The Loss Is Only The Beginning -------------------------------------------------------------------------------- Duties After An Accident Or Loss Insurance policies are called "conditional" contracts because, in order for the insurer to pay for a loss, the insured has to meet a number of conditions. One of the most important obligations concerns your actions after a loss. Once a loss occurs, the covered person's (insured's) duties include the following: Notification The insured must give the insurance company the accident details as soon as possible. The notification may be to an agent, and, ideally, should include the identity and addresses of any people hurt in the accident, as well as information on any witnesses to the accident. Notification is critical! It initiates the entire claims process, and it gives the insurer its first and best opportunity to control the expense of the claim. Assisting The Insurance Company If an insured wants coverage, he must assist the insurer in the claim's investigation and settlement, as well as help with defending against any claim or suit. The covered person must immediately send the company copies of ANY material received that's related to the accident (such as letters from any other person involved in the accident or legal papers). Assistance includes agreeing to attend as many physical exams, involving doctors selected by the insurer and/or interviews under oath, as are reasonably requested by the insurer. These requirements are at the insurer's expense. You must also permit the insurer complete access to medical and other records that relate to the accident as well as give the insurer any requested proof of loss. Your assistance allows an insurer to evaluate whether a loss payment is due and how much has to be paid. This area has a lot of potential for straining relations between you and your company since you may, at times, differ over what is "reasonable," especially when the insurance company makes repeated requests for help or information. Although companies have the right to thoroughly investigate losses, the responsible company balances their right against their customers expectation of fair treatment and right to privacy.