What to Expect During The Car Insurance Claim Investigation

Part of a car insurance claim requires a claim investigation. Understanding what this investigation entails and why it is necessary is important.

Budget Insurance also aims to provide you with the facts behind the necessity of car insurance.  This article aims to help you understand what a car cover claim investigation entails and why it’s an important part of the claims process. 

The reason why insurers conduct an investigation when you claim

If you file an auto insurance claim, your insurer does not automatically pay out — they investigate the claim's authenticity first. Most car owners are honest, but some don’t always act with integrity.

Car insurers have to be concerned about the possibility of processing fraudulent claims. It’s estimated that short-term insurers, including car insurance companies, lost about R7 billion in 2019 due to fraudulent insurance claims[1]. Preventing fraudulent car insurance claims is beneficial to car owners as well. This is because the car insurance funds stay healthy, allowing car insurers to pay out for genuine claims.

A car insurance investigation verifies that the accident has occurred and that the submitted details are correct. The aim is not only to prevent fraudulent claims but also to ensure the claim is accurate. These kinds of investigations are common when there are extensive damages to your car or a third-party property or vehicle. 

The car insurance claims process: what happens during an investigation?

Claiming from your car insurer can seem daunting, especially if you’ve lost your car due to an accident or theft. To make it easier to claim, it’s helpful to understand how the car insurance process works.

Before starting the car accident claim process, report your car damage or loss to the police. The reason is that your insurer requires a police case number[2] to process your claim.

Once you’ve reported the incident to the police, take the following steps to claim from your car insurer:

1. File a claim with your insurance company. Include all required documentation. At Budget Insurance, you can register your claim on the Budget Insurance Whatsapp Number or call 0861 60 01 20. You should receive a claim reference number to simplify future communication regarding the claim.

2. The car insurer allocates a claims representative. This individual will be your contact person throughout the car insurance claims process. This person will work with you and other parties to collect the documents needed to process the claim. Cooperating with this person is important, especially when they ask questions or ask for additional documents.

3. Assignment of the insurance adjuster. Your car insurer will assign an insurance adjuster or claims adjuster. This professional is an expert at assessing and validating car insurance claims. His or her job is to perform due diligence on behalf of the insurance company to ensure claim legitimacy.

The insurance adjuster is responsible for conducting an investigation. Most of the work needs to be done during this phase of the claim process. For instance, you may be asked to provide certain details, and witnesses may be contacted to gather additional information. The damaged vehicle may need to be inspected.

This investigation aims to establish accurately the liability involved to avoid over- or under-paying.

4. The car insurer evaluates the claim and makes a decision. It goes without saying that all the activities involved in the claims process can take time. The duration of the process depends on many factors. For instance, a minor accident will be quicker to finalise than a major one involving more damage, especially if there are conflicting accounts of the car accident. 

Therefore, concluding the auto insurance claim process can take a few days or months. Make sure you’re well-versed with the car insurance claim checklist.

Factors that affect your insurance claim

You should do your part to the best of your ability for your car insurance claim to proceed smoothly. Despite this, the claim process or investigation may be impacted by other factors, including the following:

• The extent of damage to your car or third-party property (or vehicle): Extensive damage can take longer to assess. 

• Insurance policy limits and cover: Whether you will be paid out and how much will depend on your particular policy and any limits included. 

• Past insurance claim record: Not only does your previous car insurance claims history impact your insurance premiums, but it also influences the claims process. 

• Availability of the required documents: Insurance adjusters and car insurance companies rely on evidence to assess your claim. If, for example, some documents are missing or have incomplete information, this will need to be addressed before the claim process continues.

The outcome: what can you expect?

Once the investigation is complete, it’s up to your car insurance company to rule on the outcome of your claim. There are three possible outcomes:

• Claim approval and payment: Your claim is approved, in which case you’ll be paid according to the terms and conditions of your policy. 

• Claim approval and partial payment: Your claim is approved, and you receive a partial payment. This, again, will be in line with your policy. Your car insurer will clarify why that is the case.

• The claim is rejected: Your claim may be rejected, and you won’t receive any payout. Your insurance will provide reasons for not approving your claim.

Tips for handling a car insurance claim investigation

Some of the things you can do to ensure a hassle-free claim investigation include the following:

• Be honest and transparent throughout the process: The insurance adjuster will likely ask many questions. This is not to be taken personally. It’s simply a necessary part of the process. 

• Be organised with documents: Documents include any record that can help establish facts about an accident. Some important documents include photos of the incident, contact details of the third party or a police report.

• Be aware of your rights as a claimant: Car insurance falls under short-term insurance. It’s vital to know your rights under this type of insurance. For instance, you can lodge a dispute if you are unsatisfied with the investigation’s findings or the insurer's decision. 

• Understand your car insurance policy: This is arguably the most important factor. Read and re-read your policy schedule, and if you have any questions, contact your insurer for an explanation. It’s also wise to review it annually and adjust it to meet any change in your circumstances.

Get a quote on car insurance from Budget Insurance    

 Make sure your car insurance is adequate for your needs. Even if you think it’s sufficient, consider checking with a respected insurance company, like Budget Insurance. All it takes is to request a free and no-obligation car insurance quote.