Insurance
Dealing with insurance after an accident
Almost every accident claim is paid by an insurer, and the adjuster handling it works for the insurance company, not for you. Knowing how they work makes it easier to protect your claim.
Report the accident to your own insurer promptly. Be polite and factual with the other side's adjuster, but you usually don't have to give them a recorded statement or sign a broad medical authorization. Find out which policies apply and their limits, keep every letter and email, and don't sign a release until you know the full extent of your injuries.
What an adjuster does
An adjuster investigates the claim, decides whether the policy covers it, assesses who was at fault and puts a value on your losses. Many are helpful and fair. But their job is to settle claims for what the insurer considers the right amount, and they are trained to look for reasons to pay less: gaps in treatment, earlier injuries, anything you said that suggests you were partly to blame.
You may deal with two kinds of claim. A first-party claim is against your own insurer under your own policy, such as collision cover or no-fault benefits. A third-party claim is against the other person's insurer. Your own insurer owes you duties under your contract, while the other side's insurer mainly owes duties to its own customer.
Recorded statements
The other driver's adjuster will often ask, early and in a friendly way, to record your account. A recorded statement can be used to challenge you later if anything you say doesn't match your medical records or later evidence. You usually aren't obliged to give one to the other side's insurer. Your own policy may require you to cooperate, but you can still ask for the questions in advance, keep answers short and factual, and avoid guessing about speeds, distances or how you feel.
Which coverage pays for what
Policies and names differ by country and state, but these are the covers that come up most often:
| Coverage | What it usually pays for |
|---|---|
| Bodily injury liability | Injuries the policyholder causes to other people, up to the limit. |
| Collision | Damage to your own vehicle in a crash, less your deductible. |
| Other-than-collision cover | Theft, fire, flood, falling objects and similar damage to your car. |
| No-fault benefits / PIP | Your medical costs and some lost income, whoever was at fault. |
| Medical payments | Medical bills for you and your passengers, regardless of fault. |
| Uninsured / underinsured motorist | Your losses when the at-fault driver has no insurance or too little. |
| Rental reimbursement | A hire car while yours is being repaired. |
In the UK, the at-fault driver's insurer normally pays for your injury and vehicle losses, and the Motor Insurers' Bureau covers uninsured and untraced drivers. In Canada, accident benefits and the right to sue depend heavily on the province. Check the declarations page of any policy to see its covers and policy limits.
Medical authorizations and records
Insurers often send a form asking for permission to get your medical records. Some are broad enough to cover your whole history, which gives the insurer room to blame old problems. Read what you're signing. It's reasonable to limit access to records related to the accident and to a sensible period before it.
When an insurer acts in bad faith
Insurers must handle claims honestly and fairly. Bad faith can include refusing to pay a valid claim without a reasonable basis, unreasonable delay, failing to investigate, or misrepresenting what your policy says. In the US, many states let you sue your own insurer for bad faith, and some allow extra damages. In Canada, courts recognise a duty of good faith in insurance contracts. In the UK, insurers must pay valid claims within a reasonable time, and you can complain to the Financial Ombudsman Service after using the insurer's complaints process.
If you suspect bad faith, keep a written log of every call, ask for decisions in writing, and send a written complaint. If you get a reservation of rights letter, the insurer is warning that it may deny cover, and it's a good time to get advice.
More on insurance claims
Car accident claims
How insurance fits into the whole claim after a crash.
Fault vs no-fault insurance
Whose insurer pays first in your state or province.
Actual cash value vs replacement cost
How the insurer values your car and belongings.
Insurance claim vs lawsuit
What changes when negotiation with the insurer stalls.
Diminished value
Claiming for the drop in your car's value after repairs.
Gap insurance
When your car is written off for less than you owe.
Exclusion
Policy wording an insurer may use to refuse cover.
Independent medical examination
What to expect when the insurer picks the doctor.
All insurance terms
Every insurance term explained in plain English.
Common questions
Do I have to give a recorded statement to the other driver's insurance company?
Usually not. You generally have no duty to give one to the other side's insurer, and it can be used to challenge your claim later. Your own policy may require cooperation with your insurer, but you can still ask for the questions in advance and keep answers factual.
What if the at-fault driver's insurance isn't enough?
You may be able to claim the rest under your own uninsured or underinsured motorist coverage in the US or your policy's equivalent in Canada, or directly against the driver, though collecting from an individual is often difficult.
Can the insurance adjuster see all my medical records?
Only what you authorize or what a court orders. Read any authorization form carefully and ask to limit it to records related to the accident and a reasonable period before it.
What counts as insurance bad faith?
Refusing a valid claim without a reasonable basis, unreasonable delays, failing to investigate properly, or misrepresenting your policy. The remedies differ by country and state, so keep written records and get advice if you suspect it.