding the framework will give you a lot of confidence, a lot of peace of mind, and inability to understand how you can help to speed up the claims process so that you get your vehicle back on the road.

The claim is filed and an investigator is tagged

The first step in this process is actually filing the claim with your insurance company in the first place.

This is something that you’ll have to do, and the process is very simple and straightforward. It almost always involves a quick phone call to your insurance company or insurance agent, and sometimes you’ll be able to use online tools or mobile applications provided by your insurance company to get the ball rolling.

After the claim is filed, an investigator is going to be tagged to your claim and your account and they will begin the actual investigation.

A claims investigator will usually come out to survey the damage and collect information

Gather claims investigator is either going to come out in person to survey the damage or request that you send detailed photographs, a copy of the police report that they can review, contact information for any other involved drivers, and an incident/accident list of all witnesses that can be contacted as well.

In person investigations sometimes involve visiting the accident scene as well, speaking with your doctors or your medical professionals and getting a copy of your medical documents, and finding out more about the severity of the damage and any injuries.

Your policy will then be reviewed

After all of the information is collected as part of the investigation your policy is then going to be reviewed to determine just how responsible and just how liable your insurance company is for damages and payments.

This is why it’s so essential to work with only the best and most reputable companies in the insurance game, companies like Florida Insurance Now. You want to know that you are as protected as possible without breaking your bank account along the way.

How auto insurance determines total loss?

There are a lot of different factors that go on behind the scenes to determine whether or not a vehicle is totaled in an accident, and insurance companies like Florida Insurance Now go to great lengths to make sure that if they consider a vehicle completely totaled and a total loss they are doing so appropriately.

Right out of the gate, your insurance company is going to have to determine the actual cash value (ACV) of the vehicle at the time it was involved in the accident. This has nothing to do with what you still owe on your vehicle or what you paid for it at first, but instead exactly what that vehicle could have been purchased for with cash right before the accident occurred.

This figure is going to take into account depreciation, the value of the vehicle itself, market factors in the local area, and a whole host of other proprietary figures that insurance companies usually play pretty close to the best.

On average, vehicle depreciation is going to run anywhere between 15% and 25% each year over the first five years of that’s vehicles life, and from their things get a little bit fuzzy.

On top of that, your insurance company is going to send out a claims adjuster to assess the actual vehicle condition before the accident occurred as well as what the vehicle is going to require as far as insurance covered repairs are concerned.

The make, model, and year of your vehicle is all going to be run through a proprietary system that takes advantage of a vendor database with nationwide data, providing an accurate estimate of exactly what that vehicle was worth before it was involved in the crackup. This database also takes into account local area factors, including the demand for your vehicle (pickup trucks, for example, are more in demand in rural areas the urban areas) and that will play a big role in the overall value of your vehicle as well.

Finally, your insurance company is also going to consider the resale value of any parts and metal that can be salvaged from the vehicle should be shipped off to a salvage yard when it receives the total loss designation.

Your insurance agent and claims adjuster are also going to discuss any potential future unseen damage that cannot be detected because of a significant accident, and this is where experienced adjusters rely on their knowledge and their training to figure out what could go wrong in the future that may be related to this incident.

Then, and only then, will the insurance company determine whether or not your vehicle is a total loss or not.

Why would car insurance claim go to court?

According to information released by the Florida court system and the Florida insurance community, about 80% of all cases that end up being heard in Florida courts are civil and personal injury cases – and a significant amount of them stemmed from car accidents.

Easily one of the most common types of civil cases brought to Florida courts on a day to day basis, insurance claims are regularly brought forward as part of a dispute – particularly if one of the parties involved in an automobile accident wasn’t carrying any car insurance themselves, or if other property (non-automobile property) was destroyed in the event of the accident.

Car insurance claims go through the court system when they deal with several factors, including (but certainly not limited to):

  • Disputes regarding who is truly at fault in the event of a car accident
  • Disputes regarding the extent of injuries in the extent of damages associated with a car accident
  • Disputes regarding low car insurance settlement offers from car insurance companies specifically
  • Disputes regarding any pre-existing injuries that are being blamed on the current car accident situation

… And that’s just the tip of the iceberg.

What to do if you need to bring a car insurance case to civil court?

Right out of the gate, you’re going to want to make sure that you reach out to your automobile insurance company.

It’s important that you work with legitimate professionals, like those at Florida Insurance Now, as these are the insurance professionals that are going to have your best interests at heart and are going to be willing to fight for your rights even in the midst of a civil case.

Secondly, you’ll want to make sure that you at least speak to professional legal representation. Attorneys understand exactly what these kinds of fights involve, and even if you want to walk into civil court with yourself as your own representation it certainly doesn’t hurt to get a professional opinion about how you should proceed forward – and you may even choose to lean on these experts to help you every step of the way so that you get the best results possible.

At the end of the day, it’s important that you make sure your rights are respected, that you are able to plead your case fairly and honestly, and that you are able to receive the compensation that you deserve while clearing your own name of any improper wrongdoing.

Are auto insurance claims public record?

According to the state of Florida, any car accident reports filed with the local police department or sheriff’s department are going to become public record 60 days after the date of the accident or the incident – and prior to that, only a handful of individuals or entities will have the opportunity to access this data.

This is important information for those that are looking to make sure that their auto insurance rates don’t go through the roof when they begin to shop for insurance after they have been involved in an accident that necessitated an insurance claim.

A lot of folks are aware of the fact that auto insurance rates go up just as soon as you file a claim, as the auto insurance company you are working with now deems you to be more at risk than drivers that aren’t carrying any insurance claims on their record at all.

Some people decide to start shopping around for new insurance when they are rate goes up, and if that is something that you are interested in doing you’re going to want to make sure that you begin shopping for insurance from another agency – like Florida Insurance Now – before that 60 day window he lapses and your automobile accident reports are released to the general public record.

Insurance companies may be able to learn about your accidents no matter what

Depending upon the severity of the accident that you were involved in, or the damages that were created as a part of that accident – particularly if criminal charges were assessed – your insurance company (and all insurance companies, for that matter) may already have access to that information.

Auto insurance companies will, from time to time, do deeper checks on their clients and their customers, especially those that have any kind of negative driving record under their belts already. These kinds of checks may be able to dig up information regarding criminal charges, particularly those associated with a moving violation or an accident report, and that may cause your cost of insurance to go up quite a bit.

At the end of the day, you always want to make sure that you are working with an insurance company you know you can trust to avoid and mitigate as much of this risk as possible. Do your level best to keep your insurance costs low by keeping your record clean and you won’t have anything to worry about!

Whose Auto Insurance Pays for the Incident?

When you get into an automobile accident, several factors are considered prior to any payments or adjustments being made. Without an insurance adjuster coming out to take a look, the outcome of a collision can be unfair to both drivers involved. Although the adjustment process can be a tedious and inconvenient one, such an event is necessary to determine what should happen next.

The Most Common Considerations Made by Auto Insurance Adjusters While every auto insurance adjuster does things differently, some of the same guidelines are used. In Florida, to determine who gets paid after an accident and to find out what policy premium changes need to be made, the following factors are considered:

Whose Fault Was It?

A variety of methods are used to figure out who was mostly at fault when an accident occurs. Speed limits, vehicle appearance, and witness statements (if available) are collected by the insurance adjuster to find out how the collision happened. By determining this information, the responsible party will become listed as the payer of the settlement and the rightful party will become listed as the payee.

What Type of Coverage Is Carried by Either Driver, If Any?

In some cases, a comprehensive auto insurance policy will cover uninsured drivers. In that case, the covered party’s coverage will pay for damages to their property and to the other party’s property as well. While this may seem convenient for the uninsured driver, it still leaves the insured responsible for paying increased premium prices in the end. However, if the at-fault driver has proper insurance, the not at-fault driver can enjoy a reasonable settlement once the adjustment is made.

In What State Did the Accident Occur?

All states have different rules when it comes to the type of insurance that must be carried. In Florida, it’s often required for motorists to carry coverage for uninsured drivers. Although it may seem unfair, that requirement is designed to keep everyone on the road safe, as well as to prevent the state from having to pick up the costs associated with bodily injury and/or property damage.

Were There Any Serious Injuries or Damages to Property?

Depending on the severity of the incident and the details determined by the adjuster, both parties may become responsible for paying damages after a wreck. Even with adequate state minimum coverage, some policies might only pay limited dividends. Contact your provider to find out more about what the cut-offs are.

Do Car Insurance Claims Expire?

The answer to the question depends on the specificity of the query. If you want to find out whether or not car insurance claims expire after the claims have been filed, then the answer is no. You can claim your insurance coverage and wait for your insurer to get back to you. The insurer could approve your claim or turn it down. You can follow it up with the insurer and potentially sue them if your claim is legitimate and their action illegal or against their own stated policies. If you are suing someone who has caused an accident, resulting in personal injury or damage to property, then too there is no expiry date of such a claim. The case may go to court or you may have an out of court settlement. Whether it is arbitration or a complete legal recourse through the court leading to its judgment, the claims don’t expire till the closure. Of course, the closure may not be in favor of the plaintiff.

In the state of Florida, car insurance claims do not expire but when you can file the claims do have a stipulated timeline. This is legally known as statute of limitations. The statute of limitations is in place to ensure speedy justice and to prevent fraudulent claims. If there is no time limit by when you should file a claim, anyone may become a plaintiff and make claims in the near or distant future, seeking damages for adverse consequences that may have nothing to do with the defendant. The statute of limitations is primarily about a timeframe that must be abided by. Here are the statutes of limitations pertaining to different types of claims.

  • Claims pertaining to personal injury should be filed within four years from the exact date of the accident. Ideally, the plaintiff should file a civil action lawsuit against the accused, in other words defendant, as quickly as possible. There is no harm in filing a claim early as that can be revised if the situation develops or worsens accordingly. However, claims cannot be filed after four years in most personal injury cases.
  • If an accident leads to wrongful death, then the family or kin of the departed may file a lawsuit within two years of the passing. The death must be directly related to the accident, either caused by it or owing to a condition that was caused by the accident. Wrong death lawsuits cannot be filed after two years have passed since the demise.
  • Injury claims or other damages being filed against the city or county or state government must be brought to court within three years from the exact date of the accident. Any claims filed later than three years may not be heard by a judge.

There are some exceptions to the statues of limitations, such as in cases of children or some odd instances when a serious medical condition is diagnosed much later.

Who is Car Insurance Ombudsman?

The Florida Office of Insurance Regulation serves as the car insurance ombudsman in the state. The office is responsible for regulation, enforcement of statutes and compliance with prevalent laws related to insurance. The office also monitors the industry markets and ensures fair practices across the board. Every state has its own laws in addition to applicable federal laws. Each state in the country has its own designated office regulating every major industry. The Florida Office of Insurance Regulation caters to this niche within the larger ambit covered by the Financial Services Commission.

The Financial Services Commission serves as the parent ombudsman for banking, insurance and securities. The commission is headed by the Governor and the Cabinet comprising of the Attorney General and Chief Financial Officer along with the Commissioner of Agriculture. They collectively appoint the various officials to oversee specific offices of financial and insurance regulation. The Office of Financial Regulation oversees the functioning of financial institutions and delves into consumer finance & securities. There is a bureau for financial investigations that ensures enforcement of laws and compliance with regulations. Everything from major banks to credit unions, smaller financial enterprises and even individuals, finance companies lending to consumers or businesses, money transmitters, payday loan companies and currency exchange services among others is monitored and regulated by the Office of Financial Regulation.

The Office of Insurance Regulation is the ombudsman for the insurance sector and that includes auto insurance in Florida in addition to life, health, casualty, property, specialty and other types of insurance policies. The office is responsible for all oversight, solvency and the modus operandi of insurers. The regulatory department is headed by an Insurance Commissioner. Presently, the Insurance Commissioner is Mr. David Altmaier.

While the primary function of the ombudsman is to regulate the industry, to ensure free and fair practices, to come down heavily on illegalities or questionable practices and to determine which insurers should operate and who should not, there is also an implied role. The ombudsman offers reports and statistics pertaining to all registered insurers. The reports offer insightful data to help consumers determine what is best for them. In a nutshell, the office with all its resources and knowledgebase can be the one stop solution for anyone seeking car insurance in Florida. However, the office doesn’t serve as an insurance consultant and do not offer personalized assistance, as may be necessary in most cases.

Do car insurance companies hire private investigators?

Even though most people are familiar with the fact that major car insurance companies (including operations like Florida Insurance Now) will send out claims adjusters and claims investigators to figure out exactly how much they have to pay out as part of an insurance claim, a lot of folks have no idea that insurance companies can – and often will – hire private investigators to make sure that everything is on the up and up and they aren’t being taken for a ride.

This surprises a lot of car insurance customers (for obvious reasons) and certainly isn’t the kind of thing that anyone wants to think about – especially when they are paying so much money for insurance to these companies in the first place.

At the same time, the overwhelming majority of legitimate car insurance companies out there aren’t hiring personal investigators to make sure that they are able to get off the hook for paying for legitimate car insurance claims, but are instead protecting themselves from fraud that happens more often than most people want to acknowledge.

Is it legal for Florida car insurance companies to hire private investigators?

Not too long ago, the Florida state courts determined that it was in fact completely legal for car insurance companies to hire private investigators to help protect themselves against fraudulent claims.

They also stated that Florida car insurance customers should have a reasonable expectation that an investigation will be made by an insurance company after the filings of ALL claims, and that any information discovered in the event of this investigation can and likely will be used in litigation if things progressed that far.

At the same time, there are significant limits that the Florida state courts have placed on what these private investigators can and cannot do. Basic rights to privacy MUST be acknowledged, and any invasion of and injured parties right to privacy may entitle that injured party to significant renumeration from the insurance company on top of paying out for a legitimate insurance claim in the first place.

Investigators aren’t allowed to snoop around someone’s home, introduce themselves under false pretenses, follow anyone closely in public spaces, or conduct surveillance in an unreasonable or obtrusive manner.

If you ever feel as though a private investigator is being unreasonable after you have filed a legitimate Florida car insurance claim, be sure to contact the local authorities as well as your insurance company to see what can be done about moving forward amicably and to get the harassment to stop immediately.

Do car insurance companies report accidents to the DMV?

It’s never fun finding yourself involved in an automobile accident, regardless of whether or not you or the other party were at fault.

You have to exchange insurance information, you have to deal with the insurance claims process, and (obviously) you have to deal with your vehicle being damaged – and sometimes not operable at all until it is repaired, if it can be “brought back to life” at all!

Worst of all, any accident (regardless of whether or not you were at fault) is going to go on your insurance record. The odds are pretty good that your insurance prices are going to go up, though if you’re working with a company like Florida Insurance Now the prices probably won’t jump as high as they might have otherwise, and nobody wants to deal with all of that headache and all of that hassle.

Some folks are nervous about their insurance companies reporting accidents to the DMV, putting points on your license and potentially taking your license to drive away from you depending upon the severity of the accident or the number of accidents that you have had while driving out on the open road.

But do insurance companies actually report incidents to the DMV?

It turns out that they do not report accidents as a general rule, though there are some requirements for your insurance company – and the local police – are required to alert the DMV about an accident or incident that you have been involved in.

In most circumstances, any accident that causes more than simply “fender bender” damage is going to require you to file a report with your DMV. Minor bumps, collisions, and little incidents that you and another driver can settle amicably obviously may not be reported to the Department of Motor Vehicles (or the police, even), but if you cause more than $1000 worth of damage the odds are good that you want to put in a call to your insurance company and they may send a copy of the file over to the Department of Motor Vehicles.

If someone is injured or (heaven forbid) killed in a car accident or a collision, it must be reported to the Department of Motor Vehicles in every single situation and every single circumstance. If the police or at EMT services are contacted, the odds are good that report is being filed with the DMV as well, and depending upon specific situations outlined in your insurance documents you may have to file the reports all on your own to expedite the process.

Contact your insurance representatives to learn more about this issue should you find yourself involved in an accident.

Are car insurance settlements taxable?

In almost all circumstances and situations, car insurance settlements are not going to be taxable – though there are exceptions to this rule and you want to make sure that you know exactly what you are getting into when you receive a settlement and what your tax liability may be on that settlement going forward.

As a general rule, if you receive an insurance settlement for physical injuries and did not take an itemized deduction for medical expenses that are associated with that specific injury, you are going to be able to take advantage of that car insurance settlement as a completely nontaxable entity.

In that situation, you SHOULD NOT include that car insurance settlement as part of your income when you go to file your taxes for that year.

At the same time, there are some situations where your car accident insurance settlement is going to be a taxable item and you’ll need to know exactly what you’re getting into before you file your taxes. The IRS is not at all that accepting of big mistakes having to deal with insurance settlements, and while you’ll want to lean on your tax professionals to help you out in these situations you’ll also want to work with legitimate insurance companies like Florida Insurance Now to protect yourself as well.

What part of my insurance settlement is taxable?

Part of your insurance settlement can be taxable if it is going to be used to offset lost wages, to repair or replace property that has become damaged, or to provide compensation for any pain and suffering you may have been dealt as an event of this accident.

Any settlement money that comes as part of a punishment the offending party is also going to be taxable, and you’ll want to make sure that all of this information is broken down as part of your settlement so that you have the paper trail to prove these details should you find yourself going through an audit later down the line.

Work with your tax preparation agents to figure out the fine details

At the end of the day, it’s always important to speak with a professional tax preparation agent when you’re dealing with irregular situations like this.

These are the kinds of representatives that will have the experience, the education, and the training to navigate these situations, and will be able to provide you with the information and insight you need moving forward about how best to proceed.