By Ed Sneineh

A claim is defined as the Insured’s demand from an insurer (insurance company) to pay for damages under specific insurance contract. You make an auto insurance claim when you ask an insurer to make payments to you in connection with bodily injury or property damage that you sustain because of an accident.

In the event of auto accident you need to file a loss notice with your company. A police report needs to be filed in the event of ‘hit and run’. The insured cannot start repairing the damaged vehicle without first showing it to the company for inspection of the damage. The insured is required to cooperate with the insurer to the fullest extent in order for the claim to be processed.

A claim adjuster is normally assigned to your claim. The adjuster is the person responsible for investigating, evaluating, and settling the claim. He/she is the one who will determine if the loss is covered or not, the monetary value of the loss, and the settlement (if any). During the process of adjusting the claim, the adjuster may need to interview the claimant, other people, take pictures of the accident, review police records, request estimates, etc.

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Once you file the claim the insurance company is required by law to respond to you within specific number of work days (in Illinois it is 21) from filing the claim. You are obligated to provide the insurance company with certain documents if they are requested, such as sworn statements, police reports, medical bills, repair bills, bill of sales, titles, etc.

You are not required to use company’s suggested repair shop. However, if your repair shop is charging more than the company’s suggested shop, you may have to pay the difference from your pocket. If there is existing damage on the vehicle your insurance company may deduct an unlimited amount from the value if your vehicle has old, unrepaired collision damages and they do not have to pay for the “betterment” of your vehicle (for example brand new muffler or new tires.)

You do not have to accept replacement crash parts. Despite the fact that insurance companies aren’t required to use original equipment manufacturer (OEM) replacement parts, such as GM or Ford, you have the final decision of which parts will be used to fix your vehicle. In case your company wants to use non-OEM parts, and you request more expensive OEM parts, you may have to pay the difference.

Handling a claim does not have to be a rough experience. It can be an easy experience if you focus on your responsibilities in a claim and rights. Always document your communication with claim departments by faxing things, sending registered mail, email, as opposed to leaving messages and verbal communication.

If you have a complain about the repair of your vehicle, take it first to the body shop. Explain the problem to a manager. If your problem is not resolved take it, in writing, to the claim department of your insurance company. Give them sometimes to respond, and if nothing work to your satisfaction you can always go to the Attorney General office to complain about the body shop/ repair shop, and to your state’s insurance department if you feel that your claim was mishandled.

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