April 30, 2017

How To Submit Your Reimbursement Paperwork To the Insurance Company

How you should submit reimbursement paperwork to the insurance company largely depends on what type of insurance it is. We adjusters have different requirements for health insurance claims than for third party bodily injury claims. These in turn differ from homeowner insurance claims, business insurance claims or car insurance claims.

Third Party Injury Claims

If you were in an accident caused by someone else and your claim is against someone else’s insurance company (usually their car insurance, business insurance or homeowners insurance), then you have a third party bodily injury claim. I adjusted these claims for eight years for Farmers Insurance. For these claims, save up all your bills and receipts until either the statute of limitations is approaching or you are done treating for your injury, whichever comes first. You and the adjuster will negotiate a one-time, final settlement. You want your settlement to include everything, because you cannot get any more money after you settle.

Put all these bills and receipts in chronological order with the oldest on top. On the very top, include a list of all the bills and receipts, with a running total and the amount you want for your injury claim. Some jurisdictions allow you to include a subjective amount for “pain and suffering.” If yours does, then include this amount in your list. Also include: wages you missed because you couldn’t work, wages you had to pay someone else for work you couldn’t do at your home or business, and any other expenses you would not have had if the accident had not happened.

If your adjuster requests that you send in bills as they come in, then it is your choice to do so or not. The adjuster is required to reserve your claim and to review the reserve on your claim periodically. Bills that trickle in sometimes help the adjuster with this. Often the adjuster has so many claims that this just bogs him or her down, though. I would only do this if the adjuster requests it. Whenever an attorney handles an injury claim he saves up all the bills and receipts and sends them in at the end with his demand for settlement. Adjusters actually appreciate this as it cuts down on the copious amount of mail that adjusters receive. (More below this video)

Video: How do I get my insurance company to pay for my medical bills? By Atlanta Injury Lawyers

This attorney explains why you should never assume the hospital will send the bills to your health insurance company when you have an injury claim against a third party. He explains that hospitals know they can put liens on these bills and then you will have to pay 100% of the bill out of your injury settlement. He recommends that you get an attorney to handle these matters for you. I agree.

Health Insurance Claims

Most health insurance companies have claim forms you need to fill out and submit along with your health care bills and receipts. Call the number on your health insurance bill, visit their website or if your employer pays for your health insurance, then ask your Human Resources representative for some health insurance claim forms. She should at least be able to tell you where to get them. Follow the instructions on the claim form regarding where to send all this paperwork. You send these in as you get them. Do not save them up to send in all at once.

Medical Payments or PIP Insurance Claims

Send your bills to your adjuster as soon as you receive them. Your adjuster should pay the bills for you, up to the limit of your insurance policy.

Car Insurance, Property and Business Claims

Any time property is damaged, take pictures as soon as possible. Your insurance will assign an adjuster to come out and take pictures if the damage is high enough, but take your own pictures against the unlikely but not-unheard-of event that your property disappears before the adjuster takes pictures. Use your phone if you don’t have a camera with you.

Email the pictures to your adjuster along with a detailed written description of what happened. Also send scans of any receipts you have from when you bought the damaged property. Many of these companies also have claim forms you need to fill out in addition to this, but the pictures are the key.

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