Tips for Explaining the Insurance Claims Process to Your Insured

The insurance claims process can be stressful if your insured doesn't know what's going on behind the scenes.

As a claims adjuster, you already know that part of the process in handling a file is making sure your policyholder fully understands what is happening and how to proceed. However, sometimes the way you go about having this conversation can set the tone early for a good overall experience.

Here are six tips for making the insurance claims process positive for your insured.

Tip #1: Detail Policy Coverage Before Talking About Liability

Although many insurers already recommend doing so as part of their standard claims process, it is important for adjusters to detail policy coverage prior to discussing a liability decision with the insured. The reasoning behind this is that sometimes a liability decision can cause an emotional reaction, such as anger or angst.

Chances are a policyholder is less likely to stay focused and listen clearly when you are describing their options if they are upset, which often causes confusion later on as the claim progresses. Make sure they know exactly what their policy includes and their options for using coverage or going through adverse carrier, if applicable.

Tip #2: Explain the Liability Decision in a Clear Manner

Another tip for explaining the claims process to your insured is detailing the liability decision in a clear manner using facts of the loss. If no liability decision has been made, explain the reasoning why. (For example, you need to speak to the other driver, passengers, or witnesses before proceeding.) Often, this explanation will help the insured feel as though the process is moving forward versus a general answer that you are still investigating.

Tip #3: Provide Information on the Next Steps for the Insured

Adjusters can also help ensure the claims process goes smoothly by providing a roadmap of sorts as to what steps the insured should take. This can include meeting with an auto damage adjuster, going to a body shop for an estimate, or even calling a tow truck if the vehicle is not drivable. Giving your client a loose outline of what comes next is a great way to ensure they have a positive experience with your firm.

Tip #4: Offer Insight to How the Company Will Handle the Claim with the Third Party

One more thing you can do to ensure your policyholder has a good experience with your claims department is by offering insight into how the company will handle the claim with the third party. For incidents where your insured is at fault, this usually includes mentioning that you will contact the other driver to get their repairs taken care of. In other circumstances, it might mean contacting adverse carrier on their behalf to help get a deductible back. Whatever situation applies to the particular claim you are working with, explain what will happen clearly.

Tip #: Try to Anticipate the Upcoming Needs of the Insured

Anticipating the upcoming needs of the insured is another way you can effectively make the insurance claims process a positive experience.

For example, you notice that there is rental car reimbursement on the policy. The insured mentions that she was on her way to pick up her five children from school when the accident occurred. Obviously, a family of that size wouldn’t fit in a standard rental, which would require a larger vehicle. Noticing details like this and working to solve them before they become a bigger issue is one way to really make sure your policyholder is taken care of when it counts the most.

Tip #6: Have Patience

This tip probably goes without saying, but we are including it anyway: have patience with your insured. Even though you know just about everything there is regarding auto claims, there’s a good chance he or she has never been in an accident and isn’t quite sure what to expect. Speak slowly and allow them to vent any frustrations they have appropriately without rushing along.

Bonus Tip: Take Care of Claimants, Too

As a bonus tip, remember that it is important to take good care of claimants, too. Why? Even though they don’t pay premiums, a claim is an ideal chance to try to earn their business. The way a file is handled and whether or not their experience with adjusters was positive is often a selling factor when it comes to how they decide which insurance company to ultimately utilize.

One Comment

  1. Theoretically, you can be convicted, fined and go to jail. Will that hapepn? It depends on how egregious the fraud is.Realistically, it voids your insurance, so the insurance company doesn’t pay. That ALSO means, that you no longer have the protection of the FL no fault laws, which only protect people with insurance. The OTHER guy’s insurance might sue the uninsured guy who is uninsured because he committed fraud and voided his coverage. But YOUR insurance won’t. Heck yes, being convicted of insurance fraud will make no standard insurer give you ANY kind of insurance not auto, not homeowners, not even business insurance.There is no automatic notification. Call them today, add your spouse to your policy, and they’ll change your rating status to married.

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