Insurance companies do their best to make it seem like they’re on your side, but their primary goal is to protect their bottom line. Understanding insurance companies and how they handle car accident claims can help you make sure the company doesn’t exploit you by unfairly denying or devaluing your claim.
In this post, we outline what you can expect from the car accident claims process, and lift the lid on the insurance company practices you should know about.
Pennsylvania is a “no-fault” state. This means that when you get in a car accident, you file a claim with your own auto insurance provider regardless of who was at fault for the crash (in some other states, the insurance company of the responsible party must pay all the compensation arising from the event).
The insurance claim process begins as soon as you report your car accident to your insurance company. In this report, you'll need to provide a detailed account of the accident, including its date, time, location, and any other relevant details. It's crucial to be as accurate as possible here, because the insurer could try to use any inconsistencies against you later.
After receiving your report, the insurance company will assign an adjuster to your case. We explain the adjuster’s role in more detail in the next section.
Once the adjuster’s investigation is complete, the insurance company will determine fault and calculate the compensation you are entitled to. This can include reimbursement for:
The insurance adjuster working on your case will act as the primary point of contact between you and the insurance company. They’ll also investigate your accident, assess the damage to your vehicle, and evaluate the extent of your injuries.
During the investigation, the adjuster will likely ask you for a recorded statement about the accident. While this might seem like a routine request, be cautious. Anything you say can be used to challenge your claim later. It's wise to consult with an attorney before providing a statement to ensure you don’t inadvertently harm your case.
The adjuster may also try to get you to accept a quick settlement offer. This offer may be much lower than what you are entitled to; adjusters use this tactic to close claims quickly and cheaply.
The adjuster may also make additional requests of you, such as for police reports, medical records, and witness statements. When responding to these requests, it’s important to remember that your insurer does not have your best interests at heart. You should not give the company any more information about your accident than you’re legally required to.
If you’d like a more complete rundown of the rules in this area, you should consider scheduling a free initial consultation with an experienced attorney.
The adjuster will ultimately make the initial recommendation regarding paying out on your claim. They may try to use the available evidence to question the necessity or cost of certain treatments or repairs to justify a lower payout.
Evidence is the backbone of any successful insurance claim, and certain types of evidence will be particularly valuable to you during the claims process.
Photo and Video
You should take photos and videos of the scene directly after your accident, focusing particularly on the damage to your vehicle and any visible injuries. Try to collect contact information from any eyewitnesses, as their statements may provide valuable support for your claim later on.
You should always seek medical attention after an accident. If paramedics don’t arrive on the scene, you should visit your primary care physician as soon as possible after the crash, as they’ll be able to diagnose any injuries that don’t show symptoms right away. Early intervention is crucial, particularly with head injuries and other serious conditions.
Getting a check-up also provides documentation of your injuries. The medical record from this first assessment and all subsequent medical appointments will provide crucial evidence for your insurance claim.
Be sure to follow your doctor’s orders and attend all follow-up appointments, as gaps in treatment can be used by the insurance company to argue that your injuries aren’t as serious as claimed.
Police reports can also play a significant role in your claim. If a police officer was called to the scene of your accident, they will have been obliged to file a report on it. These reports are available to download from the Pennsylvania State Police CrashReports portal.
Keep detailed records of all expenses related to your accident, including medical bills, vehicle repairs, and lost wages.
The first step to take following a claim denial is to review the denial notice carefully, ideally with the help of a car accident lawyer. The letter should explain the reason(s) for the denial, which might include:
It’s important to remember that insurance companies will often cite reasons like these without a solid basis for doing so. Unfortunately, it may fall to you to mount a legal challenge against unfair insurance company practices.
You’ll want to gather all relevant evidence, as outlined above. You may also want to obtain an independent evaluation of your damages, such as a second opinion from a doctor or a repair estimate from another mechanic.
After gathering your evidence, you should consider writing an appeal letter to the insurance company. This letter should include a clear statement of the reasons why the denial or devaluation was wrongful, and evidence to that effect. You should enlist the help of a lawyer here, as it’s important to get all the details right on an appeal letter if you want the best possible chance of success.
If the insurance company decides to stick with its original decision, you may have no choice but to file a lawsuit against it.
Insurance companies don’t become multibillion-dollar organizations by paying out on claims easily. Your insurer will do whatever it can to keep its profits high, so you need to ensure it doesn’t use you to achieve this goal. If your claim has been denied or devalued, you can fight back.
Contact The Cochran Firm in Philadelphia today to schedule a free initial consultation about your case. You can reach us by filling out our online contact form, or by calling 800-969-4400.
