Every claim filed by one of our customers moves through what we call the five claims milestones. Some move quickly, with only a brief “stopover” at each step; others may take days or weeks. But whatever the time frame, the basic process is the same.
MILESTONE #1 Assignment
Whether you reported your claim to your agent, the Claim Department, or your policy brand phone line, your claim was assigned to a claims professional, who will guide you through the claims process and work with a team of specialized claim professionals to manage your claim. During that process, you may work with:
- Your agent – the professional who sold you your insurance policy, who can answer questions about that policy and any endorsements, and about your deductible, but will not adjust your claim.
- Your claims professional, who will guide you through the claims process – inspecting your property or vehicle if necessary, determining and investigating covered damages, and helping you better understand your policy and its endorsements.
- A contractor or vehicle repair facility, whom you will select to arrange for repairs to your property or vehicle. (We do not perform repairs, nor do we select or provide a contractor or vehicle repair facility for you.)
- Other specialists, whose services you may need – for example, a structural engineer, repair facility, medical professional, etc.
MILESTONE #2 Initial Contact
In this phase, your claims professional contacts you about your claim. This is when your claims
Obtain initial information about your loss.
- Discuss your policy coverage and any applicable endorsements.
- Explain how your claim will be handled.
- Suggest ways to prevent further damage – for example, by putting a tarp over a damaged roof or a broken vehicle window. (You are responsible for maintaining and protecting your property. If it is damaged, you must take appropriate action to protect it from further damage until you have it repaired.)
- Schedule an in-person appointment, if one is needed to adjust your claim.
MILESTONE #3 Evaluation
If an inspection of your property or vehicle is needed, your claims professional will conduct that inspection to determine whether your loss is covered – gathering all the facts about your loss, investigating and documenting damage or injury, interviewing witnesses or other involved individuals, taking photos and samples, and formally evaluating your claim.
It is our objective to evaluate coverage, complete our estimate if the loss is covered, and deliver a payment during our first visit. If we can’t, we’ll explain why. And if we do, we stand ready to re-inspect your property or vehicle and provide a supplemental payment if you, a contractor, vendor or auto repair facility later identifies additional damages that are covered by your policy. During this visit, your HelpPoint Claim Services professional may discuss some terms and programs you may not be aware of. This pamphlet explains them in more detail.
MILESTONE #4 Resolution
We’ll work with you to resolve your claim fairly. In many cases, your claims professional will issue a payment based on the estimate for repairs at the end of the initial inspection. If your claim is complex, it may take a bit longer.
Payment for medical bills will be made according to the coverage being used under the policy and your state’s laws.
If you have questions about your claim payment, please review the Frequently Asked Questions section of this pamphlet – and if your question isn’t answered there, please do not hesitate to contact your claims professional. And remember – cashing a check does not waive any rights you have under the terms of your policy.
If your damages are not covered, in part or in whole, by your policy, we will provide a letter explaining what damage is not covered and identifying the portion of your policy that applies to that coverage denial.
MILESTONE #5 Claim Closed
When we resolve your claim according to the terms of your policy, we close the claim. You still may have some questions at that point. Once again, check the FAQs in this pamphlet – and if you have a question that we haven’t answered there, call your claims professional.
Once your claims professional completes your loss estimate, they will review it with you before issuing payment.
The first page includes our contact information and your claim number. That number is the unique identifier for this
claim; we use it to quickly locate your information. The estimate of the cost to repair covered damage is organized by
room, area or item, and includes individual line items that indicate what will need to be repaired or replaced to bring
your property or vehicle back to its pre-loss condition. It also includes a summary page, with an overview of all items
included in the estimate.
The estimate you receive from your claims professional is just that: an estimate. A number of issues may contribute to differences between our estimate and your contractor’s or vehicle repair facility’s. If there are differences, don’t panic: just contact your claims professional, who will probably ask you to send them a copy of the contractor’s or vehicle repair facility’s estimate for review. They’ll then discuss it with your contractor or vehicle repair service, and may then reinspect your property or vehicle to resolve any differences.
If you are reporting property damage that makes it reasonably likely that you will need the services of a general contractor to manage, supervise and coordinate repairs, we may include an amount for general contractor overhead and profit if we expect you to incur that cost.
When you contract for property restoration services, feel free to discuss that work with your claims professional and your contractor to ensure that all damages are properly inspected. We will work with you to quickly resolve any issues so your contractor can proceed with the repairs for you.