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An insurance claim is a formal request from the policyholder (that’s you) to their insurance company asking for payment after a covered incident. These incidents can include anything covered by your insurance policy, like a hospital stay, a natural disaster, or theft.
The payout provided by the insurance provider is meant to cover expenses associated with the covered incident. A claim payment is typically only issued to the person named on the policy (or a designated beneficiary). The types of claims depend on the situation at hand and the kind of insurance policy you have.
Many types of insurance policies require a claim in order to pay out – we listed a few example below. Each claim type follows roughly the same claims process, but the details may vary depending on your insurance provider.
Car insurance claims can pay out in many different cases, including:
Homeowners insurance claims typically cover a number of scenarios related to your home which can include:
Renter’s insurance claims typically cover incidents related to a rental property, such as:
Health insurance claims are typically handled by the doctor’s office, hospital, or clinic you visit. The only time you might be responsible for personally handling a health insurance claim is when a claim has been denied. Health insurance claims can be filed for:
Life insurance claims often cover a very specific set of circumstances, all related to the policyholder’s death. In the case of the insured’s death, a payment will be made from the insurance company to a designated beneficiary.
Below are all of the items you’ll need to have on hand to file a claim. Regardless of the type of policy, an insurance claim will require:
You may also need photos if you’ve been in an accident, suffered damage to your home or property, or experienced a comprehensive, no-fault incident.
Once you’ve gathered everything you need, you’re ready to file the claim. Start by checking your insurance policy details to see if your incident is covered and if there is a time limit on when you can file a claim.
Following that, all that’s left is to file with your insurance company. This can usually be done in person, online, or over the phone. You will be responsible for filling out a form outlining the details of the claim and either physically mailing the paperwork or submitting it online. The insurance company will review your claim and deny or approve it, or ask for further information.
Remember that when it comes to most medical situations, the office you visit will most likely file the claim for you—you won’t have to contact your insurance provider.
If your claim is approved, you will receive payment from the insurance provider. The amount you receive depends on your policy, insurance company, and the extent of the incident. Payment is most often sent as a check, but can also be directly deposited into an account.
Your insurance company can also pay service providers directly—for example, the payout might go to a hospital, auto shop, or contractor.
An insurance claims adjuster assesses the extent of the damage in the case of accidents, damage, no-fault claims, and other instances related to personal injury or property damage. They will estimate what the payout amount should be.
Insurance claims lawyers protect their clients’ best interests through the process of filing an insurance claim. They can provide legal advice, argue a denied claim, negotiate the payout, and more.
The actual cash value (ACV) refers to the value of your property or business as determined by your insurance company. The ACV is calculated by subtracting the depreciation of your car or other covered item from the value of a replacement or the necessary repairs to said item.
The claims process usually takes around 30 days from when you file the claim to the final resolution. However, this process can vary depending on your specific circumstances and your insurance company.
Filing an insurance claim doesn’t automatically mean your premiums will increase; however, in some instances, they might. For example, you may see your auto insurance premiums rise after you are found to be at fault for an accident.
This article is intended to provide general information about insurance. It does not describe any Metropolitan Life Insurance company product or feature.