How long does it take for insurance to pay for a claim?

insurance

As an insurance customer, one of the things you value most is the efficiency and speed of your insurer in solving problems. We know that one of the issues that most worries you after giving a claim report is knowing how long it will take to collect the compensation of the coverage or see the damages repaired. In this aspect, each company has its rhythms, but the Law establishes deadlines that allow us to calculate how long it takes for an insurance claim.

Insurance is there to make your life easier in difficult times. But they may not always act as quickly as you expect. However, before we get into how fast or slow insurance is are when it comes to compensating their policyholders, it is illuminating to highlight the work carried out by insurers.

Keep in mind that, every hour that passes, the insurance deals with more than 15,000 mishaps of clients who have had an unexpected problem and have needed help from the insurance. Over a year, insurance companies resolve more than 140 million claims of all kinds in Spain. And those are a lot of solutions to problems that are sometimes really serious.

With such a volume of work, the claims bill that insurance companies have to pay reaches figures of billions of euros at the end of the year. Specifically, in 2019, insurers allocated close to 50,000 million euros in the payment of coverage for their clients, according to data from UNEP.

All these parts must be communicated, valued, and compensated (or not), after completing a procedure in which the insurer confirms the causes that gave rise to the loss, assesses the damage, and determines, with evidence, if that incident is covered by The policy.

Claim processing

Claim processing is the process followed by insurers to offer adequate coverage to a client after an incident or serious claim has occurred. They are internal procedures of the insurance entity, which often explain the delays in the response of the insurer. It includes the following steps:

Claim notice

The procedures to resolve a claim begins when the insured communicates the incident or accident that must be covered by the insurance. This is where he starts to count down the time it takes for the insurance to pay the claim.

Opening of the file

The insurer opens a claim file, incorporating the information provided by the insured when communicating the part, and all the information and data obtained in the processing.

Assessment

The first thing the insurance company does when opening a file is to make an initial cost assessment and check that the coverage does indeed cover the claim. It is a key moment in the processing because it is where the insurance company decides to continue managing the claim.

Three situations can occur:

  • That the loss is not covered by the policy, and then the insurer will reject the part.
  • That the situation is clearly under insurance coverage. That speeds everything up and the company manages the compensation or repair that is necessary.
  • If the case presents complexities, the claim process must continue.

the expertise

The expert is one of the key figures in the processing of a claim. This professional is entrusted with the task of economically assessing the consequences of the incident and analyzing its possible causes. The company’s decision on whether or not to accept the claim depends on his report.

Resolution: the moment to indemnify

Once all the inquiries have been made, the cost of the claim has been assessed and the compensation estimated (if applicable), the insurance company decides whether to pay the compensation or order the repair of the damage, if applicable.

You can also conclude that the loss is not covered because circumstances exist that exclude that guarantee. In these cases, the company must provide all the evidence that leads it to make this decision and communicate it to the insured.

The terms of the Insurance to solve a claim

But let’s go from the general to the particular, to what interests you as a client: How long does the insurer take to pay compensation for a claim?

In this sense, the terms established offer a framework of maximum times in which insurers must complete the processing of the claim and respond to customers who have sent them a report.

Deadlines are important, although they also compromise the insured, who must start the process.

Deadline for reporting the claim: within 7 days

The first step to resolve a report must be taken as an insured, and you cannot take too long. According to article 16 of the Insurance Contract Law, “the policyholder or the insured or the beneficiary must notify the insurer that a claim has occurred within a maximum period of 7 days after becoming aware of it unless it has been established in the policy a longer-term.

If a longer-term is not established in the policy conditions, you must notify the insurer within 7 days of the event. In our blog, we give you a lot of information on how we should communicate a claim report correctly, although the insurer must establish the appropriate way for its clients to send them the details of the claim.

Deadline to claim an insurance claim

The Law speaks of a term that begins at the moment in which the policyholder or insured knows that the loss has occurred. But, between the time the event occurs and we realize what has happened, a long time may have passed. And in this matter of insurance, you have already seen that time counts.

That is why you must bear in mind that there is also a maximum period to report a claim since the incident occurred. As established in article 23 of the Insurance Contract Law, the actions derived from the Insurance contract prescribe after 2 years when it comes to damage insurance and after 5 years when it comes to personal insurance.

Therefore, if we let this period elapse without informing the insurance company, we will lose the opportunity for the insurer to provide us with coverage for the damage suffered.

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By Michael Caine

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