1. 1265 POINTS
    Drew Delaney, J.D., CLCS
    Commercial Lines Producer, Secure Investors Group, INC, Troy, Michigan
    From the agents perspective this is what happens:

    1.  Client gets into an accident and needs to make a claim: 
    1a.  The client contacts the agent and the agent files the claim by filling out the appropriate ACORD form.
    1b.  The client contacts the insurance company directly and files the claim that way.  

    2.  The insurance company will do one of a couple of things:
    2a.  The insurance company will process the claim quickly and pay out the amount as is stated in the insurance agreement (e.g. actual cash value or agreed upon amount).
    2b.  The insurance company will send an adjuster to investigate the claim and pay out according to the adjuster's findings. 
    2.c  The insurance company is going to deny the claim because it was not due to a covered peril.

    If 2b. or 2c. occurs then you should contact your agent and let him/her deal with the insurance company to try and get you more money for your claim.

    Most states have a time limit for how long it can take the insurance company to respond.  I know in Michigan the insurance company must respond within 30 days of a valid claim.  If nothing has been sent back (either a payment or dispute) then you should contact your agent or the governmental agency that oversees insurance.

    I hope this helps.
    Answered on May 28, 2013
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