How to File an Insurance Claim so You Will Likely WIN It:
An Insider's Guide
© 2019 Health Realizations, Inc.
You've been paying your insurance premiums for years, and when it comes time to actually file a claim, you should theoretically be able to fill out the paperwork and wait for your reimbursement check to arrive.
Filing an insurance claim? There are time limits on how long you're covered after an event, so don't delay sending in the paperwork.
Of course, what's simple in theory is quite complex in reality. Insurance companies, despite their altruistic ads and slogans, do not want to pay you for anything if they can avoid it.
Key Tips to Get Your Insurance Claim Approved
The following factors will improve your claim's chance of being approved.
File the claim quickly. Insurance companies say they want claims filed "as soon as possible," which usually translates to mean within 30 days. However, the sooner you file, the better.
Know what's covered. Before filing a claim, it's essential that you know what's covered by your policy and what the deductibles are.
Document everything you can. If the claim is for an auto accident, take photos as soon as possible. If it's for your home, take photos of the damage (and, even better, take photos/video of your home prior to the damage so you have something to compare against).
Make sure everything is accurate. When filling out paperwork, make sure you have the details correct, as mistakes or inconsistencies can cause your claim to be denied or delayed.
Contact your state insurance department. If you feel it's taking longer than is reasonable for your claim to be processed, or if you have questions about settling your claim, contact your state insurance department for help.
Tips for Filing Auto, Health and Homeowner's Insurance Claims
If you've made a lot of small claims in the past, you may be better off not reporting a minor fender-bender. Why? Insurance companies are known to raise premiums and even cancel polices for people who file a lot of claims.
Auto, health and homeowner's insurance represent three of the largest insurance categories among Americans. If you must file a claim, keep in mind these important tips:
For health insurance claims, often the doctor's office will submit the claim for you. However, claims are often denied because of small errors in filing (such as duplicates being filed), technicalities or mistakes (in your health insurance ID, for instance). If a claim is denied, ask your doctor to check the diagnostic and procedure codes for accuracy. If it is still denied, you can appeal the denial, a process that involves asking your insurance company to reconsider the claim.
For auto accidents that involve a collision with another party, don't admit fault at the scene or offer to pay for damages, both of which could impact your insurance coverage. Meanwhile, keep a copy of the police report, and be sure to find out the other party's insurance information before leaving the scene. As soon as possible, write down your detailed recollection of what happened.
Get a second opinion. Whether repairs are needed for your home or automobile, get a couple of estimates to be sure you have an accurate measure of how much the damages will cost.
Make small repairs, but not permanent ones. If your home is damaged, most insurance policies will cover small temporary repairs that are necessary to ensure your safety (or the home's). However, do not begin any major, permanent repair projects until you've heard from your insurance company. Be sure to save all receipts for every small repair you make.
When Not to File Insurance Claims
That said, there are times when you may be better off not filing a claim at all. This is particularly true of auto and homeowner's insurance, when filing a claim can result in an increase in your premiums.
According to experts, if the claim is small (less than $1,000 after the deductible) you may want to just pay for the repairs on your own. This is especially true if you've filed any small claims in the last few years, as insurance companies may raise your rates or even drop your insurance if you file too many claims.
"Each company has different procedures, but generally if you file a lot of small claims that can be problematic," said Jeanne Salvatore, vice president of consumer affairs for Insurance Information Institute in a CNNMoney.com article. "Statistically, most people only file a claim every 8 to 10 years, so if you're filing more than that you stand out."
Other instances when it's best not to file a claim are when maintenance problems on your end, such as a leaky pipe, may have caused the damage.
Further, just inquiring about a claim can count against you. In some circumstances, insurance agents are required to report inquiries about claims (even if you don't end up filing the claim), so always ask if the information will be reported before you turn to your agent for help.