an injured employee filing an insurance claim

What Is a Claim in Insurance Terms?

April 30, 2024
Mordechai Kamenetsky

A claim is when an insured person or business has an incident and asks the insurance company that they’ve been paying for coverage to pay for it.

What are the types of Insurance Claims?

Some of the most common types of insurance claims include:

  1. Auto Insurance Claims - Auto claims are usually filed after an accident or a theft related to vehicles. The claim might be for damage to the vehicle or other liabilities related to injuries to others or damage to their property. 
  2. Health Insurance Claims - Claims related to health insurance involve asking for a direct payment or reimbursement for medical services the insured person used. These may be filed by the person who is insured or the healthcare provider. 
  3. Liability Claims - A liability claim occurs when someone who is insured has been held legally responsible for causing damage or injury to someone else. As an example, general liability insurance could be used to cover claims against a business that harmed a third party by accident. 
  4. Life Insurance Claims - Life insurance claims are initiated by the death of an insured person. The beneficiaries listed on the life insurance can file to get the death benefits included in the policy.
  5. Property Claims - A property claim involves loss of or damage to property because of things like natural disasters, fires, or thefts. Property insurance claims are common both with commercial and personal insurance policies.
  6. Workers’ Comp Claims - A workers’ comp claim is when an employee is injured at work or on a job. The insurance company will cover their medical treatments, lost wages and death benefits. 

Being aware of what types of claims exist is important. As someone who holds insurance, you want to make sure you have the proper level of coverage and are aware of how to move forward after an accident or some other type of incident.

How long do Insurance Claims take?

The amount of time that it takes to handle an insurance claim can vary a lot. In many cases, it comes down to the type of claim, how efficient the insurance provider is, and the level of complexity of the incident. 

In most cases, the process starts when the insured person or business tells the insurance company that they have a claim. This should happen as soon as possible after the event that led to a loss.

Several factors can determine how long a claim takes. For instance, life insurance claims might take longer than other insurance claims. 

In addition, a large and complex case is going to take longer than a simple one. Local laws and regulations can also come into play and have a bearing on the length of time.

Steps involved in processing an Insurance Claim

The first step in the process is the notification. As soon as a problem occurs, the insured person or business needs to let the insurance company know. This should happen quickly and will lead to the initiation of the claim process.

Next up is assessment and investigation. The insurance company will investigate the claim to see if it’s valid and determine the extent of liability. This might involve several things, such as a review of medical reports, an audit of financial records, or an inspection of property damage.

Third is the process of adjustment and estimation. An insurance adjuster is going to evaluate the claim and decide what the cost of replacement or repairs would be. Once this information is known, this number is used to determine how much the claim will pay out to the policyholder.

Finally, once the claim has been approved, the insurance company will give a payment either to the insured or a service provider. 

Ready to protect your Business?

Whether it's a mishap on the road, damage to your property, or an injured worker, knowing how to navigate the claims process is crucial. 

But even more important is choosing the right insurance partner who can guide you through smoothly and efficiently. That's where we come in. 

At Kickstand Insurance, we're committed to providing the coverage you need with the understanding and support you deserve. Don't wait for the unexpected to happen. Get a comprehensive commercial insurance quote and secure your peace of mind for whatever comes your way.

Mordechai Kamenetsky

Mordechai Kamenetsky, co-founder and lead agent of Kickstand, is recognized as an expert in workers' compensation. He is passionate about helping small businesses manage risks and lower their workers' comp costs. In his articles, he educates readers and clients on the intricacies of workers' comp insurance.

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