Understanding Different Types of Insurance Claims

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Lee Goodwin
Managing Director
Last Updated
12 November 2024

Insurance is there to protect us in times of need, but filing a claim can often feel like navigating a maze. Understanding the different types of insurance claims can simplify the process and ensure you get the support you deserve. Whether you’re safeguarding your home or business, this guide provides an in-depth look at various insurance claims, highlighting their unique aspects and offering practical advice on managing them successfully.

Fast Facts: Types of Insurance Claims

Common Claims

  • Fire and explosion (24%)
  • Faulty workmanship/maintenance (24%)
  • Defective products (11%)
  • Natural catastrophes (9%)
  • Negligence/misadvice (7%) 

Home Insurance Claims

  • Claims Acceptance Rates: For domestic property insurance, about 79% of claims were accepted, with the average claim amounting to approximately £4,066.
  • Trends in Claims: The home insurance sector continues to evolve, with increasing claims related to weather events and other unforeseen circumstances. The ongoing analysis by the ABI indicates that insurers are adapting their policies to meet these emerging risks. 

Demystifying Insurance Claims: What You Need to Know

Insurance claims are formal requests made by a policyholder to an insurance company for compensation or coverage of a loss or event covered under their policy. When a claim is approved, it activates the benefits outlined in the policy, providing financial assistance to the insured party. Knowing the different types of claims helps you make informed decisions and maximise the benefits of your insurance coverage.

Why It’s Crucial to Understand Different Types of Insurance Claims

While insurance policies are designed to provide security and peace of mind, filing a claim can often be confusing and daunting. Being well-versed in the various types of insurance claims helps you avoid common pitfalls and ensures you receive the support you need when it matters most. Whether you’re dealing with property damage, a health issue, or a car accident, understanding your policy and the claims process is crucial.

Common Reasons for Filing Claims

Insurance claims can arise from various incidents, and understanding these reasons can help you navigate the process. Here are some of the most common reasons for filing claims:

  • Fire Damage: Claims related to losses caused by fires, including structural damage and personal property loss.
  • Water Damage: Claims for damage due to leaks, flooding, or other water-related insurance incidents.
  • Storm Damage: Coverage for damages caused by severe weather events such as hurricanes, tornadoes, and heavy storms.
  • Impact Damage: Claims for damage resulting from accidents involving vehicles, falling objects, or other external forces.
  • Theft or Burglary: Claims filed for losses due to theft, including stolen property and damages incurred during break-ins.
  • Medical Expenses: Coverage for medical bills resulting from illness or injury, including hospital stays and treatments.
  • Car Accidents: Claims related to damages sustained in vehicle collisions, including repairs and medical costs.
  • Business Interruptions: Claims for losses incurred due to business interruptions, whether from property damage, legal issues, or other unforeseen events.



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Types of Insurance Claims Explained

Insurance claims can be broadly categorised into several types, each tailored to address specific losses or damages. Knowing these categories helps streamline the claims process and ensures you know what coverage you have and how to file a claim effectively.

Property Insurance Claims

Property insurance claims cover damages or losses related to physical assets, such as homes, offices, and personal belongings. These claims are typically filed for natural disasters, theft, or accidental damage. Proper documentation, such as photos and an inventory of lost or damaged items, is crucial when filing a property insurance claim.

Key Takeaway: Always document damages thoroughly and file claims promptly to avoid delays in receiving compensation.

Health Insurance Claims

Health insurance claims are used to cover medical expenses such as doctor visits, surgeries, and prescriptions. The process usually involves submitting a claim form along with documentation of the medical services provided. Understanding your policy’s terms, including co-pays and deductibles, is essential to avoid unexpected costs.

Key Takeaway: Review your health policy’s terms to understand out-of-pocket costs and coverage limits before you need to use it.

Car Insurance Claims

Car insurance claims are filed for vehicle-related incidents, including accidents, theft, and damages from hail or floods. These claims can cover repair costs, medical expenses for injuries sustained in an accident, or compensation for a stolen vehicle. It’s important to report the incident to your insurer promptly and provide all necessary documentation, including police reports and photos of the damage.

Key Takeaway: Keep a checklist of steps to follow in case of a car incident to ensure a smooth claims process.

First-Party vs. Third-Party Insurance Claims

It’s important to differentiate between first-party and third-party insurance claims, as they involve different processes and responsibilities.

  • First-Party Claims: These are claims you file with your own insurance company for coverage under your policy. For example, if a tree falls on your house, you would file a first-party claim with your homeowner’s insurance.
  • Third-Party Claims: These are claims filed against someone else’s insurance policy. For instance, if you’re involved in a car accident where another driver is at fault, you would file a third-party claim with their insurance company to cover your damages.
insurance claim types

Exploring Specific Types of Insurance Claims

Let’s take a closer look at some specific types of insurance claims to understand how they work in practice.

Car Insurance Claims

Car insurance claims are among the most common. They can be categorised based on the nature of the incident:

  • Accidents: Cover damages resulting from collisions or other accidents involving your vehicle.
  • Theft: Provide compensation if your vehicle is stolen.
  • Damage: Cover repairs for damages caused by incidents such as vandalism or natural disasters.

Tip: Always document accidents and damages with photos and reports to strengthen your claim.

Health Insurance Claims

Health insurance helps offset the costs of medical care. Understanding your policy terms, including deductibles (the amount you pay out-of-pocket before coverage begins) and co-pays (a fixed fee you pay for specific services) is crucial.

Tip: Keep track of all medical bills and receipts to ensure accurate and timely claim submissions.

Homeowner Claims

Homeowner insurance protects against property damage from various risks, including natural disasters and theft. It can cover repairs, replacements, and sometimes temporary living expenses if your home is uninhabitable.

Tip: Maintain a home inventory list to expedite the claims process in case of significant property loss.

Natural Disaster Claims

Natural disaster claims cover specific events like floods, earthquakes, or storms. Some policies include standard coverage for these events, while others require additional endorsements.

Tip: Check your policy for specific natural disaster coverage and consider additional endorsements if you live in high-risk areas.

Renter’s Insurance Claims

Renter’s insurance covers personal property and liabilities within a rented space. Claims can be filed for stolen or damaged items and liability if someone is injured in your rented home.

Tip: Document valuable items and keep receipts to simplify the claims process if needed.

Life Insurance Claims

Life insurance claims provide financial support to beneficiaries after the policyholder’s death. Filing a claim requires notifying the insurance company, submitting a death certificate, and choosing a disbursement method.

Tip: Ensure beneficiaries know how to file a claim and have access to necessary documents.

types of insurance claims

Holding Insurers Accountable: Bad Faith Insurance Claims

Sometimes, insurers may act in bad faith by not upholding their end of the policy agreement. Recognizing and addressing such behaviour is crucial.

What Is a Bad Faith Claim?

A bad faith claim arises when an insurer fails to honour its obligations to the policyholder, such as delaying claim processing, offering insufficient settlements, or denying claims without valid reasons. Signs of bad faith include:

  • Unreasonable Delays: Prolonging claim processing without valid reasons.
  • Insufficient Settlements: Offering settlements far below the claim’s actual value.
  • Denial Without Explanation: Refusing claims without providing a clear reason.

If you suspect your insurer is acting in bad faith, it’s important to seek legal advice and consider filing a complaint with your state’s insurance department or pursuing legal action.

Types of Insurance Claims: Take Control

Understanding the intricacies of insurance claims can be your strongest tool when unexpected events occur. The key takeaway is to familiarise yourself with the different types of claims, know what your policies cover, and document everything meticulously. This preparation can help you navigate the claims process confidently and ensure you receive the support you’re entitled to.

Take Action: Review your insurance policies now. Make sure you understand your coverage and the claims process for each type of policy you hold. Being proactive today can save you time, money, and stress when you need it most.

Types of Insurance Claims: FAQs

What Does an Insurance Claim Do?

An insurance claim activates the benefits of your policy, providing financial compensation for covered losses or events.

How Do I Know If My Insurer Is Acting in Bad Faith?

Look for signs such as unreasonable delays, insufficient settlements, or denial without explanation.

What Happens If My Insurance Claim Is Denied?

If your claim is denied, you can:

  • Appeal the Decision: Provide additional evidence or clarification.
  • Seek Legal Advice: Consult with an attorney to explore your options.

We Can Help

Oakleafe Claims have represented policyholders and managed their insurance claims since before the First World War. We have vast expertise and experience in both domestic and commercial insurance claims with thousands of satisfied policyholders who have received their deserved insurance settlement. With no upfront fees required, our internal data shows that insurance claims managed by professional loss assessors like Oakleafe can expect a settlement up to 40% higher than claims managed by the policyholder.



What Oakleafe Clients Say:

Book your complimentary consultation with our insurance claim professionals.

Our insurance claim professionals will explain the claim process to ensure you understand your options.

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