Assessment of the claim: the work of the expert

Once we have given part to the insurance, the insurer starts the analysis and verification of the damages or losses caused by the incident, following step by step the claims processing that we have seen previously. This step is the one that explains in most cases how long it takes for insurance to pay a claim.

To assess and clarify how the accident occurred, the insurer normally sends an expert to assess the consequences of the incident and estimate the damages and losses.

This is a step that is also provided for in the regulations, which establishes the obligation of the insurer to pay compensation “at the end of the investigations and expert reports necessary to establish the existence of the claim and, where appropriate, the amount of the damages that result from it”.

This investigation can take a long time, especially when it comes to more complex claims or that require documentation that takes time to process. Despite the wait, it is important not to lose patience and adopt certain measures that can help the final result of this entire process:

• Do everything possible to reduce the damage caused by the accident.
• Do not assume any payment or repair without consulting the Insurance if they are covered in the policy.
• Keep elements that can facilitate the work of the expert.

Payment of compensation or repair of the insured object

Be that as it may, the Law establishes 40 days, from when the insurance received the notification of the claim, to make “the payment of the minimum amount of what the insurer may owe, according to the circumstances known to him”.

Normally, this period is sufficient for the insurer to complete the processing of the claim and pay the corresponding compensation or manage the repair or replacement of the insured object.

What if insurance compensation is delayed?

However, the deadlines are not always met and on many occasions, insurers pay only that minimum amount to comply with the Law. However, that “minimum amount” does not correspond to the total amount that the insured must collect, under that which is in your contract.

For these cases, section 3 of article 20 of Law 50/1980 is taken as a reference, when it is established that “it will be understood that the insurer is in default when it has not fulfilled its provision within three months from the production of the claim or has not proceeded to pay the minimum amount of what may be owed within forty days from receipt of the claim statement.

Or what is the same, the Insurance must comply with the payment of the compensation or the repair of what was damaged in the accident within a maximum period of three months since it occurred, if it does not want to assume the possible consequences -economic, with a surcharge of interest – which would mean a delay. A delay that would only be accepted if there was a “just cause”.

So, how long does the Insurance have to fix a claim?

In conclusion, and according to the Law, insurance companies take a maximum of 40 days to pay the first amount of the guarantee or manage the repair or replacement of the insured objects.

Most of the time, this term is enough to solve the payment of the indemnity or the repair that the coverage establishes.

However, there may be circumstances that complicate the processing of the claim. In those cases, the insurance company has up to three months to resolve the process, before falling into default and we can claim a surcharge from the insurer for late payment interest.

In short, if you suffer an accident or an incident at home or with the car, it is advisable to start the procedures for claiming the compensation that may correspond to you as soon as possible and provide all the information we have about what happened. As we have seen, timing is important when collecting insurance.