5 steps of the insurance claims process (2024)

You hope it never happens, but sometimes things go awry. You’ve been hit with a loss.

What’s next? Who do you reach out to first? What are your obligations?Losses are stressful, but they shouldn’t be confusing. You have your claims professionals to lean on as you regroup and recover your business operations. They can walk you through the crucial steps that follow.

Navigating the 5 steps

The insurance claim process typically involves five main stages, from the moment you report your loss to the resolution of your claim. You can prepare for the process by gathering relevant documents (think receipts, original invoices and proof of ownership), gathering photos and accounts of the event or damage, and familiarizing yourself with the steps below.

Your insurance claim, step-by-step

5 steps of the insurance claims process (1)

Connect with your broker. Your broker is your primary contact when it comes to your insurance policy – they should understand your situation and how to proceed. Once you give your broker a detailed list of all the items that were damaged or lost, and any photos or videos that help to explain the circ*mstances, an adjuster will follow up with you to continue the claims process.

Claim investigation begins. After the claim has been reported, it will need to be investigated by an adjuster to determine the amount of loss or damages covered by your insurance policy. The adjuster will also identify any liable parties, and you can help the process by providing any witness information or other parties’ contact information.

5 steps of the insurance claims process (3)

Your policy is reviewed. Once the investigation is complete, the adjuster will go through your policy carefully to determine what is and isn’t covered under your policy, and inform you of any applicable deductibles that may apply to your case.

5 steps of the insurance claims process (4)

Damage evaluation is conducted. In order to accurately evaluate the extent of the damage, your insurance adjuster may hire appraisers, engineers, or contractors to lend their expert advice. Once the evaluation is complete, your adjuster will provide you with a list of preferred vendors to help with repairs. You’re not obligated to hire these vendors, but it can save you a good deal of time and research.

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Payment is arranged. After repairs have been completed and lost or damaged items have been replaced, your adjuster will contact you regarding settlement of your claim and payment. The amount of time it takes to receive payment will depend on the complexity and severity of your situation.

Every claim is different, and although the claims process can vary slightly according to the situation, your adjuster will devote the time and attention it takes to resolve your particular case. Northbridge Insurance is committed to ensuring every claim is handled as fairly, professionally and as carefully as possible. If you run into questions or concerns during the claims process, you can always contact us on our website or by phone at 1.855.621.6262 to get the answers you’re looking for.

5 steps of the insurance claims process (2024)

FAQs

5 steps of the insurance claims process? ›

Think deeply about the exact question the agent asked, and only provide that specific information. Never admit to fault. Never admit to even being partially at fault. Never admit that you are uninjured.

What are the five steps of the insurance process? ›

Five steps to getting your insurance claim paid
  • Make your claim. Submit your claim, along with photos and videos of all damage, to your insurance company or someone else's company. ...
  • Answer questions. The insurance company will ask follow-up questions. ...
  • Be aware of deadlines. ...
  • Choose a contractor. ...
  • Get paid.

What are the 5 steps to the medical claim process? ›

What are the Five Steps to the Medical Claim Process?
  • The Initial Processing Review. In the intricate journey of medical claims, the Initial Processing Review stands as the foundational checkpoint. ...
  • The Automatic Review. ...
  • The Manual Review. ...
  • The Payment Determination. ...
  • The Payment.
May 2, 2024

How do you answer insurance claim questions? ›

Think deeply about the exact question the agent asked, and only provide that specific information. Never admit to fault. Never admit to even being partially at fault. Never admit that you are uninjured.

What are the 5 steps to file a claim? ›

Your insurance claim, step-by-step
  1. Connect with your broker. Your broker is your primary contact when it comes to your insurance policy – they should understand your situation and how to proceed. ...
  2. Claim investigation begins. ...
  3. Your policy is reviewed. ...
  4. Damage evaluation is conducted. ...
  5. Payment is arranged.

What are the 5 C's of insurance? ›

The 5Cs of transformation in insurance are – communication, customization, connection, cognition and consensus. Let's look at each in turn: Communication At its core, insurance is a promise. Now, there isn't much value in a promise if you can't communicate it!

What are the stages of a claim? ›

These are the key stages to making a claim:
  • Initial Instructions. ...
  • Letter of Claim. ...
  • Collating Evidence. ...
  • If Liability is Admitted. ...
  • Obtaining Medical Evidence. ...
  • Preparing a Schedule of Financial Losses. ...
  • Negotiating Settlement. ...
  • If Liability is Denied.

What are the six steps in claim processing? ›

Six Steps in Making an Insurance Claim
  • Step One: Contact Your Agent Immediately. ...
  • Step Two: Carefully Document Your Losses. ...
  • Step Three: Protect Your Property from Further Damage or Theft. ...
  • Step Four: Working with Adjustor. ...
  • Step Five: Settling Your Claim. ...
  • Step Six: Repairing Your Home.

What is the claim cycle of insurance? ›

The insurance claim life cycle has four phases: adjudication, submission, payment, and processing. It can be difficult to remember what needs to happen at each phase of the insurance claims process. This blog post will break down the insurance claims life cycle for you so that you know where your claim stands!

What questions do insurance investigators ask? ›

Insurance adjusters are trained to find flaws in your story and ask certain leading questions that may end up with your recorded statement being used against you later. For example, they may ask you how you were injured in the crash, how you are feeling now, and what the extent of your injuries are.

How do I argue an insurance claim? ›

Steps to Appeal a Health Insurance Claim Denial
  1. Step 1: Find Out Why Your Claim Was Denied. ...
  2. Step 2: Call Your Insurance Provider. ...
  3. Step 3: Call Your Doctor's Office. ...
  4. Step 4: Collect the Right Paperwork. ...
  5. Step 5: Submit an Internal Appeal. ...
  6. Step 6: Wait For An Answer. ...
  7. Step 7: Submit an External Review. ...
  8. Review Your Plan Coverage.

What are the five steps to take out an insurance policy? ›

5 Steps to Getting Insured
  • Research Insurers and Get Quotes.
  • Compare and Select an Insurer.
  • Get Underwritten.
  • Choose your beneficiaries.
  • Start Paying Premiums and Get Your Contract.

What are the 5 essential elements of an insurance contract? ›

These elements are a definable risk, a fortuitous event, an insurable interest, risk shifting, and risk distribution.

What is the insurance process cycle? ›

The insurance claim life cycle has four phases: adjudication, submission, payment, and processing. It can be difficult to remember what needs to happen at each phase of the insurance claims process. This blog post will break down the insurance claims life cycle for you so that you know where your claim stands!

What are the five main insurance? ›

Home or property insurance, life insurance, disability insurance, health insurance, and automobile insurance are five types that everyone should have.

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