How Car Insurance Companies Investigate Claims
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- Part 1 of 2: Factors that cause a car accident
- Part 2 of 2: How insurance companies investigate a car accident
Following a car accident, you might wonder what actually caused it to happen. The reality is that a lot of factors play a part when a crash happens, including the speed of the vehicles involved, whether all drivers were following the rules of the road, and weather and road conditions at the time. What exactly does an insurance adjuster look at when deconstructing a car accident, and how do they determine negligence to decide how much the insurance company pays on a claim?
In this article, Part 1 looks at factors that cause car accidents and Part 2 breaks down how insurance adjusters analyze car accident claims.
Part 1 of 2: Factors that cause a car accident
Most often, a combination of factors lead to a car accident. It is only in hindsight that it becomes obvious as to what causes an accident. The section below details three tops factors that lead to an accident:
- Maneuver: Did the driver of any of the vehicles involved in the accident perform an unsafe maneuver, usually in the form of an unsafe lane change, speeding, or failing to yield when they should have? Some of the more common driving maneuvers that can lead to an accident include:
- Following too closely to another car
- Driving too fast
- Failing to yield when required
- Making unsafe lane changes
- Event: Was there an unexpected event that occurred that led to the accident? Some examples include a person, animal, or object crossing the road and causing the driver or drivers to attempt to avoid hitting it.
- Attention: The amount of attention to the road ahead, or lack thereof in some cases, often plays a part in an accident happening. A questions that authorities might ask includes was the at-fault driver distracted in some way, such as through a conversation, the use of a handheld device, or taking their eyes off of the road for some reason?
Part 2 of 2: How insurance companies investigate a car accident
Once you file a claim, your insurance company assigns an adjuster to determine who was at fault for the accident and how much you will receive on your claim. As a matter of fact, each driver involved receives their own adjuster, even if you both use the same insurance company.
While investigating an accident, adjusters usually follow the process detailed below:
Step 1: Interview drivers and witnesses. First, the adjuster contacts all drivers involved in the accident and any witnesses.
Immediately following an accident, look for any witnesses to the crash and get their name and phone number to give to your insurance company for this purpose.
Step 2: Examines information. Next, the adjuster examines any evidence from the accident.
Information that an adjuster looks at in the course of their investigation include:
- Photographs of your car before and after the accident
- The vehicles involved in the accident
- The accident scene
- Any witness written statements
- A copy of the police report (if any)
Step 3: Determines negligence. The next step in investigating a car accident involves determining who was actually at fault, or the amount of negligence on the part of each party.
Depending on the state, the amount of negligence can determine how much of a payout you receive after an accident, or even if you are entitled to a payout at all.
The levels of negligence include:
- Contributory negligence: The at-fault party or any other at-fault parties. The result could lead to one or the other parties receiving only a partial payout on their claim, or no payout at all.
- Comparative negligence: The adjusters take into account the amount of fault of each party in the accident, with the payouts adjusted accordingly.
Comparative negligence follows two models when determining the payout for each driver involved.
- Pure comparative negligence: Each party receives a payout in the amount of the percentage that the other party was at fault.
- Modified comparative negligence: If the party not at-fault in the accident is found 51% or more negligent for the accident, they receive no payout.
The following table shows the negligence system for each U.S. state:
|Negligence Systems by State|
|Alabama||Pure Contributory Negligence|
|Alaska||Pure Comparative Negligence|
|Arizona||Pure Comparative Negligence|
|Arkansas||Modified Comparative Negligence – 50% Rule|
|California||Pure Comparative Negligence|
|Colorado||Modified Comparative Negligence – 50% Rule|
|Connecticut||Modified Comparative Negligence – 51% Rule|
|Delaware||Modified Comparative Negligence – 51% Rule|
|District of Columbia||Pure Contributory Negligence|
|Florida||Pure Comparative Negligence|
|Georgia||Modified Comparative Negligence – 50% Rule|
|Hawaii||Modified Comparative Negligence – 51% Rule|
|Idaho||Modified Comparative Negligence – 50% Rule|
|Illinois||Modified Comparative Negligence – 51% Rule|
|Indiana||Modified Comparative Negligence – 51% Rule|
|Iowa||Modified Comparative Negligence – 51% Rule|
|Kansas||Modified Comparative Negligence – 50% Rule|
|Kentucky||Pure Comparative Negligence|
|Louisiana||Pure Comparative Negligence|
|Maine||Modified Comparative Negligence – 50% Rule|
|Maryland||Pure Contributory Negligence|
|Massachusetts||Modified Comparative Negligence – 51% Rule|
|Michigan||Modified Comparative Negligence – 51% Rule|
|Minnesota||Modified Comparative Negligence – 51% Rule|
|Mississippi||Pure Comparative Negligence|
|Missouri||Pure Comparative Negligence|
|Montana||Modified Comparative Negligence – 51% Rule|
|Nebraska||Modified Comparative Negligence – 50% Rule|
|Nevada||Modified Comparative Negligence – 51% Rule|
|New Hampshire||Modified Comparative Negligence – 51% Rule|
|New Jersey||Modified Comparative Negligence – 51% Rule|
|New Mexico||Pure Comparative Negligence|
|New York||Pure Comparative Negligence|
|North Carolina||Pure Contributory Negligence|
|North Dakota||Modified Comparative Negligence – 50% Rule|
|Ohio||Modified Comparative Negligence – 51% Rule|
|Oklahoma||Modified Comparative Negligence – 50% Rule|
|Oregon||Modified Comparative Negligence – 51% Rule|
|Pennsylvania||Modified Comparative Negligence – 51% Rule|
|Rhode Island||Pure Comparative Negligence|
|South Carolina||Modified Comparative Negligence – 51% Rule|
|South Dakota||Pure Comparative Negligence|
|Tennessee||Modified Comparative Negligence – 50% Rule|
|Texas||Modified Comparative Negligence – 51% Rule|
|Utah||Modified Comparative Negligence – 50% Rule|
|Vermont||Modified Comparative Negligence – 51% Rule|
|Virginia||Pure Contributory Negligence|
|Washington||Pure Comparative Negligence|
|West Virginia||Modified Comparative Negligence – 50% Rule|
|Wisconsin||Modified Comparative Negligence – 51% Rule|
|Wyoming||Modified Comparative Negligence – 51% Rule|
Step 4: Settles claim. After taking all evidence into account and determining the amount of negligence each party holds, the adjuster determines how much the insurance company must pay you to cover any injuries or damages.
In addition, at this point you must pay the deductible before receiving any kind of payout.
Understanding how accidents occur can give you a heads up on what sort of driving habits you need to avoid to keep from having a wreck. And while avoiding an accident should be the ultimate aim of any driver, making sure you have the proper insurance coverage can go a long way toward making sure you are covered when an accident does happen.