Behind the Scenes: The Influencing Factors behind How Insurance Companies Choose to File Your Claim

Behind the Scenes: The Influencing Factors behind How Insurance Companies Choose to File Your Claim
  • Opening Intro -

    Every insurance claim is different.

    You might think that insurance companies are out to cheat you, but the truth is that the outcome of a claim depends on a variety of factors.


A claim can be made on any type of insurance policy like auto, homeowners or casualty. Although the outcome of a claim will depend on the incident, your coverage, and your insurance provider, there are certain similarities in the way that most claims are handled once they get to the insurance company. The following are a few things that the insurers look for:

Vehicles, Drivers and Dates

An auto insurer will look to see if the vehicle involved in a claim is an insured vehicle. Remember, auto insurance travels with the vehicle and not the driver. They’ll also look into whether the driver was an insured person as defined under the policy, whether the damage resulted from a covered risk or peril, and whether the claim arose during coverage period. Check your auto policy, and you’ll see these requirements.


Whenever a claim is made against a policy of insurance, the insurer is exposed to a potential loss. Under the contract of insurance, the insurer is given the right to investigate a claim under its policy. The primary purpose of time constraints is to prevent insurance fraud. All insurance policies have notice provisions where the insured must notify the insurer of a claim or the potential for one within a specified period of time. A claim not timely filed can be denied. Almost all insurers have their own fraud prevention units, so be sure of any time constraints when filing a claim with your insurer.

Anticipated Loss

When a claim is made against an insurer, they can move money from one column to another column known as anticipated loss or reserves. They can earn a higher rate of interest on that money with tax advantages, so long at it sits in that column. The longer a claim is delayed, the less of a loss the insurer takes on a claim. Sometimes, errors or omissions on your initial claim application can lead to a delay in the process, so be sure to double and triple check your paperwork to ensure that all information is correct and accounted for.

Defend Claims

Delay, deny and defend remains a strategy for many insurers. They’ll make a low offer, and if you don’t accept it, you’re forced into litigation. Keep in mind that there are many reasons that an insurance claim might be rejected, so while it is good to keep an eye out for these tactics, don’t automatically assume that your insurer is taking you for a ride.

Although the process of filing a claim will be different with every agency, the best thing a policy holder can do to help their chances is provide detailed information—and a lot of it. Many times, claims are denied or delayed not because of a devious insurance agent, but because of misinformation or miscommunications during the claim process, or in the paperwork. Educate yourself on your own policy, ask questions, and be as thorough as possible in order to assist with a smooth process of filing your claim.

The information for this article was provided by the professionals at Steers Insurance Limited, an insurance company in St. John’s.


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