If you’re involved in a car accident, your auto insurance policy is designed to help pay for damages, injuries, and liability costs depending on the coverages you carry. Understanding how the claims process works can make a stressful situation much easier to handle.
Here’s a simple step-by-step explanation of how auto insurance claims work in California and across the U.S.
1. The Accident or Loss Occurs
An auto insurance claim starts when your vehicle is damaged or someone is injured in an incident such as:
- A car accident with another driver
- Hitting a stationary object (like a pole or fence)
- Theft of your vehicle
- Vandalism
- Fire damage
- Weather damage (hail, flooding, falling trees)
- Animals hitting the vehicle
The type of coverage that applies depends on the cause of the loss.
For example:
- Collision Coverage → covers damage from accidents
- Comprehensive Coverage → covers theft, vandalism, fire, animals, and weather
- Liability Coverage → covers damage or injuries you cause to others
2. Document the Accident
If an accident occurs, gather as much information as possible.
Important things to collect:
- Photos of the vehicles and accident scene
- Names and contact information of drivers involved
- Insurance information of the other driver
- Police report (if applicable)
- Witness information
In California, it’s recommended to call the police if there are injuries or significant damage.
3. File the Insurance Claim
You can file a claim with:
- Your own insurance company
- The other driver’s insurance company (if they were at fault)
Most claims can be filed:
- Through a mobile app
- Online
- By phone
- Through your insurance agent
You will typically provide:
- Policy number
- Description of the accident
- Date and time of the incident
- Photos and documentation
Your insurance company will then open a claim file.
4. Insurance Adjuster Investigation
After the claim is opened, the insurance company assigns an adjuster to investigate.
The adjuster may:
- Review accident reports
- Look at photos of the damage
- Speak with drivers and witnesses
- Determine fault
- Estimate repair costs
They may also inspect the vehicle in person or ask you to visit a preferred repair shop.
Many companies now allow photo estimates through mobile apps.
5. Vehicle Damage Estimate
Once the inspection is completed, the insurance company prepares an estimate for repairs.
There are three possible outcomes:
Repairable Vehicle
If the repair cost is less than the vehicle value, the insurer pays for repairs.
Total Loss
If repairs exceed a certain percentage of the vehicle’s value (often around 70–80% in California), the car may be declared a total loss.
The insurance company will then pay the Actual Cash Value (ACV) of the vehicle.
Supplement Claims
Sometimes additional damage is discovered during repairs, and the repair shop may submit a supplement request for additional payment.
6. Deductible Applies
If you’re using collision or comprehensive coverage, you must pay your deductible.
Example:
- Repair cost: $4,500
- Deductible: $500
- Insurance pays: $4,000
If the other driver is clearly at fault, their insurance should pay and you may not have to pay a deductible.
7. Rental Car Coverage (If You Have It)
If your policy includes rental reimbursement coverage, the insurance company may pay for a rental car while your vehicle is being repaired.
Typical limits include:
- $30 per day / $900 maximum
- $40 per day / $1,200 maximum
- $50 per day / $1,500 maximum
Coverage usually lasts until the vehicle is repaired or declared a total loss.
8. Medical Claims (If Someone Is Injured)
If injuries occur, different coverages may apply:
Medical Payments Coverage (MedPay)
Pays medical bills regardless of fault.
Bodily Injury Liability
Pays for injuries you cause to others.
Uninsured Motorist Coverage
Protects you if the other driver has no insurance.
9. Claim Settlement
Once repairs are completed or the total loss value is agreed upon, the insurance company issues payment.
Payments may be made:
- Directly to the repair shop
- To you and the repair shop jointly
- To the vehicle lender if the car is financed
Important Tip: Fault Matters in California
California uses a comparative negligence system, which means multiple drivers can share fault.
Example:
- Driver A is 70% responsible
- Driver B is 30% responsible
Each insurance company pays based on the percentage of fault.
Common Reasons Auto Insurance Claims Get Denied
Claims may be denied if:
- The driver was excluded from the policy
- The vehicle was used for commercial purposes without coverage
- The policy had lapsed
- Damage existed before the claim
- Fraud or misrepresentation occurred
Need Help With an Auto Insurance Claim?
If you ever have an accident, a good insurance agency can help guide you through the claims process.
At Starwest Insurance Services, we help drivers throughout Westminster, Irvine, Santa Ana, and all of Orange County understand their coverage and assist with claims when accidents happen.
If you’d like help reviewing your coverage or getting a quote, feel free to contact us anytime.