Car Accident Insurance Claims Process

Filing Your Insurance Claim

After a car accident, you should report the accident to your own insurance company promptly — most policies require notification within a reasonable time, and some specify 24-72 hours. Reporting to your insurer is separate from filing a claim against the at-fault driver's insurer. Your own insurance provides collision coverage (for vehicle damage regardless of fault), medical payments or PIP coverage (for your medical expenses), and uninsured/underinsured motorist coverage.

When filing a claim against the at-fault driver's insurance company, you are a "third-party claimant" with different rights and obligations than a policyholder. The at-fault driver's insurer has a duty to its own insured, not to you. This adversarial relationship means everything you say to the other driver's adjuster can and will be used to minimize your claim. You are generally not legally obligated to give a recorded statement to the other driver's insurance company, and it is usually advisable to decline until you have consulted with an attorney.

The Adjuster's Process and Tactics

Insurance adjusters investigate claims by reviewing the police report, contacting witnesses, inspecting vehicle damage, reviewing your medical records (with your authorization), and sometimes conducting surveillance. Their goal is to resolve claims for the lowest amount the company will accept paying. Common adjuster tactics include making quick settlement offers before the full extent of injuries is known, requesting broad medical record authorizations that allow access to unrelated medical history, and using recorded statements to elicit admissions that undermine your claim.

The adjuster will evaluate your claim using software that assigns a value based on diagnosis codes, treatment costs, and other data points. Understanding that this is a starting point for negotiation — not a fair valuation — is critical. Adjusters are trained negotiators who begin low and expect counteroffers. Their initial offer typically represents 25-50% of what the claim is actually worth, particularly in cases involving soft tissue injuries or ongoing treatment needs.

Demand Letters and Negotiation

Once your medical treatment has concluded or reached maximum medical improvement (MMI), you or your attorney will send a demand letter to the insurance company. This letter details the accident, establishes liability, itemizes medical expenses and lost wages, describes your pain and suffering, and states a specific dollar amount demanded as settlement. Supporting documentation — medical records, bills, proof of lost income, photographs, and expert opinions — accompanies the demand.

Negotiation typically involves multiple rounds of offers and counteroffers. The insurer will respond to your demand with an initial offer, you will counter, and the process continues until either a settlement is reached or negotiations reach impasse. If negotiations stall, mediation (a voluntary, facilitated negotiation) can help bridge the gap. If no settlement is reached, filing a lawsuit is the next step — which often prompts the insurer to make a more reasonable offer before trial.

When to Involve an Attorney

You should consult a car accident attorney before accepting any settlement offer if: you suffered injuries beyond minor bruising or soreness, the accident involved a commercial vehicle or government entity, liability is disputed, the insurance company is delaying or denying your claim, or the settlement offer seems inadequate. Most personal injury attorneys work on contingency (fee arrangements vary by attorney), so cost should not be a barrier to consultation.

Studies consistently show that claimants represented by attorneys receive significantly higher settlements than unrepresented claimants, even after deducting attorney fees. The Insurance Research Council found that settlements for represented claimants average 3.5 times higher than for unrepresented claimants. Attorneys understand how to value claims accurately, negotiate effectively, preserve critical evidence, and leverage the threat of litigation to motivate fair settlements.