What Is An Insurance Claim & How Do They Work? | MetLife (2024)

An insurance claim is a formal request from the policyholderto their insurance company asking for payment after a covered incident, such as a hospital stay, a natural disaster, theft, and more.

This payment – typically issued to the person named on the policy (or a designated beneficiary – helps pay for expenses associated with the covered incident.

In this article, we’ll discuss types of insurance claims, the general process of filing a claim, and help answer several FAQs on the topic. For specific claims information, be sure to refer to your policy or contact your insurer.

Types of insurance claims

There are as many insurance claim types as there are types of insurance.A claim is a request to an insurance company to pay for a covered service or event under the current insurance policy.

1. Car insurance claims

Car insurance claims may include:

  • A collision with another vehicle, person, or property, and property damage and/or bodily harm
  • Damage caused by an outside force (like a natural disaster, collision with an animal, and other no-fault instances)
  • Damage caused by uninsured or underinsured drivers, should they cause a collision with you (depending on the extent of your policy)

2. Homeowners insurance claims

Homeowners insurance claims may include several scenarios that relate to your home:

  • Structural damage
  • Injuries to visitors while they’re in your home
  • Damage to your personal property, including theft
  • Additional living expenses (ALE) if your home becomes uninhabitable and you need to stay in an alternate residence for a period of time

3. Renter’s insurance claims

Renter’s insurance claims may include incidents related to an apartment or other property you’re renting such as:

  • Theft from your property or vehicle
  • Damage to your personal propertyInjuries to people while they’re in your rented property
  • Damage from natural disasters or other predetermined instances

4. Life insurance claims

Life insurance claims cover a very specific set of circ*mstances, all related to the policyholder’s death. In the case of the insured’s death, the insurance company makes a payment to the designated beneficiary – the person(s) selected by the policyholder to inherit the policy’s assets.

How do insurance claims work?

Filing an insurance claim typically involves a few basic steps:

1. Start by checking your insurance policy details to see if your policy covers the incident and if there’s a time limit for filing a claim.

2. Gather important information, such as:

  • The names and contact information of those involved
  • The date of the incident
  • Insurance policy numbers of those involved
  • An incident, accident, or medical report
  • Photos if you’ve been in an accident, suffered damage to your home or property, or experienced a comprehensive, no-fault incident.

3. File a claim with your insurance company if your incident requires you to do so. You'll provide the details of the claim and submit the information to your insurance company via their preferred method (e.g. mail, online or digital app). Note that for some medical insurance claims, the healthcare provider's office may file the claim directly for you.

How is an insurance claim paid?

If your insurance provider approves the claim, they’ll remit payment to you or the service provider. Payment can be in the form of a physical check, direct deposit or sent directly to the service provider (such as a hospital, auto repair shop or contractor.)

What Is An Insurance Claim & How Do They Work? | MetLife (2024)
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