When you have a claim, it can feel like everything is out of your hands and that you have no say in the decisions that are made. This is especially true of your settlement. Car insurance claim settlements are determined by the insurance adjusters who review all of the facts of the claim, verify your insurance benefits and decide what kind of settlement you will receive. But when it comes to your claim settlement, you do have some rights you should be aware of.
One of the first things the car insurance companies involved in a claim will do is to determine fault. Even in a no-fault province someone will be determined to carry the responsibility for the accident; however, if you have no-fault insurance your company will pay out on your claim no matter what is decided.
Once fault is determined the insurance company will review your benefits and decide which coverage applies to the claim. If you are at fault and have collision coverage, that coverage will apply, as will your liability coverage. If you are not carrying collision coverage you will likely have no recourse for the damage to your car. Of course, if you are not at fault and not in a no-fault province, the other party’s liability coverage will apply to the repairs to your vehicle.
The insurance company will then determine the cost to repair the car or the value of the car if it is being written off. They will also review claims for injuries. From all of this information they will decide the total amount of your settlement.
If you disagree with the results of your insurance company’s investigation into the claim and with the settlement that they offer you, you do have the right to appeal the decision. Your insurance company will have procedures in place to allow you to appeal their decisions, and it is best to follow this process. Usually you will have the claim reviewed within the insurance company first. If you still disagree, the appeals process will go to a third party arbitration process.
Insurance companies can be very intimidating, but don’t be afraid to stand up for your rights. You pay the insurance company to provide you with coverage, and you have the right to argue their decisions.
In many provinces you have the right to take your case to court and sue for pain and suffering as well as for physical damages. This may be necessary when you are being denied the compensation you need and deserve in an accident where you are the victim. Each province sets its own limits and laws on how you can sue for damages. Before pursuing a lawsuit, take the time to get to know the laws in your province.
Settlements determined in court take a lot longer than going through the claims process. In most cases everything possible will be done to avoid actually going to court and an acceptable settlement may be offered without having to actually step into a courtroom. This is generally preferable to both sides since it avoids the court costs and the time and effort required for a court battle.
If you are not satisfied with your claim settlement, you have options to appeal it. Remember that as a customer of your insurance company you have the right to disagree with them, and you also have the right to fight for what you deserve after an accident. Follow all of the procedures available to you; they exist in order to assist you as the insured to obtain a fair settlement.
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