How Does the Insurance Claim Process Work?
You can either file a claim with your own insurance company, which is called a first-party claim, or with another driver’s insurance company, which is called a third-party claim. The laws, procedures, and reasons for filing each type of claim are different.
When to File a First Party Claim
People usually file claims with their own insurance company when they were involved in single-car accident, or if they were the at-fault driver in a multi-car crash.
When you file a first-party claim, you do so on the basis of your contract with your insurance company. This means that you can only file a first-party claim for damages that are covered under your insurance policy.
To determine whether your vehicle’s damages are covered, look under the collision and comprehensive section of your policy. If you want compensation for injuries sustained in a crash, look at the medical payments section.
When to File a Third Party Claim
If you think another driver was the cause of an accident in which you were involved, you can file a claim with that driver’s insurance company.
Illinois is a so-called “fault state,” which means that you can recover from another driver’s insurance company so long as you were less than 50% responsible for the accident. Other states have “no-fault” systems, which require that accident victims exhaust their own insurance coverage before attempting to recover from other drivers or their insurance companies.
Claims investigators will analyze the facts of the case, determine who is at fault, and adjust the awards accordingly. For example, if you are 20% responsible for an accident, you can expect to receive only 80% of the compensation to which you would normally be entitled.
Filing a Claim For Car Damage
Whether you’re attempting to recover from your own insurance company or that of another driver, you’ll need to substantiate the damages for which you are seeking compensation. Insurance companies have investigators or claims adjusters whose job it is to ensure that claims accurately reflect the claimant’s actual damages.
If you’re claiming car repair expenses, the insurance company will need an estimate from your repair shop. Sometimes, they will tell you that the repair estimate is too high, and ask you to either go to another shop or pay the difference.
The insurance company will also investigate whether the repairs are only for damages caused by the accident. For example, you may have damaged your car a few weeks before the accident, and then attempted to have all of your car damage repaired under the accident claim.
For this reason, it can be useful to take photos of the accident scene and your car damage. If you can provide credible evidence to the claims adjuster or investigator, not only will his or her job be easier, but you’ll have a better chance of getting the compensation you deserve.
Filing a Claim For Medical Expenses
When claiming for medical expenses, you’ll need to prove that the treatment you received was reasonably necessary to address injuries that were actually caused by the accident.
An investigator will compare your medical bills with the police’s accident report and any available witness testimony. If he or she sees anything suspicious, you might need to provide further justification for your medical expenses. In some cases, investigators will follow an accident victim around to determine whether the injuries are real or not.