Auto Insurance Claim Under Investigation

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Key takeaways...
  • After you submit a claim to an auto insurance company, it will be assigned to a claim adjuster to document all of the details about the incident
  • Make sure that all of the information that you provide to the claim adjuster is accurate so that you do not have to worry about being accused of filing a fraudulent insurance claim
  • There has been an increase in fraudulent claims being filed in recent years, which is why auto insurance companies are taking potentially fraudulent claims very seriously
  • If you do not like the way that your auto insurance company has handled the claim investigation process, you can find auto insurance coverage from another company
  • Be sure to keep copies of all documents related to the incident until the claim is fully settled

Whether you file your claim through your own auto insurance company or that of another party responsible for the accident, there will be a claim adjuster assigned to the case.

This person will communicate with you to obtain all of the information that you have about the claim and will assess the amount of damage involved.

Unless you have been dishonest in the materials and statements given to the adjuster, there is nothing to worry about regarding the claim investigation process.

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How an Auto Insurance Claim is Investigated

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A claim adjuster will gather all of the information relevant to the claim, such as the following:

  • The names and contact information of all parties involved
  • Statements of any witnesses
  • Estimates for repairs
  • Medical bills
  • Receipts
  • Photographs
  • Any other statements

You should always retain copies of whatever you submit to the adjuster.

Did you know that the insurance industry estimates that insurance fraud amounts to about $34 billion each year? This is a major loss for auto insurance providers, which is why they take so many steps to try to prevent fraud in the claim settlement process.

The National Insurance Crime Bureau (NICB) publishes a list of suspicious loss indicators to assist adjusters in rooting out fraud in an insurance claim. Some of these suspicious factors include:

  • Failure to mention pre-existing damage to a vehicle
  • Extremely vague description of other vehicle involved in a hit-and-run
  • Inconsistent accounts of the details of the accident
  • Injuries inconsistent with the type of accident described

While there is no bright-line rule about how many of these factors must be present in order to determine whether there was fraud involved in an insurance claim, the presence of multiple factors typically indicates a higher possibility of fraud.

In looking into a claim, the adjuster will likely interview as many available witnesses as possible in an attempt to rule out inconsistencies in descriptions of the accident.

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What You May be Asked After an Accident Claim

Once a claim has been filed, you can expect to be asked a long list of questions about the incident. Some of the many questions you may be asked could include:

  • When did the accident happen?
  • Who else witnessed the accident?
  • What were you doing immediately before the accident?
  • What all can you remember about the accident?
  • How was your vehicle damaged?
  • What types of injuries did you sustain?
  • What type of medical treatment did you receive after the accident?
  • Did you have any type of injuries or medical condition before the accident?
  • What is the contact and insurance information for anyone else who was involved in the accident?

It is crucial to be honest with your answers. It is perfectly fine if you cannot remember every single detail about the accident, but it is important to be accurate in what you tell the adjuster.

You should avoid accepting responsibility or getting emotional during your interview with the adjuster.

Stick to the facts as much as possible, and try not to embellish any of your answers so that you do not raise suspicion for your story being different from that of any witnesses to the car accident.

What You Can Do if You Want to Go to Another Insurance Company

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There is a long list of reasons why people might switch to a new auto insurance company. One of them is that they do not like the service or response time that they typically get from their current auto insurance provider.

It could be that while the rate that they receive is competitive, they are unhappy with their experience with their current car insurance company.

If you find yourself in that boat because of how one of your claims was handled by your auto insurance provider, you can easily switch to a new auto insurance company.

Before you jump the gun to switch, make sure that you take the time to compare different rates that are available online. With a simple online rate comparison tool, you can put your zip code in and see what types of rates would be available in your area.

After you receive a range of car insurance rates that are acceptable, you can choose among the possible providers to find the one that has the best reputation for great customer service in your area.

You also want to make sure that the company has a good history of operating in your area and appears to be financially secure so that you do not have to worry about having coverage for a claim down the line.

Some Last Thoughts on Handling an Auto Insurance Claim Under Investigation

If you receive notice that an auto insurance claim you have filed is under investigation, there is not necessarily need to panic right away.

Every claim that gets filed is the responsibility of an auto insurance adjuster to check and make sure that the documents that get filed are accurate.

The claims adjuster will work to figure out which party was at fault for the accident, the severity of the damage and whether there has been any type of fraud involved.

As long as you do not submit anything fraudulent to the auto insurance company, there is no reason to fret having a claims adjuster or any other type of third party investigator assigned to your claim.

If you think that your auto insurance provider has not been honest or fair with you throughout the claim investigation process, then you have every reason you need to find an alternate auto insurance company.

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