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1. Claim receipt and acknowledgment

When the insurer receives your claim it should log the claim and give you a claim number. Many companies send a written or electronic acknowledgement that includes the name of the adjuster and contact information. Keep that claim number and any written acknowledgement—this is how you and the company track the matter.

2. Assignment to an adjuster

An adjuster (company employee or independent contractor) will be assigned to evaluate your claim. The adjuster’s job is to:

• Contact you and collect details, photos, and documents;
• Inspect the property or review medical records, if applicable;
• Speak with witnesses, contractors, or medical providers; and
• Prepare a report about the cause, scope, and value of the loss.

Keep notes of every call (date, time, who you spoke with, and what was said).

3. Investigation and documentation

The insurer will investigate whether the loss is covered by your policy and how much the insurer will pay. Typical documents requested include a proof of loss, receipts, estimates, photographs, police or incident reports, and medical records. Provide clear, organized documentation promptly—delays or missing records can slow resolution.

4. Coverage analysis and reservation of rights

The insurer will review your policy language to determine if the event is covered. Sometimes an insurer will investigate while reserving its right to deny coverage later—called a “reservation of rights” letter. If you receive such a letter, it means the insurer is investigating but believes there may be policy exclusions or other reasons to deny the claim.

5. Decision: acceptance, partial payment, or denial

After the investigation the insurer will:

• Accept and pay: The insurer approves the claim and issues payment for covered losses, subject to your deductible and policy limits.
• Offer a settlement: The insurer makes a cash offer to resolve the claim. Review any release carefully—signing a full release generally ends your right to recover more money for that loss.
• Partially pay: The insurer pays some items but not others based on coverage or valuation disputes.
• Deny: The insurer refuses coverage for some or all of the claim and should give a written denial explaining reasons.

6. If the insurer denies or undervalues the claim

If you disagree with a denial or the payment amount, your options include:

• Request a clear written explanation and the policy language the insurer relied on.
• Provide additional documentation or get independent estimates, repair bids, or medical opinions.
• Use any appraisal, mediation, or arbitration process described in your policy.
• File a complaint with the Rhode Island Department of Business Regulation, Division of Insurance (DBR) if you suspect unfair handling.
• Consult a lawyer experienced in insurance disputes—especially for large losses or suspected bad faith handling.

7. Claim payment and subrogation

When the insurer pays, it may seek reimbursement from a responsible third party through subrogation (for example, if another party caused the loss). If the insurer pursues subrogation, it may ask you to cooperate in the attempt to recover money from the responsible party.

8. Closure and record keeping

Once resolved, keep all claim records—letters, estimates, photographs, and receipts—for several years. They may be important if a related dispute resurfaces or if there are questions about coverage down the road.

How Rhode Island law and resources can help

Rhode Island regulates insurance through statutes and through the Division of Insurance within the Department of Business Regulation. For the statutory code that governs insurance matters in Rhode Island, see Title 27 of the Rhode Island General Laws: https://www.rilegislature.gov/Statutes/TITLE27/.

If you believe an insurer treated your claim unfairly or failed to follow state rules, you can contact the Division of Insurance at the Rhode Island Department of Business Regulation. The DBR provides consumer information and accepts complaints: https://dbr.ri.gov/divisions/insurance/consumer-information.

Practical timeline expectations

Exact timing varies by claim type and insurer. Simple claims (minor auto or property damage) may resolve in days to a few weeks. Complex claims (catastrophic property loss, disputed liability, or complicated medical issues) can take months. If the insurer requests documentation, respond promptly to avoid unnecessary delay.