An Inside Look at How Insurance Companies Pay Out Claims
So you’ve filed an insurance claim. What happens next? Here’s the insider’s guide on how insurance companies evaluate and pay out claims.
Any event that triggers an insurance claim is a stressful one, to say the least. Your client may have incurred property damage as a result of your contracting work, or one of your employees may have been injured on the job.
Fortunately, filing an insurance claim is a fairly straightforward process. You share all pertinent information with your insurance company, and they get to work evaluating your claim.
When the dust has settled and you’ve filed your claim, you may find yourself wondering, “When will I get paid?” Below we share the details on how the insurance claim process works, from submission to payment.
1. Filing Your Claim
Before we get into how insurance companies evaluate and pay claims, let’s quickly review how filing a claim works.
Your goal is to start the filing process as soon as possible after the accident occurs. This is your best opportunity to give your insurance company the advantage in managing and fairly evaluating your claim.
Your first step should be to document what happened and file a claim report with your insurance company. While it’s fresh in your mind, write down a full incident report, including how the accident happened, when, and where. Get the contact information of everyone who was there, as you’ll need it later when you file the claim. Take photos at the scene. If property damage occurred, do what you can to temporarily repair the property to prevent further damage, keeping track of expenses and a copy of all receipts.
With this information on hand, you’re ready to file your claim. At Thimble, all of our policies are underwritten by Markel Insurance Company. If you have a policy with us, you can start the filing process by visiting Markel’s website, emailing firstname.lastname@example.org, calling 800-362-7535, or sending a fax to 855-662-7535. When you report your claim, you’ll want to have the following information readily available:
- Names, email addresses, and phone numbers for the insured and the claimant, if it’s someone other than yourself
- The same contact information for anyone else involved in the claim
- Your policy number
- The date, time, and location of the loss
- A description of the loss from your incident report
- Any other relevant information you can provide to assist your insurance company with evaluating the claim, including photos of any damage or missing items, police reports, etc.
Once your claim is submitted, you’ll receive a confirmation message from your insurance company with a claim number you can reference during any subsequent communications.
2. Evaluating Your Claim
Once you file your claim, your insurance company will begin evaluating it for reimbursement. The amount of time that this part of the process will take can vary based on the complexity of your claim and the number of individuals involved. If you’ve filed a claim through Markel, you can rest assured that their team will respond as quickly as possible to get your claim processed.
First, the insurance company will follow up with you to let you know if they need you to complete additional forms or provide more information. For example, they may require you to work with an approved vendor to evaluate and assess the cost of property damage. An insurance adjuster may be assigned to your claim, who may communicate with you, the claimant, vendors, and other parties. Injured parties may be asked to submit to an independent medical examination.
This step becomes a collaborative process between you and your insurance company. To speed things along, make yourself available to the insurer whenever they have follow up questions, and be sure to send them any new information as soon as you get it. This includes:
- Bills and invoices
- Assessments of damage from vendors and other professionals
- Emails or letters from claimants or others involved in the incident
Keep a copy of all this correspondence, and reference your policy number and claim number on each item as you send it in. The sooner they have a full picture of the incident, the faster your insurance company can process your claim. In the meantime, avoid discussing the claim with anyone outside of your insurance company.
3. Approving or Denying Claims for Payment
Next, the insurance company will determine whether to approve or deny your claim. Coverage can be denied for a variety of reasons, depending on your policy. If any of the following apply, your claim may be denied:
- The incident took place outside of your policy period
- The type of incident or damage isn’t covered under your policy
- The claim was filed outside of the time required by your policy (for example, some policies require you to file a claim within 24 hours)
- You have an outstanding payment on your insurance premium
To fully understand any scenarios in which your claim may be denied, it’s important to read through your policy. If you have any questions about potential exclusions, speak to your insurance agent (in this case, Thimble!). You’ll also want to review your deductibles carefully.
If your claim is denied, your insurance company will give you a detailed explanation of why it was denied.
4. Receiving Your Payment
If the insurance company determines that there are no exclusions or other factors, such as non-payment of premium, preventing you from coverage, your claim will be approved.
Then, they’ll determine the amount of reimbursement and issue payment. Depending on the nature of your claim, you may receive a check directly, or the insurance company may pay vendors on your behalf. The total amount you receive will be based on the amount of coverage in your policy and the specific details of your claim.
For example, if you’re a handyman and accidentally damaged a window in your client’s garage door when entering the home to perform your services, that property damage would be covered under your General Liability policy. You may have had to perform temporary repairs, such as duct-taping the window. Your insurance company will reimburse you for those costs. Then, if they send out one of their approved vendors to complete the repairs, they may pay that vendor directly.
How to Speed Up the Insurance Claims Process
It takes two to tango—or to process an insurance claim. By law, your insurance company is required to act in good faith, communicating with you on an ongoing basis throughout the investigation and evaluation process, approving or denying your claim within a reasonable amount of time, and, if it’s approved, remitting payment promptly.
Those are your insurance company’s responsibilities. For your part, you can make the process go faster by:
- Contacting your insurer as soon as possible after the incident occurs.
- Filing your claim quickly afterwards, either online, or via phone, email, or fax.
- Completing any additional forms your insurance company sends you.
- Sending in supplemental information as soon as you get it.
- Working with your insurance company to assess damages, using their approved vendors.
- Being available and responsive when the adjuster has any follow up questions.
Our editorial content is intended for informational purposes only and is not written by a licensed insurance agent. Terms and conditions for rate and coverage may vary by class of business and state.
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