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What to do in the Event of a Claim

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Experiencing a loss to your property or worse yet, bodily injury or death is a very stressful time. It may be difficult to know what your next steps are after making sure everyone involved is okay or being treated by emergency responders. Here are a few tips to help guide you through a loss and claim process whether it is to property, auto, employees (Workers Compensation) or a liability claim.

Property Insurance Claims

In the event of damage to your building or contents, follow these steps:

  1. Protect the property from further damage and call the proper authorities and utilities (e.g., gas, electric, telephone).
  2. Take photos of the damage before having emergency repairs made, such as boarding up windows or covering holes in the roof.
  3. Call Top O' Michigan Insurance to report the loss.
  4. Call a contractor to estimate the building damages.
  5. Separate damaged contents from undamaged contents. Do not discard any items until the claims adjuster gives you the authority to do so.
  6. Keep records of expenses if you are forced to temporarily relocate.
  7. Do not authorize repairs until the claims adjuster has given you the authority to do so.

Homeowner Storm Damage Claim

After we report the claim to the insurance company, the claims adjuster will do the following:

  1. Contact you by phone, email, or mail to discuss the loss.
  2. Arrange for an appraiser to inspect extensively damaged property.
  3. Assist you with your choice of contractors to make the repairs.
  4. Coordinate alternative living or business expenses.
  5. Be available for questions or to discuss ongoing expenses associated with the claim.
  6. Contact you for a settlement.
insurance claim estimate
Auto Insurance Claims

In the event of an automobile accident, follow these steps:

  1. Report the accident to the police.
  2. Obtain information about the other people involved in the accident such as the following:
    • Names, addresses and phone numbers
    • Insurance company
    • Type of vehicle
    • Auto and driver’s license numbers
  3. Have your vehicle towed to the nearest repair shop if the vehicle is not drivable. Do not authorize repairs until the claims adjuster gives you the authority to do so.
  4. Call us to report the accident.

In the event of a windshield, vandalism or theft loss, follow these steps:

  1. Report the vandalism loss or theft to the police.
  2. Call us to report a loss.

Auto Accident Insurance Claim

Auto Insurance Claim Windshield Damage

After we report the claim to the insurance company, the claims adjuster will do the following:

  1. Contact you to request details of the accident and repair estimates.
  2. Arrange for an appraiser to inspect the damages of vehicles that are not drivable or extensively damaged.
  3. Coordinate with the auto repair shop and coordinate for rental reimbursement (if you have it).
  4. Contact you for a settlement.
  5. Deal directly with the others involved in the accident.

You should not talk to others involved in the accident, but refer them to your claims adjuster.

auto insurance claim estimate

Auto Repair Mechanic

Workers Compensation Claims

In the event an employee is injured on the job, follow these steps:

  1. Complete the Employer’s First Report of Injury (click here) or Disease form for all claims. Either use the “call in” reporting system or fax the original form to the insurance company. Send a copy of this form to the State Department of Industry, Labor and Human Relations (refer to the First Report for the address).
  2. Forward a copy of the First Report to us in the event of a disabling injury or death claim. We will follow up with the insurance company for their prompt handling of the claim.
  3. Contact the insurance company to question the status of a claim. If you experience delays or have questions, please contact us for assistance.

Employee Workers Compensation Injury

After you report the claim to the insurance company, the claims adjuster will do the following:

  1. Contact the injured employee to discuss the accident.
  2. Request copies of bills and doctors’ reports for medical treatment administered.
  3. Contact you, the employer, if there is any lost time from work as a result of the injury.
Workers Compensation Injury Claim Form
Liability Insurance Claims

In the event of injuries or damage to property of others which you allegedly caused, follow these steps:

  1. Call us to report the claim immediately.
    • Even if no action has taken place yet, it is best to notify your agent and insurance company of any possible claim.
  2. Forward any correspondence, including a summons from an attorney representing the other party.
  3. Do not discuss the claim with the other party or their attorney. Refer them to your insurance company’s claims adjuster or to us.
Liability Bodily Injury Claim

After we report the claim to the insurance company, the claims adjuster will:

  1. Contact you to discuss the incident that allegedly caused the injury or damage to the property.
  2. Deal directly with the other party and/or attorney to handle the claim.

The insurance claim process can be difficult and complex with so many elements involved. Even if you are mindful and diligent, it can be easy to overlook some of the important details that impact the management and overall success of your claim. Be sure to watch out for potential red flags throughout the process including:

  • Slow response time from the insurance company (within reason following major weather events).
  • Requesting an examination under oath.  Speak with your agent before making any statement or if you have concern.
  • You are required to use a "preferred vendor". While you are not required to use the vendors that are recommended to you by your insurance company, it can make the process much easier and be completed ahead of schedule. However, you have the final say and should do your own research before hiring any vendors. 

Ultimately, you want to be sure that the premium dollars you've paid will respond how they should under the contract of the insurance policy. If you have any questions along the way, you should contact your agent for guidance and have honest, pen communication with the claims adjuster.


A Note to Our Clients

The Top O' Michigan Insurance team is here to serve you. This service includes assisting you in the event of a claim. If a loss occurs, please follow the steps highlighted in this guide.

Your insurance contract requires that you report all claims promptly. Therefore, contact us as soon as possible after a property, liability, workers’ compensation or automobile claim. We will report your claim to the insurance company. An insurance company claims adjuster will be assigned to handle your claim. You should then be able to deal directly with the adjuster to settle your claim.

We also work directly with our claims department to analyze the policy language to find coverage when it should apply. So don't assume a claim denial or a lesser payment is automatically correct. If you encounter any unusual delays or problems in the handling of your claim, please contact us at 800-686-8664 or ClientService@TOMIA247.com.

We appreciate your business and are here to assist you.

For more personal risk management guidance or questions about your policy's coverage limits, contact us today.

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About Top O' Michigan Insurance Solutions:

At Top O’ Michigan Insurance Solutions, we pride ourselves on using our skills to provide clients with competitive pricing, stability and understanding, and peace of mind. With eight locations throughout Michigan and 24/7 client access, our team is your 'expert buyer' of insurance for home, auto, farm, boat, motorcycle, business owners, workers compensation, bonds, life and health, employee benefits and more.

We will provide unparalleled and caring service to our clients through our knowledgeable staff and give back to our employees, agency, industry and our communities. Part of our mission is to give back to the Michigan communities we serve. This is something we take action on through We Care and you can learn more about our community outreach at TOMIA247.com/WeCare.

National Resources, Locally Sourced.

Disclaimer: This Blog/Web Site does not provide insurance or legal advice. This site is for educational purposes only as well as to provide you with general information and a general understanding of insurance, not to provide specific legal advice or specific contract advice. Viewing this site, receipt of information contained on this site, or the transmission of information from or to this site does not constitute a client relationship. 

The information on this Blog/Web Site is not intended to be a substitute for professional insurance or legal advice. Always seek the advice of a licensed agent in your state pertaining to insurance and legal issues.

Author: Tyler Bartosh

Sources: BizJournals.com;  Zywave, Inc 

 

 

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