At Crain Insurance Group, we understand that filing an insurance claim often comes at one of the most stressful moments in life. Whether it’s after a car accident, a burst pipe, or a house fire. The last thing you need is confusion about what happens next.
That’s why we’re breaking it down step-by-step.
Whether you’re a first-time claimant or just looking to be better prepared, this guide will walk you through what to expect from start to finish. From initial damage to final payout, here’s how insurance claims really work, and how having the right agent makes all the difference.
What Is an Insurance Claim?
An insurance claim is a formal request you submit to your insurance company asking for payment or service based on the terms of your policy. This could be for:
- Vehicle damage
- Property loss
- Injuries
- Liability expenses
- Theft
- Vandalism
- Natural disasters
- And more
Once your claim is filed, your insurance carrier evaluates it, determines whether it’s covered, and how much they’ll pay if the claim is accepted.
Step 1: When Something Happens
The claim process begins with the event itself: a storm, accident, fire, injury, or other unexpected loss.
First, protect your safety and prevent further damage:
- Call emergency services if necessary.
- Mitigate damage (e.g., shut off water, board up windows, move valuables).
- Save receipts for temporary repairs or emergency services.
Tip: Most policies require you to take reasonable steps to prevent further damage. Failing to do so can impact your claim.
Step 2: Document the Damage
Before you file a claim, it’s essential to gather clear documentation of what happened and what was lost.
For property/home claims:
- Take photos and videos of damage from multiple angles.
- Make a list of damaged or destroyed items.
- Note the date and time of the incident.
For auto claims:
- Photograph vehicle damage, license plates, and surroundings.
- Get contact info from all parties involved.
- Collect police reports if applicable.
Pro tip: Create a home inventory before disaster strikes, it helps speed up and validate your claim.
Step 3: Call Your Independent Agent (That’s Us!)
Your next call should be to your agent, ideally before you file the claim directly with the carrier.
Why? Because not every incident requires a claim, and not every loss will exceed your deductible.
At Crain Insurance Group, we help clients:
- Understand if the damage is covered
- Estimate whether the claim is worth filing
- Walk through what your deductible means in this situation
- Coordinate communication with the carrier
Sometimes it’s better to pay out of pocket. Other times, a claim is absolutely the right move. Having an expert in your corner helps you make a confident, informed decision.
Step 4: File the Claim with the Insurance Carrier
Once you’re ready to proceed, you’ll file the claim; either online, through a mobile app, or over the phone.
You’ll be asked to provide:
- Your policy number
- Date and details of the incident
- Description of damage or loss
- Supporting documentation (photos, reports, receipts)
Once submitted, you’ll receive a claim number for reference. That number tracks your file through the entire process.
Step 5: Meet Your Claims Adjuster
Next, the insurance company assigns a claims adjuster to your case. This is the person who investigates the claim, determines if it’s covered, and estimates repair or replacement costs.
The adjuster may:
- Call you to discuss the incident
- Schedule a property inspection
- Request more documentation
- Coordinate with repair shops or contractors
For auto claims, the adjuster may also review body shop estimates, rental car coverage, and repair timelines.
For home claims, the adjuster may bring in third-party inspectors (roofing experts, engineers, mold remediation teams) depending on the severity of damage.
Step 6: Damage Assessment and Coverage Review
Now, the carrier determines:
- What’s covered under your policy
- How much they’ll pay based on replacement cost, actual cash value, or depreciation
- Your deductible, which is subtracted from your total payout
You’ll receive a summary of findings, sometimes called a settlement offer or coverage letter. This will detail:
- The amount they’ll pay
- Any limitations or exclusions
- Instructions for next steps (repairs, replacement, etc.)
Step 7: Claim Resolution and Payment
Once everything is reviewed and approved, the insurance company will issue a payment either directly to you, your mortgage lender (for home claims), or a service provider (like a repair shop or contractor).
There are a few types of payments you may receive:
- Initial payment: For emergency repairs or partial settlement
- Final payment: After work is completed or loss is fully evaluated
- Replacement cost holdback: If your policy includes replacement cost coverage, part of your payment may be held back until proof of repair/replacement is provided
💵 Example: Let’s say your roof is damaged in a hailstorm. Your total approved cost is $12,000, your deductible is $2,000, and depreciation is $2,000.
- You’d initially receive $8,000.
- Once the new roof is installed and documented, you’ll get the final $2,000 replacement cost difference.
Step 8: Repairs or Recovery
Now it’s time to fix the damage, replace lost items, or finish the recovery process. Depending on the size of the claim, you may work with:
- A body shop (for auto)
- A contractor (for home repairs)
- A restoration company (for fire, water, or mold)
- A public adjuster (for large or disputed claims)
Make sure to keep receipts, invoices, and documentation of all work; especially if additional funds are needed from your carrier.
Step 9: Closing the Claim
Once everything is resolved and payments are finalized, the insurance company will officially close the claim. That said, if new issues arise related to the same incident, it may be reopened.
You’ll receive:
- A final claim summary
- Any remaining paperwork
- Confirmation that your claim is complete
How Claims Impact Your Future Rates
One of the most common questions we hear:
“Will my premium go up if I file a claim?”
The short answer: It depends.
Factors include:
- Type of claim (liability vs. property)
- Severity of the claim
- Whether you were at fault (especially in auto)
- Your claims history
- Your insurance carrier’s underwriting guidelines
Some carriers offer claim forgiveness or don’t surcharge for the first claim. Others increase rates after any claim, even small ones. That’s why it’s so important to consult with your agent before filing.
How Crain Insurance Group Supports You During a Claim
As your independent insurance agency, we’re here to be more than just a voice at renewal. During the claim, we act as your advocate and guide.
Here’s what we help with:
- Explaining your policy and what’s covered
- Helping you decide if a claim should be filed
- Connecting you with reliable repair pros and restoration teams
- Clarifying timelines, documents, and communication from the carrier
- Following up with the adjuster if needed
And if you ever feel like your claim wasn’t handled fairly, we’ll help you escalate the issue or review your options.
Quick Claim Tips for a Smoother Process
Report the incident quickly. Delays can complicate the process.
Document everything. Photos, receipts, written descriptions. More is better.
Ask questions. Don’t be afraid to ask your adjuster (or us) for clarification.
Know your deductible. Understanding this in advance helps you plan financially.
Keep a paper trail. Log every phone call, email, and letter related to the claim.
Final Thoughts: Claims Can Be Stressful, But You Don’t Have to Do It Alone
No one wants to file a claim. But when life happens, you deserve to be taken care of quickly, fairly, and clearly.
At Crain Insurance Group, we’re not just here for the sale, we’re here for every step of your journey, including the hard ones. Our job is to protect you, advocate for you, and simplify the process from start to finish.
Disclaimer: The information provided in this post is for general recommendation purposes only. Please consult with your own licensed insurance agent for advice specific to your situation. Insurance can vary by state. If you don’t have a trusted agent, we’re happy to assist with quotes and guidance.