Six Steps in Making an Insurance Claim (2024)

Michael T. Olexa and Sean Olevnik

Step One: Contact Your Agent Immediately

  • Give your name, address, policy number, and the date and time of your loss.
  • Make sure to tell your insurance agent where you can be reached, especially if you are unable to stay in your home.
  • Follow up the call with a letter detailing the problem. Keep a copy of the letter.
  • Your insurance agent will arrange for an adjustor to visit your property and assess the damage. Be sure the adjustor is properly licensed. In Florida, call the Department of Financial Services Consumer Help Line, toll-free, at 1-877-693-5236. If you are not in Florida, check online or in a phone book for your state's insurance consumer help line.

Step Two: Carefully Document Your Losses

Safety first! Before entering a building, always check for structural damage. Do not go inside the building if there is any chance of the building collapsing. Be careful walking around inside and outside the building. Upon entering the building, do not use open flames since gas may be trapped inside the building. Instead, use your flashlight to light your way. Keep power off until an electrician has inspected your system for safety.

  • Make a detailed list of lost or damaged property.
  • Videotape and/or photograph damaged property before beginning any repairs.
  • Do not throw away damaged property without your adjustor's approval.
  • Try to document the value of each object lost. To help valuate lost objects use bills of sale, canceled checks, charge account records, and insurance evaluations. If you have no such records, estimate the value, and give purchase place and date of purchase. Include this information with your list.
  • List cleaning and repair bills, including materials, cost of rental equipment, and depreciation of purchased equipment.
  • List any additional living expenses you incur if your home is so severely damaged that you have to find other accommodations while repairs are being made (this includes motel bills, restaurant bills, home rental, and/or car rental).

Step Three: Protect Your Property from Further Damage or Theft

  • If there is roof damage or broken windows make sure to make temporary repairs. Cover damaged roof areas with tarps and cover broken windows with boards or plastic.
  • If household furnishings are exposed to weather, move them to a safe location for storage.
  • Remember the documentation from Step Two! Save receipts for what you spend and submit them to your insurance company for reimbursem*nt.
  • If your home has been flooded, protect your family's health by cleaning your home right away. Floodwaters pick up sewage and chemicals from roads, farms, and factories. Throw out food and medicine that may have come into contact with floodwater. Dry out water-damaged furnishings and clothing as soon as possible to prevent fading and deterioration.

Step Four: Working with Adjustor

  • Your insurance agent will arrange for an adjustor to visit your property and assess the damage. Be sure the adjustor is properly licensed. In Florida, call the Department of Financial Services Consumer Help Line, toll-free, at 1-877-693-5236. Check online or in a phone book for your state's insurance consumer help line.
  • Be sure that you or a trusted advisor is present when the adjustor visits the site.
  • Work with the adjustor. It is the adjustor's job to assist you and review your claim. The adjustor will inspect your list of lost or damaged property. The adjustor will work with you to calculate the value of the items on the list and prepare a repair estimate of damage to the property.
  • You and your adjustor need to come to an agreement as to the scope of damage, which is an agreement as to what needs to be repaired or replaced without a dollar amount.
  • Make sure you know what needs to be done to follow up on this agreement and why. If you do not understand what needs to be done, ask the adjustor for instructions in writing.

Step Five: Settling Your Claim

  • You may settle personal property and structural claims at separate times, although your adjustor may suggest that you file the claims together. Filing the two types of claims separately allows you to take the time needed to determine the full extent of your losses.
  • Do not be in a hurry to settle your claim. Wait until you have discovered all the damage before filing a claim.
  • If you are dissatisfied with the settlement offer, talk things over with your agent and adjustor.
  • If you and your adjustor cannot reach a settlement, you may obtain mediation through your state's department of insurance. Mediation is an informal process where a neutral third party helps the parties resolve the dispute. If you are in Florida, call the Department of Financial Services Consumer Help Line, toll-free, at 1-877-693-5236 for information on mediation or other methods of dispute resolution. Check online or in a phone book for your state's insurance consumer help line.

Step Six: Repairing Your Home

  • You or your insurance company may contract for the repair of your home. Make sure the contractor is a reputable firm that is both licensed and insured. You can find out whether the contractor holds a proper license by contacting your state's department of business regulations. In Florida, contact the Department of Business and Professional Regulation online, or call 1-850-487-1395 (this is not a toll-free number).
  • Beware of door-to-door sellers when choosing a contractor to make repairs. Sometimes undependable workers enter a damaged area, make cheap repairs, and leave before the residents discover that the repairs are inadequate. If your local contractor cannot do the work, ask the contractor to recommend someone.
  • Get a written estimate that includes any oral promises the contractor made. Always ask if there is a charge for an estimate before allowing anyone into your home.
  • Your insurance company may initially pay you a sum equal to the actual cash value, unless you request minimal repairs. The company will withhold the balance of the full replacement cost until after you complete the repairs.

Sources for This Publication

Tips on Filing Your Flood Insurance Claim. Federal Emergency Management Agency (FEMA). Access online at: https://www.fema.gov/nfip-file-your-claim

Insuring Your Home: A Guide for Consumers. Florida Department of Financial Services. Access online at: https://www.myfloridacfo.com/docs-sf/consumer-services-libraries/consumerservices-documents/understanding-coverage/consumer-guides/english---homeowners-insurance-toolkit.pdf?sfvrsn=1a17d80c_16

This publication is designed to provide accurate, current, and authoritative information on the subject. However, since the laws, regulations, administrative rulings, and court decisions on which it is based are subject to constant revision, portions of this publication could become outdated at any time. This publication is distributed with the understanding that the authors are not engaged in rendering legal advice or opinions, and the information contained herein should not be regarded, or relied upon, as a substitute for legal advice or opinion. For these reasons, the utilization of these materials by any person constitutes an agreement to hold harmless the authors, the Institute of Food and Agricultural Sciences, and the University of Florida for any liability claims, damages, or expenses that may be incurred by any person as a result of reference to or reliance on the information contained in this fact sheet.

Publication #DH199

Release Date:January 18, 2024

Related Units

Six Steps in Making an Insurance Claim (1)

Agricultural and Biological Engineering

Six Steps in Making an Insurance Claim (2)

Food and Resource Economics

Related Topics

Insurance

Disaster Recovery

Home Ownership

Six Steps in Making an Insurance Claim (3)

About this Publication

This document is DH199 (formerly DH0431), one of a series of the Food and Resource Economics Department, UF/IFAS Extension. Original publication date May 2003. Revised January 2016, October 2019, and November 2023. Visit the EDIS website at https://edis.ifas.ufl.edu for the currently supported version of this publication. The funding for the revision of this publication was provided by the James S. and Dorothy F. Wershow Endowment. This publication is part of the Disaster Handbook, a component of the Comprehensive Disaster Preparedness and Recovery Education Module. There are ten Disaster Handbook documents by Olexa and Olevnik: DH138, DH199, DH200, DH201, DH202, DH203, DH204, DH206, DH215, and DH219.

About the Authors

Michael T. Olexa, professor, Food and Resource Economics Department, and director, Center for Agricultural and Natural Resource Law; and Sean Olevnik, senior legal researcher and student, UF Levin College of Law; UF/IFAS Extension, Gainesville, FL 32611.

Contacts

  • Michael Olexa

Six Steps in Making an Insurance Claim (4)

Six Steps in Making an Insurance Claim (2024)

FAQs

Six Steps in Making an Insurance Claim? ›

The insurance claim life cycle has four phases: adjudication, submission, payment, and processing.

What are the six important steps to follow before submitting a claim? ›

There are six steps in making a claim.
  1. Step 1: Contact Your Agent Immediately. ...
  2. Step 2: Carefully Document Your Losses. ...
  3. Step 3: Protect Your Property from Further Damage or Theft. ...
  4. Step 4: Working With the Adjuster. ...
  5. Step 5: Settling Your Claim. ...
  6. Step 6: Repairing Your Home.

What are the 4 steps in making a claim? ›

Follow these four simple steps to file a claim:
  1. 1.Claim intimation/notification. ...
  2. 2.Documents required for claim processing. ...
  3. 3.Submission of required documents for claim processing. ...
  4. 4.Settlement of claim.

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 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 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 four stages of the insurance claim cycle? ›

The insurance claim life cycle has four phases: adjudication, submission, payment, and processing.

What are the steps to write a claim? ›

A claim or claim statement answers a question posed by a writer in a paragraph or essay, which the writer then must prove to be true. The next component, evidence, is research, data, or textual evidence that supports the claim. It must be factual and cannot be the writer's opinion. The final component is reasoning.

What is the best way to make an insurance claim? ›

If you need to make a claim contact your insurer as soon as possible and ask them to send you a claim form. They may be able to email this to you to speed things up. Complete the claim form carefully and keep a copy for yourself.

What is the first thing an insurer must investigate before taking on a claim? ›

The first step in this process completed by the adjuster is to determine whether coverage is applicable to a loss. The methodology they use depends on whether the claim is first-party or third-party in nature.

What are the top 3 most important aspects to a claim? ›

The three most important aspects of any medical claim include:
  • Basic patient information, including full name, birthday, and address.
  • The provider's NPI (National Provider Identifier)
  • CPT codes that reflect the provided services.

What to do before making a claim? ›

10 Things to Consider Before Filing an Insurance Claim
  1. File Quickly. It's best not to wait to file a claim. ...
  2. Show Your Knowledge. ...
  3. Be Diligent. ...
  4. Find Experts to Help. ...
  5. Make a List. ...
  6. Work With Insurance Adjusters. ...
  7. Document Insurance Adjuster Interactions. ...
  8. Report and Document Damages.

What are the 6 C's of insurance? ›

“There are six Cs as to why companies form captives: cost, capacity, control, compliance, cover, and commercial,” said Patrick Ferguson, senior vice president, Marsh Captive Solutions.

What are the 6 rules of insurance? ›

In the insurance world there are six basic principles that must be met, ie insurable interest, Utmost good faith, proximate cause, indemnity, subrogation and contribution.

What are the steps to follow when making an insurance claim? ›

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

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

What are the steps of claim investigation? ›

It involves many steps, such as collecting and reviewing documents, taking statements, locating and interviewing witnesses, inspecting and photographing the damaged property or accident site, conducting surveillance, analyzing social media accounts, and insurance fraud reporting.

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