Making sense of your insurance coverage after a serious car crash
A licensed insurance professional walks through the choices behind a claim
One bad crash can set off several claims at the same time. The car may need fixing. Someone may need medical care. You may need a rental today. An insurer may tell you it is “still investigating.” You may wonder what that means. [1, 2]
Start by sorting out three separate questions. Does a policy cover this kind of loss? Who is responsible for the crash? How much is owed for a loss that is covered? Each one may get answered at a different time. [1, 2]
This article walks through the general process in the United States. Your policy and your state’s law set the real benefits, duties and deadlines. Report the crash quickly, even if you don’t have every document yet. Share the facts you know now. You can add to the claim later. [1, 3]
Call it in and get a claim number
Reach your own insurer through the phone number on your insurance card, its app or your agent. Ask how your policy says you must give notice. Do this even if you think another driver caused the crash. Your policy may call for prompt notice. Your own coverage may also help before the other insurer makes a decision. The NAIC advises filing as soon as you can. [1, 3]
Share the date and place, the vehicles, the drivers and the passengers. Include the police report number if you have it, the damage and any injuries you know of. Speak up when you’re not sure about a detail. For instance, “I did not see the other car before impact” is better than a guess at its speed.
Ask for the claim number plus the adjuster’s name and contact information. Different people may handle the damage to your car and your injuries. If so, get both claim numbers and ask which papers go to whom.
Medical care comes first. Don’t hold off on urgent treatment while you wait for a claim decision. If you can’t make the call, a trusted person can help report the crash. Afterward, check with the insurer on the authorization it needs before it can discuss your claim with that person.
Find the page that lists what you bought
Your declarations page usually lists the vehicles, drivers, coverages, limits and deductibles you paid for. The full policy lays out conditions and exclusions. A coverage listed on that page is a place to start. It doesn’t promise that every cost after a crash will be paid. If you can’t find the page, ask the insurer for a copy. [2, 4]
- Liability coverage pays for injuries or property damage to other people when an insured driver is legally responsible. It pays up to the limits that apply. It won’t pay to fix your own car. [2]
- Collision coverage generally pays for crash damage to your insured car. Its deductible and the policy terms apply. It can kick in before anyone has settled who was at fault. Comprehensive coverage usually applies to events that aren’t collisions, like theft, fire or hail. [2]
- Medical payments coverage and personal injury protection, often called PIP, may pay some medical costs tied to the crash. They may pay no matter who was at fault. In some states, PIP may cover other losses too. The rules on who must file, what proof is needed and how fast you must file vary. [2, 5]
- Uninsured or underinsured motorist coverage may help when the driver at fault has no insurance or not enough. The bodily injury and property damage versions are different. Whether you can get it, and on what terms, varies by state and policy. [2, 6]
- Rental reimbursement, towing, roadside assistance and loan or lease gap protection are each separate benefits or products. Ask if you really have each one and what its limits are. [2]
Pick a path for your car's damage
With collision coverage, you can have your own insurer handle the claim for your car’s damage. You’ll usually pay the deductible. If someone else is responsible, your insurer may later try to get its money back from that person or their insurer. That process is called subrogation. Getting your deductible back is possible, though there’s no guarantee. Ask how your insurer will keep you posted. [2, 6]
You can also file a property damage claim with the other driver’s insurer. That company has to look into its customer’s coverage and responsibility. Ask when it expects to decide. Ask if it will pay for towing, repairs or transportation. [1, 6]
An apology from the other driver doesn’t count as the other company’s final decision. Neither does a police citation or your own insurer’s opinion. If you need the car dealt with sooner, ask your own insurer what using your collision coverage would involve. [1, 6]
A deductible is your share of a covered claim. Say covered repairs come to $8,000 and your collision deductible is $1,000. Your insurer may then pay $7,000 under that coverage. The exact payment can work differently if the car is a total loss, a lender is involved or other limits apply. Ask for an itemized calculation. [2]
What the adjuster does behind the scenes
Once the claim is open, an adjuster collects statements and records and confirms coverage. The adjuster also reviews the damage and the bills, then explains a payment decision. The insurer may inspect the car or ask for photos. It may review the police report, talk to witnesses or ask for medical and wage records. [3]
Some claims have one adjuster for car damage and another for injuries. The California insurance department calls all of these normal parts of an investigation. [3]
Ask what information is still missing and who is supposed to get it. The insurer may ask for a recorded statement, a medical authorization, an exam or a signed form. If so, ask what it covers and why it’s needed. Read it before you sign. Your policy may require you to cooperate with the investigation. [3]
Sometimes a request is broad, you have a serious injury or fault is in dispute. In those cases, a local attorney can explain what the request could mean for you. [3]
The first repair estimate may change if the shop finds hidden damage. The shop can then talk with the insurer about a supplement to the estimate. Declaring a total loss requires a valuation of the car. Ask for the written estimate, valuation report or payment explanation behind the decision. [1, 3]
Handle injury coverage on a separate track
Tell the insurer if anyone was hurt, even before the full diagnosis is known. Ask whether medical payments, PIP, uninsured motorist or another benefit might apply. Find out which insurer should get the medical bills and what claim number to give providers. Ask which forms you need and when the filing deadline falls. [5]
New York, for one, has a specific short deadline for its no fault claim notice. Don’t assume your state’s deadline matches. [5]
Hold on to discharge papers, bills, receipts, work restrictions and wage records. Let medical providers know the care is related to a car crash. Ask your health insurer and your auto insurer how to coordinate billing. [3, 5]
Another person may be to blame for the crash. Even so, their insurer won’t necessarily pay each bill the moment it arrives. Keep up with the care your doctors recommend. If bills are coming due, ask a patient financial counselor for help. [3, 5]
Keep one folder for the claim
A single folder and one running note will do. Save the declarations page and full policy, claim numbers and adjuster contacts. Add police report details, photos, estimates, bills, receipts and written decisions. After each call, write down the date and the person’s name. Note what was decided, who will do what next and when you should hear back. The NAIC suggests keeping notes and asking for explanations in writing. [1]
- Bring a list of questions to each call. Lead with the decision you need right now. That might be where the car should go or how to send in a medical bill.
- Put important corrections in writing. Name the exact mistake and attach proof. Hold on to the old version of a document. Don’t swap in a new one without saying so.
- When an item is denied, cut or delayed, ask for a written explanation of the coverage or payment. Request the policy language that applies and the specific facts the insurer relied on.
Know what a check or a signature wraps up
Car repair payments, medical benefit payments and injury settlements may each deal with a different part of the crash. Don’t assume one payment closes every claim. Before you accept a final settlement or sign a release, ask which claim, person and type of loss it covers. A release may settle more than the bill sitting in front of you. [3, 6, 7]
Get advice from an attorney licensed where the crash happened if injuries are significant or fault is in dispute. Do the same if you’re asked to make a final injury settlement. [3, 6, 7]
You may use your own insurer and later get a separate offer from another party. Tell your adjuster before you accept it. Your policy may require you to protect the insurer’s right to recover what it paid. [6]
When the claim stalls or the answer looks wrong
Start by asking the adjuster to explain in writing what’s still open and what evidence is missing. Ask for the date of the next decision, too. If that doesn’t fix the problem, ask for a supervisor or the insurer’s complaint process. The NAIC advises calling your state insurance department if you still disagree with how the claim is handled. [1]
An appraisal clause in your own policy may help settle a dispute over the amount of a vehicle loss. It typically won’t decide every coverage or fault question. [1]
The other driver may have no insurance, may be impossible to find or may carry too little coverage. If so, ask your insurer right away about uninsured or underinsured motorist benefits. The rules can be technical, with deadlines that matter. With a serious injury, a local attorney can help you understand the deadlines and the effect of a proposed settlement. [2, 6]
What to ask the adjuster next time
- Which coverages are you reviewing for my car, my injuries, towing and transportation? What limits and deductibles apply?
- Are you waiting on a decision about coverage, about who is responsible or about the amount? What information is still missing?
- Who is handling the car damage, and who is handling medical or injury benefits? Where should each document go?
- What do you need from me right now, and by what deadline? When will I hear from you next?
- Will you send me the estimate, valuation, coverage decision or payment calculation in writing?
Habits that keep a crash claim on track
Report the crash quickly and get your claim numbers. Read through the coverages you paid for. Treat coverage, responsibility and the payment amount as separate questions. Ask what’s needed next and get big decisions in writing. Those habits make a complicated claim easier to manage while you’re also trying to heal.
Sources and further reading
- 1NAIC filing an auto claim
- 2NAIC auto coverage guide
- 3California accident guide
- 4NAIC declarations page
- 5New York claim guidance
- 6Washington claims guide
- 7New York release guidance
This is general information about claims in the United States. Your policy terms and your state’s law decide coverage, duties, deadlines and payment. An insurance professional or a local attorney can look at your specific claim.
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