How to file an insurance claim

Need to make an insurance claim? Not sure how that process works? We'll tell you what to expect on this edition of the Texas Insurance Podcast. I'm Ben Gonzalez. Today we're talking with Melissa Herman from TDI's Property and Casualty Division. She's going to tell us what to expect when we do have to make an insurance claim. If you find this information useful, be sure to rate and review the Texas Insurance Podcast. Subscribe and share it with your friends and family. Melissa, thanks so much for joining us today. Really appreciate you taking some time. Thanks for having me. You bet. So we're talking about claims today and when you should make one because for a lot of people, they don't do it very often and so it's always a new experience. When should you make a claim and what should you be thinking about there? So as soon as you're involved in an accident, you should contact your insurance company to let them know that you were involved in an accident because most policies do require you to notify either your agent or the company. Now that doesn't necessarily mean you have to file the claim. If you do decide to file a claim, you need to do so immediately. So contact your agent. You can go online with some insurance companies. Just do anything possible to reach the insurance company and turn in the claim while it's still fresh on your mind. And that's whether it's home or auto, you want to do so immediately. And you can always just contact them, find out how much your deductible is, let them know if it's even a covered loss, but it's always best to contact the company immediately. Yeah. You mentioned the deductible there. That's kind of a big decision on whether or not you file a claim depending on the size of the loss. Talk to us a little bit about the deductible. So the deductible is the money that you need to pay out of pocket and it is one that you've selected whether it's home or auto, you've selected the amount of the deductible. So the insurance company should cover anything over your deductible that's related to the loss. So it's what you actually pay out of pocket. So sometimes people like to get an estimate first, just to see how much it's going to be and how much out of pocket they'll have. And for homeowners, once you pay your deductible, make sure to say proof of the deductible you've paid because it is a state law that contractors or roofers, anybody that's repairing your home cannot waive your deductible. And choosing that deductible when you're buying your policy is also a way to take on some of that risk yourself and maybe control some of your premiums? Yes, absolutely. For sure. Okay. So once you decide, yes, this is over my deductible and I do want to make a claim, what's the first step? So first step is to contact your agent or your insurance company. Let them know you've been involved in an accident. And at that point, you want to write down when you contacted them, who your adjuster is going to be, the phone number and document anything that the insurance company has asked you to provide. So when you make that initial call, they're going to set up a time for somebody to come out and look at the damage, correct? Correct. Yeah. So they might tell you the next step, such as where to take your vehicle to get the estimate, or if they're going to send an estimator out or what exactly you need to provide to them, whether it's going online and submitting pictures of the accident scene, just anything, but they'll make sure to tell you and make sure to do that as soon as you've been asked. So you don't delay the decision that adjuster needs to make. Perfect. And so a lot of PBI materials talk about documenting any damage that you can see, just walking around with your phone, taking pictures. Why do we do that? Why should people do that? So for after an auto accident, as soon as an accident has happened, first things is to get to a safe location. So if you're on a busy highway or street, you want to make sure to pull over into some kind of parking lot somewhere it's safe, if you're able to. If it's somewhere safe, go ahead and just kind of get off the main thoroughway. And you want to do everything as soon as an accident happens while all the information is available to you. So you want to take pictures of the accident scene, the damage to your vehicle, another vehicle if it was involved, take photos of the other driver's insurance information, their driver's license, get their license plate, and do document photos of their damage as well. And then take pictures of your damage. We also recommend to take photos of the scene. So if there's any street signs nearby, take photos of that. If there's, you know, just of the street itself, if you hit a tree, take pictures of any damage you might have caused. And then also if the police come out, get any information you can from them, such as a police report number. Also if there's any witnesses that stopped, you want to get their information there at the scene. Get their name and their number, maybe exchange phone numbers or emails. So just do everything while it's still fresh and available to you, because as soon as you leave the accident scene, and you're gonna have a lot going on, and once your adrenaline calms down and you're calling your insurance agent, they'll ask for all that. So it's best to have pictures and document everything right when you're, right when an accident happens. After you calm down, yes, why didn't I get that information? Exactly. And then same with homeowners. As soon as you notice any damage to your house, or flooding, or a storm damage, go ahead and write down the date and the time of, let's say if it was a storm or a pipe busted, just anything. Go ahead and write it all down, because as time goes on, you might not remember what date was that. Also maybe take note of the weather outside, and then take photos of any damage that possibly could have happened to your house. That way you can provide those to the adjuster as well. And you're documenting what you can see, but the adjuster is going to go in there with some knowledge about what's underneath there as well. Yes, absolutely. Anything else we should do right away besides that documentation? Just write down everything you can, just know that later memories fade. So just make sure to notate everything. And one thing we also talk about in our materials is making sure that you prevent further damage. Is that something that you have to pay for? It just depends. So you definitely, if after an accident, whether it's to your car or your home, you want to mitigate any damages. So let's say your windshield is cracked open, you want to cover that to prevent any additional water damage. Same thing if any house windows broke, you want to cover those up. So and then anything that you do pay out of pocket to mitigate your damages, the insurance company should reimburse you. So save all of your receipts so you can provide those to the adjuster as well. Just don't make any permanent repairs until the adjuster has been out to take photos and look at the damage itself. So covering up holes with plywood or tarp, that's the kind of thing that you can do right away to keep more damage from happening. How long does it generally take after you make a claim to hear back about a decision from the company? So the insurance company is supposed to have a decision with you if you have provided all the documents necessary. So once they have everything they need to make their decision, they should make it within 15 days. And then if they need more time, such as up to 45 days, they will notify you in writing saying we need additional time to make our decision. So when does that 15 days start after you make the claim? After they have everything they need to make the decision. After they have all the information. Is that the same for an auto accident? Yes, it's the same for auto and home. And one issue we sometimes hear about from consumers is disagreement about the size or the amount of the claim payment. What should you do if you think what you're being offered is too low for the situation? So that is common. So sometimes it's because, so let's say you damage your car. An insurance company could say, hey, here's some shops that we work with. And you could say, I actually prefer to go through my own shop, which is absolutely right. And you can use any shop. So the adjuster will come out, inspect your vehicle, and provide an estimate. And you'll take that estimate to the body shop whenever they start the repairs to your vehicle. And it's very common when vehicles start getting taken apart for the actual estimator working on your vehicle to see more damage. So they either contact you or the insurance company, provide an additional estimate to the insurance company, or the insurance company will send an adjuster back to the body shop. And they should come up with a fair estimate that time to cover the additional amount of damages. So the closer, the more information that's available, the closer it should be to accurate. Yeah. Because usually the insurance company just, it's an initial estimate. So sometimes they need more data on what happened, more photos. They actually need the teardown of the vehicle to see any hidden damages. So that's usually where the discrepancy lies. We hear a lot about you can choose any repair shop you choose, but the amount will be what the market dictates as far as what the repair should cost. Is that the same for a home damage? Can they direct you to a particular contractor? Usually with a home insurance is they will provide an estimate to you for the repairs. And then what we recommend is to get a bunch of bids and estimates from different contractors or roofers, and just see who's offering to cover everything and who you like the best, and then provide them with the estimate that you receive from the insurance company. And they will work off that estimate. And again, if they find additional damage, they will contact the insurance company or ask you to, and the insurance company will see what additional damages might be covered. Well, this sounds like a lot of moving parts and a lot of back and forth. So it can be a little frustrating and you just need to take your time to go through this process. How soon should you expect to get a payment once everything's settled and you decided on an amount? Once an amount has been agreed upon, you should receive that check within five days. Okay. That's a faster step. Yeah. And if you have a loan on your vehicle, your home, now that check might be issued to the lien holder as well as you, or you can also be paid to the body shop or the contractor. So there's just different ways to receive the payment, but it should be issued from the company within five business days. That's interesting. So if you have a lien on the car or you've got a mortgage, it might go to the mortgage holder or the note holder. Yeah. Just depending on what their policy is. And then you'll have to work with them to get them to cash it out or give it to you. Any other common issues that we hear about from people when they first make a claim or haven't made one in a long time? Just to be patient, just document everything that you're seeing happening. Take notes. So every time you talk with an adjuster, go ahead and take a note in case you're asked to do something and just know the insurance company will work with you. So if you're having problems, contact them, seeing what they need, and just know that they want to get this claim solved to help you out as well. Right. So communication is key there. And if you need additional information, we have information on our website as well. Yeah. And if you do have additional problems and you are just not getting what you need, you could always contact TDI with our consumer complaint portal and we can have someone help you with it. Well, thank you so much, Alyssa. I appreciate it. So now that you know more about how to make an insurance claim, watch this video for tips on how to avoid contractor scams when you're making repairs. If you have insurance questions, call our helpline or visit the TDI website. That's it for now. We'll see you next time.