An insurance claim is a formal request to your insurance company, requesting payment based on your insurance policy. Insurance claims are reviewed by the insurance company (to ensure they are valid) and are then paid out to the individual (or another depending on your jurisdiction’s insurance laws). Insurance claims cover a variety of things, from death benefits issued pursuant to life insurance policies to annual doctor’s visits. In general, states utilize 1 of 2 insurance systems: “fault” or “no fault”. No fault insurance aims to lower premiums by attempting to avoid litigating fault, while also providing prompt payment for injuries sustained.
No Fault Insurance
No fault insurance is the type of insurance where an individual’s insurance company pays for his losses, regardless of who is actually at fault for accident. No fault insurance is commonly used to describe state automobile insurance laws. No fault automobile insurance laws, in general, mean that the policyholder is reimbursed by his own insurance company (without having to prove fault) and is also restricted in his right to bring a civil lawsuit against the person causing his loss.
Filing Your No-Fault Insurance Claim
Under the no fault insurance scheme, your insurance company pays for your medical bills and lost earnings up to your policy’s limits, but the law places restrictions on receiving compensation for your non-economic damages, such as pain and suffering and emotional distress. In no fault insurance states, individuals can sue for non-economic damages only if they meet the state’s “tort threshold”. Depending on which state you reside in, the tort threshold is either economic or verbal. Economic tort thresholds are met by adding up your medical bills and meeting, or exceeding, a specific dollar amount required by law. Verbal tort thresholds are set forth in qualitative terms and describe injuries (serious ones) such as broken bones, scarring, long-term disability, disfigurement, or death. All of the no fault insurance states require a minimum amount of Personal Injury Protection (PIP) to be carried.
Aside from no fault insurance’s nuances, submitting an insurance claim is usually fairly simple. Typically, you first contact your insurance agent. You then fill out a claim form, and a claims adjuster will look over and assess the damage. After that, if the claim goes through, you should receive your check. Sometimes filing a claim can be hazardous to you, especially if you make too many claims within a short period of time. Many companies will cancel your insurance policy if you make too many claims (such as 2 or 3 claims within 1 year). Insurance companies are in the business of making money and, therefore, want to avoid high risks. You do not want to be a high risk.
Importance of Speaking with an Attorney
If you would like more information regarding your state’s insurance rules and regulations, contact a qualified attorney in your area.