Car Accident Claim Investigation | Nolo

Getting into a car accident is often a stressful experience, and the resulting car insurance claim process can be almost as unpleasant. Depending on the type of claim you file and the facts surrounding the accident, the insurance company’s investigation process can take anywhere from a week to several months.

In this article, we’ll look at:

Reading: How long does car insurance investigation take

  • why an investigation is necessary for the auto insurance claim process
  • what the insurance investigation process involves, and
  • what happens if you don’t cooperate with the investigation.
  • why should car insurance companies investigate a car accident?

    There are two main reasons auto insurance companies will investigate your accident after you file a claim.

    first, they are protecting themselves against auto insurance fraud. According to the Insurance Information Institute, more than 15 percent of all automobile claim payments made in 2012 were the result of a fraudulent claim.

    To protect themselves, auto insurance companies will ask their policyholders and third-party claimants to provide evidence to support their car accident claim, and will also send adjusters or investigators to collect their own evidence about the cause of the accident and the claim. damage or injury.

    Second, the auto insurance company is trying to properly assess your claim. there could be confusion as to the cause of the car accident or the extent of damage and/or injuries resulting from the vehicle. the only way to get to the bottom of problems like this is to gather as much information and detail as possible.

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    Generally speaking, the auto insurance company is not trying to find a reason to deny or delay your claim. Most claims adjusters want to process claims as efficiently and fairly as possible. The auto insurance company (especially yours) also doesn’t want adjusters to deny claims without proper investigation, which could lead to a “bad faith” insurance claim.

    Get the basics on the role of insurance in a car accident case.

    what happens during an auto insurance claim investigation?

    The answer here depends on the type of auto insurance claim you’re filing and what potential red flags your claim may raise. If the accident involved no injuries and your vehicle damage fell below a certain dollar threshold, the investigation may take a few days and will be resolved once you answer a few questions over the phone and submit a quote from an auto repair shop. local.

    If your claim involves significant car accident injuries, the investigation may be more complicated. Not only is there potentially much more money at stake, but the claims adjuster will need more information to confirm the nature and extent of your injuries and the resulting medical treatment.

    This means you may need to answer more questions about your injuries, provide (or authorize access to) medical records, and obtain a copy of the police report for the adjuster. then the insurance adjuster will likely talk to other people involved in the accident and witnesses. Other investigative tools available to an adjuster include:

    • take a recorded statement (beware if the other driver’s insurance company requests this)
    • request your cell phone records
    • visiting the accident scene
    • perform a background check
    • review your social media presence, and
    • obtaining medical clearances.
    • The more losses you claim, the more thorough the auto insurance company’s investigation will be. but sometimes a more intensive investigation means the insurance company has identified a potential problem with your claim.

      when the adjuster might conduct a more thorough investigation

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      If the insurance company suspects a fraudulent auto insurance claim, they will look for information about the possible motivation for the fraud and evidence that the claim may be false.

      for example, the investigation will check if you have financial problems (by looking for liens on your property or recent bankruptcy filings, for example). They might also take a look at your social media presence to confirm the truth of what you’ve already told the adjuster.

      So if your claim includes a large medical bill for a shoulder injury, but the day after the accident there’s a video of you playing an intense game of basketball on social media, the auto insurance company will likely suspect fraud. . Or maybe you said the car accident happened on a certain date, but your social media feed shows you were on a cruise ship at the time.

      Requests for cell phone records are becoming more common, especially when it comes to determining fault in a car accident. Because the use of electronic devices is a leading cause of car accidents, your insurance company may consider the possibility that your phone use may have caused or contributed to the accident. cell phone records can confirm (or disprove) that you were using a device at the time of the accident.

      cooperate with the insurance company’s investigation

      One thing to keep in mind during this investigative process is that you are under no legal obligation to provide the information requested by the insurance company. Unless your claim has moved to the lawsuit stage and there is a court order stating so, an insurance company has no legal way to force you to provide the information it requests.

      This doesn’t mean it’s a good idea to rule out the claims adjuster’s investigation. While your own auto insurance company is contractually obligated to pay a valid claim, this obligation is contingent upon your taking reasonable steps to cooperate with the company’s investigation. by not cooperating with the investigation, your claim will almost certainly be denied. there is also the risk of being left as insured. If you’re filing a third-party claim with the at-fault driver’s auto insurer and decide not to cooperate in the investigation, don’t be surprised if the adjuster comes to the table with a minimal settlement offer.

      Normally, an auto insurance company isn’t out to catch you, but if they can find a plausible reason to pay you less than what you’re asking for, they usually will. that’s one of the reasons why it’s a good idea to consult an attorney after a car accident.

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