How Will the Insurance Company Investigate My Car Accident?

How (and why) a car insurance company examines the basis for your car accident claim.

Getting into a car accident is often a stressful experience, and the ensuing car insurance claim process can be almost as unpleasant. Depending on the type of claim you're filing, and the facts surrounding the crash, the insurance company's investigation process can take anywhere from a week to several months to complete.

In this article, we'll take a look at:

  • why investigation is necessary to the car insurance claim process
  • what the insurance investigation process entails, and
  • what happens if you don't cooperate with the investigation.

Why Do Car Insurance Companies Need to Investigate a Car Accident?

There are two major reasons why car insurance companies will investigate your accident after you file a claim.

First, they're protecting themselves against car insurance fraud. According to the Insurance Information Institute, more than 15 percent of all auto claims payments made in 2012 were the result of a fraudulent claim.

To protect themselves, car insurance companies will ask their insureds and third-party claimants to provide evidence to support their car accident claim, and will also send adjusters or investigators to gather their own evidence about the cause of the accident and the claimed damages or injuries.

Second, the car insurance company is trying to properly assess your claim. There could be confusion as to the cause of the car accident or the extent of the resulting vehicle damage and/or injuries. The only way to get to the bottom of issues like this is to gather as much information and detail as possible.

Generally speaking, the car insurance company is not trying to find a reason to deny or delay your claim. Most claims adjusters want to process claims as efficiently and fairly as possible. The car insurance company (especially your own) also doesn't want adjusters denying claims without proper investigation, which could lead to a "bad faith" insurance lawsuit.

Get the basics on the role of insurance in a car accident case.

What Happens During a Car Insurance Claim Investigation?

The answer here depends on the type of car insurance claim you're filing, and any potential red flags your claim might raise. If the accident involved no injuries and your vehicle damage fell below a certain dollar threshold, the investigation might take a few days and be resolved once you answer a few questions over the phone and submit an estimate from a local car repair shop.

If your claim involves significant car accident injuries, the investigation can become more involved. Not only is there potentially far more money at stake, but the claims adjuster will need more information to confirm the nature and extent of your injuries and resulting medical treatment.

This means you may need to answer more questions about your injuries, provide (or authorize access to) medical records, and obtain a copy of the police report for the adjuster. Then the insurance adjuster will likely talk to other individuals involved in the accident, and any witnesses. Other investigative tools at an adjuster's disposal include:

  • taking a recorded statement (beware if it's the other driver's insurance company asking for this)
  • requesting your cellphone records
  • visiting the scene of the accident
  • conducting a background check
  • reviewing your social media presence, and
  • obtaining medical authorizations.

So the more losses you're claiming, the more thorough the investigation by the car insurance company. But sometimes a more intensive investigation means the insurance company has identified a potential problem with your claim.

When the Adjuster Might Conduct a More Thorough Investigation

If the insurance company suspects a fraudulent car insurance claim, they'll seek information on possible motivation to commit fraud, and evidence that the claim might be bogus.

For instance, the investigation will check to see if you're in financial trouble (looking for any liens against your property, or recent bankruptcy filings, for example). They might also take a look at your social media presence to confirm the truth of what you already told the adjuster.

So, if your claim includes a large medical bill for an injured shoulder, but the day following the accident there is a video of you on social media playing an intense game of basketball, the car insurance company will probably suspect fraud. Or perhaps you said the car accident occurred on a certain date, but your social media feed shows you were on a cruise at that time.

Requests for cellphone records are becoming more commonplace, especially when it comes to determining fault for a car accident. Because the use of electronic devices is one of the major causes of car accidents, your insurance company may look into the possibility that your phone use caused or contributed to the accident. Cellphone records can confirm (or disprove) that you were using a device around the time of the accident.

Cooperating With the Insurance Company's Investigation

One thing to keep in mind during this investigation process is that you are under no legal obligation to provide the information requested by the insurance company. Unless your claim has moved into the lawsuit stage and there is a court order saying so, an insurance company has no legal way to force you to provide the information they're asking for.

This doesn't mean it's a good idea to blow off the claims adjuster's investigation. While your own car insurance company is contractually obligated to pay a valid claim, this obligation hinges on your taking reasonable steps to cooperate with the company's investigation. By failing to cooperate with the investigation, it's almost assured that your claim will be denied. There's also a risk they will drop you as an insured. If you're filing a third-party claim with the at-fault driver's car insurer, and you decide not to cooperate in the investigation, don't be surprised if the adjuster comes to the table with a lowball settlement offer.

A car insurance company isn't typically out to get you, but if they can find a plausible reason to pay you less than what you're asking for, they usually will. That's one reason why it's a good idea to consult an attorney after a car accident.

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