How to File an Insurance Claim

A step-by-step walkthrough.

A claim is the moment your insurance policy actually does its job. How you file affects how fast you get paid, how much you get paid, and whether the process turns into a months-long fight.

The steps differ by claim type, but the principles are the same. Do a few things right in the first hour and the rest of the process tends to go your way.

Before you call anyone, do these first

1. Make sure people are safe. Get medical attention if needed.
2. Stop further damage if it's safe to do so. Tarp the roof, shut off the water main, move the car off the road. Most policies require "reasonable steps to mitigate damage," and reimburse you for the supplies you use.
3. Document everything. Photos and video before you clean up or move anything. Time-stamped photos are best.
4. Save receipts for emergency repairs, hotel stays, and supplies.

Filing an auto claim

1. At the scene: call 911 if there's injury or major damage. Get a police report, this is critical for insurance.
2. Exchange info with the other driver: name, phone, license plate, insurance carrier, policy number, license number.
3. Photos: all damage, all vehicles, the scene from multiple angles, road conditions, traffic signs.
4. Witness names and contact info if available.
5. Call your insurer as soon as practical (most apps now allow filing in minutes).
6. Don't admit fault at the scene or to the other driver's insurer.
7. Get the claim number and the assigned adjuster's contact info.

Filing a home insurance claim

1. Stop the damage (tarp, water shutoff, board up windows).
2. Call the police for theft or vandalism.
3. Document everything, photos, video, and a detailed inventory of damaged items with estimated values.
4. Save damaged items if possible. Insurers often want to see them.
5. Save receipts for emergency repairs and temporary lodging.
6. Call your insurer. Get the claim number and adjuster info.
7. Don't accept the first lowball estimate without comparing it to a contractor's bid.

Filing a life insurance claim

1. Get certified copies of the death certificate (you'll need 5 to 10 for various accounts).
2. Locate the policy and any beneficiary documents.
3. Call the insurance company and request claim forms.
4. Submit the claim form, death certificate, and policy (or policy number).
5. Choose payment option: lump sum (most common), installments, or annuity options.
6. Most life claims pay within 30 to 60 days if documentation is complete and there's no contestability issue.

Filing a health insurance claim

Most providers file directly with the insurer. When you need to file yourself:

1. Get an itemized bill with CPT/diagnosis codes from the provider.
2. Submit through your insurer's portal or by mail.
3. Track claim status. Denials can usually be appealed.

Don't say these things to an adjuster

• "I'm sorry." Can be interpreted as admission of fault.
• "I'm fine." Especially after an injury. Soft tissue and concussion symptoms develop over days.
• "That sounds about right." When they offer a settlement, take time to evaluate it.
• "I don't have an attorney." True or not, this can affect how the case is handled.

Get everything in writing

• Claim numbers.
• Adjuster contact info.
• Coverage decisions.
• Settlement offers.
• Repair authorizations.

When to involve an attorney

For most property claims and small auto claims, an attorney is unnecessary. Consider one for:

• Serious injury claims with significant medical bills and lost wages.
• Disputed liability in an at-fault accident.
• Claim denials you believe are wrong.
• Bad faith insurer behavior (unjustified delays, lowball offers, denials of clearly covered claims).

Most personal injury and bad faith attorneys work on contingency (no fee unless they recover).

For more on what happens after you hang up with the adjuster, move on to the next module.

What Happens After You File

The 90% of the process most people don't know.

Filing the claim is the first 10% of the process. The other 90% is what happens next, and it can take days, weeks, or months depending on the claim type.

Knowing the timeline helps you ask the right questions and follow up at the right times.

Step 1: Claim assignment (within 24 to 48 hours)

The insurer assigns an adjuster. For auto claims, this often happens within hours. For home claims, sometimes a day or two. The adjuster's job:

• Investigate the claim.
• Determine coverage.
• Estimate the loss.
• Negotiate or pay the settlement.

Step 2: Inspection

• Auto: Either an in-person inspection at a body shop or a "virtual inspection" via photos and video through the carrier's app. Many auto claims now resolve entirely virtually within 7 to 14 days.
• Home: A field adjuster visits the property, typically within 7 to 14 days. They take photos, measurements, and notes.
• Life: No inspection. The death certificate and policy documents are the evidence.
• Health: Provider files directly; the insurer reviews coding, medical necessity, and network status.

Step 3: Coverage decision

The adjuster compares the claim against the policy:

• Is this loss type covered?
• Is the cause covered?
• Are exclusions involved?
• What's the deductible and limit?

If something is excluded or limited, you'll receive a coverage explanation letter.

Step 4: Damage estimate

The adjuster prepares an estimate, for repairs (auto, home), or for valuation (total loss vehicle, total loss home). You'll typically receive this within 14 to 30 days for non-catastrophe claims; longer during catastrophe events.

Step 5: Negotiation (if needed)

If you disagree with the estimate:

• Get a competing estimate from a contractor or repair shop.
• Submit it to the adjuster with documentation.
• Negotiate. This is normal, insurers expect it.
• For complex claims, consider hiring a public adjuster (works for you, takes a percentage of the settlement) or an attorney.

Step 6: Settlement and payment

• Auto: Either pays the body shop directly (with you paying the deductible), or pays you a check and you handle repairs.
• Home: Typically pays in two parts, actual cash value upfront, depreciation released after repairs are completed and documented.
• Life: Typically lump sum within 30 to 60 days of receiving complete documentation.

Step 7: Closure

The claim closes when:

• Payment has been made.
• All repairs are documented (for home claims with depreciation holdbacks).
• The statute of limitations expires (for liability claims with potential late-arriving claimants).

When claims drag on

• Catastrophe events (hurricane, wildfire, hailstorm) overwhelm adjuster availability. Expect 2 to 6 month delays in major events.
• Disputed liability (auto), when fault isn't clear, both insurers investigate before paying.
• Coverage disputes, when there's a question about whether something is covered.
• Documentation gaps, missing receipts, no photos, incomplete inventory.
• Bad faith, insurer is deliberately slow-walking. Document everything and consider a state DOI complaint.

Total loss vehicles

If the cost to repair exceeds 70 to 80% of the vehicle's value (the threshold varies by state), the insurer "totals" it. They pay you the actual cash value (ACV), what the car was worth right before the accident. Use sources like Kelley Blue Book, NADA, and recent comparable sales to negotiate if the offer feels low.

Total loss homes

For homes, "total loss" means the cost to repair exceeds the policy limit (or the home is unrepairable). Settlements involve:

• Dwelling limit payment for the structure.
• Personal property payment for contents.
• Loss of use for temporary housing during rebuild.
• Sometimes ordinance and law coverage for code-required upgrades.

A total loss home claim can take 12 to 24 months to fully resolve.

Your right to a public adjuster

A public adjuster is licensed (in most states) to represent you against the insurer in property claims. They typically charge 10 to 20% of the settlement. For large or complex claims, especially in catastrophe events, they often recover more than their fee.

Right to appeal denied claims

If a claim is denied:

• Get the denial in writing with specific policy language cited.
• Request a re-review with additional documentation.
• Appeal through the insurer's formal appeal process.
• File a complaint with your state Department of Insurance.
• Consult an attorney for serious disputes.

For more on coverage that affects claim outcomes, see our auto, home, and life insurance pages.

Marriage and Divorce

The insurance changes everyone forgets.

Marriage and divorce both trigger important insurance updates. Skipping them can leave one spouse uncovered, leave the other paying for coverage they no longer need, or in the worst case, leave a death benefit going to the wrong person.

Insurance changes after marriage

Auto insurance

• Combine policies under one carrier for multi-car discounts (often 15 to 25%).
• Add your spouse to your policy or vice versa. They can't drive your car without coverage.
• Re-quote. Married drivers get lower rates on average.

Home insurance

• Add your spouse to the deed AND the policy.
• Update beneficiary designations on any escrow accounts.
• Re-evaluate dwelling coverage if combining households means more belongings.

Health insurance

• Marriage triggers a Special Enrollment Period, 60 days to add a spouse to your plan or to switch plans.
• Compare your two employer plans and pick the better or cheaper one.
• Update HSA and FSA elections.

Life insurance

• Re-evaluate coverage amounts. A working spouse needs coverage too. The surviving spouse may face mortgage and childcare costs alone.
• Update beneficiaries on existing policies (don't leave your ex-fiancé as beneficiary by accident, it's happened).
• Consider buying coverage on a stay-at-home spouse based on the cost of replacing their household labor.

Disability insurance

• Marriage can change your need calculation. Household income now depends on two incomes.
• Update beneficiary on group LTD if applicable.

Insurance changes after divorce

Auto insurance

• Separate policies. The spouse keeping the car needs to be the named insured.
• Remove the ex from your policy (they cannot legally drive your insured car).
• Update garaging address if you move.
• Ensure no coverage gap during the transition.

Home insurance

• Update the named insured on the policy if one spouse keeps the home.
• Remove the ex from the deed AND the policy.
• The spouse leaving needs renters or new homeowners coverage.

Health insurance

• Divorce qualifies for a Special Enrollment Period.
• A spouse losing employer-based coverage through divorce typically has 60 days to enroll in Marketplace coverage, and often qualifies for subsidies based on new (lower) household income.
• Children's coverage: usually one parent carries them, with the divorce decree specifying details.

Life insurance

• Update beneficiaries immediately. This is the single most-missed step in divorce. Some states automatically revoke ex-spouse beneficiary designations; most don't. Insurance contracts override divorce decrees.
• Decide whether to keep ex as beneficiary if there are children or alimony obligations. Sometimes the divorce decree requires it.
• Consider whether existing policies are still appropriate or whether you need new coverage.

Disability insurance

• Update beneficiary on individual disability policies.
• Verify what happens to group LTD coverage tied to a spouse's employer.

For ongoing planning, see our auto, home, life, and health insurance pages.

New Baby

The insurance updates that need to happen within 60 days.

A new child changes almost every insurance policy you have. Some changes are mandatory and time-sensitive. Others are easy to forget but financially important.

Here's the checklist most new parents never see.

Health insurance, within 60 days

• Add the baby to a parent's plan. Birth qualifies for a Special Enrollment Period, 60 days to enroll. Coverage is typically retroactive to the birth date.
• Compare both parents' plans if both work. Pick the one that covers the baby better.
• Newborn nursery charges: some plans cover under the mother's plan for the first 30 days; some require immediate enrollment.
• Update FSA and HSA contributions. Childcare FSAs allow $5,000 in pre-tax childcare savings.

Life insurance, high priority

• Re-evaluate coverage amounts. Most parents are dramatically underinsured. A common rule of thumb: 10 to 12x annual income, plus enough to pay off the mortgage and fund college.
• Cover both parents, even a stay-at-home parent. Replacement costs for childcare, household management, and lost income for the working parent during early grief are real.
• Add a child rider or standalone children's coverage if desired.
• Update beneficiaries if needed.

For a deeper dive, see our how much life insurance post and our posts on term life and whole life.

Disability insurance, also high priority

• Re-evaluate coverage. A new dependent means more income at risk.
• Confirm benefit period is at least to age 65. The goal is to protect income through child-raising years.
• Add or increase individual coverage if employer LTD is the only coverage.

Estate planning (related)

• Will and guardianship. Name guardians for the child. Without a will, courts decide.
• Trust if life insurance is significant. Minor children can't directly receive large insurance payouts.
• Beneficiary designations updated to reflect new family structure.

Auto insurance

Less urgent, but consider:

• Adding car seats and stroller. These may be covered under personal property coverage (auto and home both apply).
• Re-evaluate vehicles if planning to upgrade for safety.
• Add teen driver coverage down the road (file this for later).

Home insurance

• Update personal property coverage. Baby gear adds up fast.
• Liability coverage. Re-evaluate if you're hosting more visitors.
• Pool and trampoline reminders. These are attractive nuisances that change as kids grow.

529 plans (related to insurance planning)

• Open a 529 plan early. Even small contributions compound dramatically.
• Some states (NY, IL, MI, OH, VA) offer state income tax deductions for in-state 529 contributions.

For a deeper review, our life, disability, and health pages cover post-baby planning.

Moving Between States

How insurance changes when you cross a state line.

Moving between states isn't just changing your address. Auto insurance, homeowners insurance, life insurance, and health insurance all have state-specific rules that change when you cross a state line.

Some changes are required by law within days of moving. Skipping them can mean uninsured driving, denied claims, and tax consequences.

Auto insurance

• Update your address with your insurer immediately. Premiums are based on garaging ZIP code, premium will change.
• State-required minimum coverages differ. A 25/50/25 policy from one state may not meet another state's minimums.
• Policy form differs by state. Your insurer typically issues a new policy with your new state's standard form.
• Re-register the vehicle and get a new license within the timeframe required by your new state, typically 30 to 60 days.
• No-fault states (FL, NY, MI, NJ, MD in OnePoint's footprint) require PIP coverage you might not have had before.

Homeowners insurance

• Cancel the old policy effective the day after closing on the old home.
• New policy in place before closing on the new home. Lenders require it.
• Coverage limits change because rebuild costs vary by area.
• Coverages required vary: wind and hail deductibles in FL, TX, LA, NC, SC; earthquake in TN, MO, SC, AR; flood in coastal areas.

Renters insurance

• Same insurer can usually move the policy to a new state.
• Update address and re-quote. Premiums vary by area.

Life insurance

• Generally portable across states. Your existing policy stays in force regardless of where you live.
• Update address so the insurer can reach you for premium notices and policy updates.
• State-specific consumer protections may change. A few states have specific replacement rules and disclosures.

Health insurance

This is the big one. Most major moves trigger a Special Enrollment Period:

• Marketplace coverage is state-specific. Moving to a new state requires enrolling in that state's exchange (or healthcare.gov).
• Employer coverage is generally portable. Coverage continues regardless of state.
• Medicare is national, but Medicare Advantage and Part D plans are state and region-specific. Moving requires choosing new plans.
• Medicaid is state-administered with different eligibility rules. Eligibility can change drastically across state lines.
• Provider networks change. Your old in-network doctor may be out-of-network in your new state.

Business insurance

• Workers' compensation is state-specific. A multi-state operation needs coverage in every state where employees work.
• Commercial auto rates change by state.
• Professional licensing affects E&O coverage.

State residency and taxes

Your insurance address is one factor in establishing legal residency. For people moving for tax reasons (high-tax to low-tax state), insurance is part of the documentation trail showing genuine residency change.

Snowbirds and dual-state residents

• Auto: the vehicle should be insured in its primary garaging state.
• Home: primary residence vs. second home affects rates and policy form.
• Health: Medicare works in all states, but Medicare Advantage networks are local.
• Life: unaffected.

For state-specific guidance, see our auto, home, and health insurance pages.

Retirement

How your insurance changes when you stop working.

Retirement reshapes nearly every insurance need you have. Coverage you needed disappears; coverage you didn't need becomes critical.

Planning the transition starts about 5 years before retirement and continues through Medicare enrollment.

Health insurance, the biggest change

Pre-65 retirement: you likely lose employer coverage and need a bridge until Medicare. Options:

• COBRA. Keep employer coverage for 18 months at full cost ($800 to $2,500+ per month).
• Spouse's employer plan, if available.
• ACA Marketplace, often qualifies for substantial subsidies based on early-retirement income.
• Short-term medical. See our post on short-term medical for limits.

At 65: enroll in Medicare during your Initial Enrollment Period, the 7-month window around your 65th birthday.

Choose your Medicare path:

• Original Medicare (A + B) + Medigap + Part D. Predictable costs, broad provider access.
• Medicare Advantage (Part C). Lower premiums, network restrictions, often includes dental, vision, and Rx.

Life insurance

• Re-evaluate need. Once kids are grown, the mortgage is paid, and you have retirement savings, life insurance may be much less necessary.
• Term policies that expire in retirement years often don't need renewal.
• Permanent policies with cash value can become a source of supplemental retirement income (loans against cash value are tax-free if the policy stays in force).
• Final expense insurance (see our post on final expense) becomes more relevant.

Disability insurance

• Group LTD ends with employment.
• Individual disability generally ends at age 65 or 67 (the policy's "to-age" limit).
• In retirement, disability becomes less relevant. You're no longer earning income. But long-term care insurance becomes critical.

Long-term care insurance

• Best to buy before age 60. Premiums rise sharply with age, and health changes can disqualify you.
• Hybrid life and LTC policies combine death benefit with long-term care coverage.
• Medicare doesn't cover long-term care beyond a brief skilled nursing stay.
• Medicaid covers long-term care but only after spending down assets.

Auto insurance

• Annual mileage drops. Most retirees drive less. Update mileage to lower premium.
• Drop commuting from rating, savings of 5 to 15%.
• Pleasure use only rating in some states.
• Senior driver discounts for taking defensive driving courses (often 5 to 10%).
• Telematics programs can save more for low-mileage drivers.

Home insurance

• Mortgage paid off. You no longer have a lender requiring specific coverages, but coverage is still essential.
• Re-evaluate dwelling limit. Replacement costs may have changed significantly.
• Senior discounts in some states.
• Consider downsizing implications. If you move, see the moving module above.

Estate planning intersection

• Update beneficiaries on all life insurance and retirement accounts.
• Trusts for estate tax planning if assets are above relevant thresholds.
• Powers of attorney, financial and healthcare.

Travel insurance

• Becomes more relevant in retirement when traveling more.
• Annual multi-trip policies are often cheaper than per-trip for frequent travelers.
• Cruise and international travel need separate medical coverage. Medicare doesn't cover most foreign care.

Our health and life insurance pages cover retirement-stage planning, and our Medicare guide walks through enrollment.