Overview — how the claim process typically unfolds

Once you file a claim with your Connecticut insurance company (for example, after a car crash, home water damage, or theft), the insurer begins a series of standard actions: acknowledging your claim; assigning an adjuster; investigating coverage, liability, and damages; and either paying, negotiating, or denying the claim. Timing and steps vary with the claim type and policy language.

Step 1: Confirmation and claim number

Shortly after submission you should receive a claim number and a written or electronic acknowledgement. This acknowledgement may list a claims adjuster or customer-service contact. Keep that claim number and all communications — it is the reference for every call, estimate, and payment.

Step 2: Assignment of an adjuster and initial contact

The insurer will assign a claims adjuster or examiner. That person will contact you to:

• Confirm facts and obtain a signed proof-of-loss or statements;
• Explain what documents are needed (police report, photos, receipts, estimates);
• Schedule inspections, estimates, or examinations under oath if required.

Be brief, factual, and consistent in your statements. Take notes of the date, time, and name of every person you speak with.

Step 3: Investigation — what the insurer reviews

The insurer investigates three main things:

1. Coverage: whether your policy covers the type of loss you reported (perils, policy limits, exclusions).
2. Liability (for third‑party claims): who caused the loss and how much the insurer must pay to others.
3. Damages: the amount needed to repair or replace property, medical bills, lost wages, or other covered losses.

The insurer may inspect the damaged property, interview witnesses, request medical records or bills, and obtain repair estimates. Respond promptly to reasonable requests for documentation — delays can slow your claim or be used as a basis for denial.

Step 4: Coverage decision — acceptance, partial payment, or denial

After investigation the insurer must decide whether to accept the claim (in whole or in part) or deny it. If the insurer accepts, it will present a settlement offer or issue payment for covered losses minus any applicable deductible.

If the insurer denies or partially denies coverage, Connecticut practice generally requires a written explanation stating the reasons. If you disagree, you can request a written denial, ask for reconsideration, and later appeal or file a complaint with the Connecticut Insurance Department.

Step 5: Repair, replacement, or settlement

If your property will be repaired or replaced, the insurer may:

• Pay the vendor directly;
• Issue payment to you to hire a contractor;
• Provide a partial advance for emergency repairs.

For total-loss situations (commonly with vehicles), the insurer may pay the actual cash value (replacement cost minus depreciation) unless your policy includes replacement-cost coverage. Read your declarations page and ask the adjuster to explain the calculation.

Common outcomes and follow-ups

• Payment in full: claim closed after payment and releases are signed.
• Partial payment: insurer pays part and continues to investigate or negotiate the rest.
• Denial: insurer declines coverage; you may appeal internally, file a regulatory complaint, or consider legal options.
• Stalled claim: if an insurer delays without clear reasons, document communications and consider contacting the Connecticut Insurance Department.

When to involve an attorney

Consider consulting a Connecticut attorney if:

• The insurer denies a clearly covered claim;
• The insurer’s payment is far below reasonable repair or replacement estimates;
• You face bad-faith tactics (unreasonable delay, failure to explain denial, or misrepresenting policy terms);
• Liability is disputed after a serious injury or significant property loss.

An attorney can explain contractual rights, negotiate with the insurer, and, if needed, pursue litigation or settlement. If cost is a concern, some attorneys handle insurance disputes on contingency (they are paid a portion of recovery).

Connecticut resources

For general information, complaint filing, or to check insurance company practices in Connecticut, use the Connecticut Insurance Department (CID): https://portal.ct.gov/CID. If you want to see Connecticut’s statutes and legislative resources, visit the Connecticut General Assembly home page: https://www.cga.ct.gov/.

Helpful hints

• Document everything: photos, receipts, repair estimates, police reports, and all communications (dates, times, names, and summaries).
• Get the claim number and adjuster’s contact info on every call.
• Ask for written explanations of denials or partial payments.
• Don’t sign a final release until you are satisfied with the settlement amount.
• Keep duplicate copies of proof-of-loss forms and any records you give the insurer.
• If repairs are urgent, get reasonable estimates and ask the insurer about emergency advance payments.
• If the insurer delays, consider filing a complaint with the Connecticut Insurance Department and ask about mediation or appraisal clauses in your policy.