Overview
Understand every step of the insurance claim process — what happens when, why it matters, and what you must do to stay ahead.
Use this sequence to time your submissions, track deadlines, and keep leverage when the carrier slows down.
Claim sequence
Follow these events in order. Stay proactive with documentation and deadlines.
01 · First Notice of Loss (FNOL)
Notify the carrier with date, cause, affected areas, and preferred contact. This starts statutory response clocks.
02 · Acknowledgment
Carrier confirms receipt and assigns an adjuster. Capture contact info and claim number.
03 · Inspection Scheduling
Confirm scope and attendees. Provide access notes and safety concerns.
04 · Inspection Completed
Capture who attended, what was photographed, and any verbal commitments. Note missing areas.
05 · Initial Estimate
Review carrier estimate against your contractor bids and photos.
06 · Documentation Phase
Deliver photos, receipts, invoices, and mitigation proof. Track what was sent and when.
07 · Dispute / Reinspection
Request reinspection with side-by-side comparisons. Keep written records of requests and responses.
08 · Revised Estimate / Negotiation
Present evidence, code references, and contractor statements. Propose a clear settlement number.
09 · Settlement Decision
Review settlement statement, depreciation, deductibles, and contingencies before agreeing.
10 · Final Payment & Closure
Confirm checks align with coverages, endorse only after amounts are correct, and file a closure memo.
Common carrier delays
- Missing documentation requests — respond with a dated list of what you already sent.
- Delayed acknowledgment — escalate after the statutory window; log every outreach.
- Slow estimate release — request a delivery date in writing and cite state timelines.
- Reinspection stall tactics — offer two time windows and document refusals.
- Adjuster changes — send a concise case brief so progress does not reset.
Required documentation timing
- Photos: capture immediately and after mitigation or repairs.
- Receipts: upload weekly to avoid missing reimbursements.
- Proof of Loss: submit before policy or state deadline.
- Supplements: send updates within 3–5 days of receipt.
What to do if the carrier stops responding
- Send a dated follow-up citing prior attempts and the expected response window.
- Escalate to a supervisor and request a call time; keep all notes in your journal.
- Reference applicable state claim-handling deadlines.
- Prepare a complaint draft if silence continues; attach your communication log.
Legal time limits
- State acknowledgement and decision timelines.
- Policy deadlines for Proof of Loss and suit limitation.
- Bad faith triggers when evidence is ignored or underpaid.
Use with these tools
Deadlines Tool — track statutory and policy response clocks with reminders.
Claim Journal — log every touchpoint, document requests, and carrier promises.
Evidence Organizer — keep submissions organized to prevent clock resets.
Claim Playbook — step-by-step scripts and escalation language.