A clearer view of the insurance claims process
Understand what happens after a covered loss is reported, how claim files are reviewed, and where coverage, documentation and valuation can affect the final outcome.
Report the Loss
The claims process begins when you notify your insurer of a covered event through the carrier's available reporting channels. A claim number is typically assigned and the file is opened for review.
Information to provide
Policy details, date and description of the loss, location and any immediate documentation such as photographs or incident records.
Adjuster Assignment & Review
A claims professional reviews the reported loss, verifies applicable coverage and evaluates the available evidence. Depending on the claim, this may involve an inspection, additional records or conversations with contractors and other parties.
Review focus
Applicable coverage, policy limits, exclusions, supporting documentation and the circumstances surrounding the reported loss.
Valuation & Deductible Applied
The insurer determines the covered value of the loss and applies the policy's deductible, applicable coinsurance and other relevant terms. The resulting valuation forms the basis for the settlement amount.
Key valuation issue
Replacement cost and actual cash value can produce different settlement figures, depending on the policy and circumstances of the loss.
Settlement & Payout
After the claim decision and settlement terms are finalized, payment is issued according to the policy and applicable claim requirements. Larger property losses may involve multiple payments as repairs or replacement work progresses.
If the outcome is disputed
Available options can include an insurer's internal review process, appraisal where permitted by the policy, or assistance from the applicable state insurance regulator.
Build a complete claim record from the start
A well-documented claim gives the carrier a clearer record of the loss, the resulting damage and the costs involved. Keeping relevant records together can also make follow-up requests easier to handle.
- Timestamped photos or video showing the condition before repairs
- Receipts, estimates and invoices associated with the reported loss
- A clear record of what occurred and when it occurred
- Police, fire, medical or other official records relevant to the claim
Need help understanding your coverage?
Reach the policy desk with your question.