When you have an accident, you not only walk away from obtaining advantageous insurance plans. Besides the fact that you surely won’t get car insurance now and pay later, you will also have to deal with the stressful claim process.
Every auto insurance company has its own method of processing claims. Still, the extensive process conducted by insurance companies regarding motor claims are as follows:
Acknowledgment of the claim
The insurance company may assign the claim to its claims supervisor or claims representative. The insurance claims representative will immediately acknowledge the insured about the receipt of the claim, provide them with the motor insurance claim form and solicit necessary documents as follows (the list is not exhaustive).
The claim application should be completed appropriately with the accident’s details and approved by the insured, or the authorized driver, or their legal representative. The claim form should be submitted along with the following general requirements.
Let us have a look into the general requirements and special requirements for processing the claims:
General requirements for motor insurance claims
The following are the general requirements in the event of a car insurance claim.
- The original incident report issued by the traffic department
- Original accident sketch
- Copy of the coverage policy
- Copy of the driving license showing it is valid
- Copy of the motor vehicle registration
- Traffic police reports
- Fire brigade report, where necessary
- Original repair license issued by the traffic department
Special requirements for commercial vehicle
Apart from the general requirements there may special requirements for commercial vehicles as follows:
- Fitness certificate
- Any other documents related to the usage of the vehicle
Special requirements for third party liability claims
As we have seen earlier that the third-party liability claims settlement further can be classified into two types as death or bodily injury and property damage claims.
Third-party claims consume a major portion of the time of the claims staff. It arises due to the fault of the vehicle insured or its driver. It has to be handled properly to avoid leakages.
The insurance company should be careful when handling third party insurance claims, as in most of the insurance markets it is compulsory or mandatory insurance. In some countries, the claim settlement is faster, whereas in some countries it may take years before a third-party claim is settled. Usually, the documents required under a third-party insurance claim are the court verdict and in case of death of the victim, the death certificate along with the post-mortem certificate becomes a requirement.
The court has to give the verdict against the insured. Based on the verdict the claim is settled. In some countries, death, large bodily injury, and large property claim only require court verdicts. Whereas the smaller claims are settled by the insurance company based on their investigation. If the third-party property damage claim is settled without a court verdict then the procedure will be similar to own damage claims as mentioned below.
Special requirements for own damage claims
In case of own damage claims, apart from the general requirements, the additional requirement may be the submission of three claims estimates or estimate from the insurance company nominated workshop. Companies like Rodney D Young Insurance may appoint a third-party motor claims loss adjuster, who will assess the claim and submit his report to the insurance company, based on which the claim is processed.
The motor loss adjuster is appointed by the insurance company. In some countries, the traffic department appoints an agent to estimate the claims to avoid the disputes and manipulations of the claim amounts. Few claims may warrant the insurance company to appoint an investigator to investigate the claim. The role of the investigator is to find the validity of the claim and find the element of fraud if any.
Special requirements for Miscellaneous claims
Other than the own damage claims there are other claims like personal accident claims and workmen compensation claims for the driver and other employees of the insured. In case of death of the covered person apart from the general requirements, a death certificate and post mortem certificate may be required.
In case of bodily injury, an authorized medical report should be submitted along with the cost of treatment. In case of a claim under the workmen compensation extension then the employment certificate will also be required, the workmen compensation covers a wide range of liabilities including the liabilities arising out of death.
Claims assessment and investigations
Once the claims representative is able to establish the relationship with the claimant. His next job is to make the assessment of the claim. He will try to find the cause of loss and the quantum of loss based on the claims form submitted, estimates received from the garages. He will also look into the police reports, examine the witness, and also may cross-examine the insured.
Where necessary the claims representative may appoint an investigator. The investigator will try to solve the issues related to the suspicious nature of the claim. In some countries, there are third party surveyors, appointed by the insurers, who will visit the insured and suggest the names of the workshops where it can be repaired. The assessment job can also be done directly by the skilled claims representative.
Once the claims representative is able to establish the relationship with the claimant. His next job is to make the assessment of the claims and help him understand the difference between comprehensive, collision, and liability and how your insurance covers it. He will try to find the cause of loss and the quantum of loss based on the claims form submitted, estimates received from the garages. He will also look into the police reports, examine the witness, and also may cross-examine the insured.
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