Claimant FAQs

What is AUTEN CLAIMS MANAGEMENT, and how are you involved in my insurance claim?

AUTEN CLAIMS MANAGEMENT (ACM) is an independent adjusting firm that specializes in investigating third-party liability claims. We work on behalf of insurance companies and self-insured entities to assess claims involving injuries or property damage. Our role is to conduct a thorough investigation to determine liability, collect evidence, and provide an unbiased report to help in the resolution of your claim.

What do I need to do to file a claim with ACM?

To file a claim, you should first report the incident to the insurance company or the person or business you believe to be responsible for the incident causing you to make a claim. The insurer, in turn, will inform us if they've appointed ACM to handle the claim. You can then provide us with the initial details of the claim, including your contact information, the date of the incident, and a brief description of what happened. We'll guide you through the next steps.

What information and documents do I need to provide for my claim?

The information needed can vary depending on the specifics of your claim. Generally, you'll need to provide:
• A detailed account of the incident.
• Any police or incident reports filed.
• Contact information for any witnesses.
• Photographs of the damage or injuries, if applicable.
• Medical reports and bills, in case of personal injury.
• Estimates for repairs or replacements, in case of property damage.

How long does the claim investigation process take?

The duration of the investigation process can vary widely depending on the complexity of the claim, the availability of evidence, and the cooperation of all parties involved. Typically, an investigation can take anywhere from a few weeks to several months. We strive to conduct a thorough and efficient investigation to resolve claims as promptly as possible, keeping all parties informed throughout the process.

Can I expect to be contacted directly by an ACM adjuster? If so, what should I prepare for that meeting or call?

Yes, it's likely that an ACM adjuster will contact you directly as part of the investigation process. To prepare, you should gather any documents or information related to the incident, including any of the items listed in response to question three. The adjuster may ask for a detailed account of the incident, so think about the sequence of events leading up to and following the incident. It's also helpful to have a list of any questions or concerns you might have about the process.

How is liability determined in my claim?
Liability is determined by examining the evidence collected during the investigation, including statements from all parties involved, witness accounts, photographs, and any relevant reports, such as police or incident reports. Our adjusters analyze this information to assess who was at fault according to the applicable laws and regulations. The determination of liability is a crucial part of resolving your claim and will guide the decision on compensation.
What happens if the policyholder disputes my claim or the events that led to the injury/property damage?

If the policyholder disputes your claim or the events, ACM will conduct a detailed investigation to uncover all relevant facts. This may involve collecting additional statements, seeking further evidence, and possibly consulting with experts. Both parties will have the opportunity to present their side of the story. The goal is to arrive at a fair and unbiased conclusion based on the evidence available.

Will I need to provide medical records or evidence of property damage? How should I submit these?

Yes, if your claim involves personal injuries, you'll likely need to provide medical records and bills related to your treatment. Do not email medical records. We will follow HIPAA guidelines for securing those from your healthcare providers.

For property damage claims, evidence such as photographs of the damage and repair estimates are necessary. These documents can be submitted directly to your ACM adjuster, preferably in electronic form via email for efficiency and speed. If you're unable to submit electronically, your adjuster can provide alternative methods.

How can I track the status of my claim throughout the investigation?

ACM understands the importance of keeping you informed about your claim's status. You can track the progress of your claim by directly contacting your assigned adjuster. We aim to provide regular updates as the investigation progresses and are always available to answer any questions or concerns you may have.

Are there any deadlines I should be aware of when filing a claim or submitting additional information?

Yes, there are typically deadlines for filing a claim and submitting additional information, which can vary depending on the policy under which the claim is made and the jurisdiction where the incident occurred. It's important to file your claim as soon as possible after the incident and to promptly submit any requested information. Your ACM adjuster can inform you of specific deadlines relevant to your claim to ensure that you remain within the required timeframes. These answers aim to provide claimants with clear and helpful guidance on what to expect during the claims process, ensuring they are well-informed and can participate effectively.

Why Can't I Receive a Copy of the Final Investigation Results?

We prioritize fairness, adhere to the directives and policies of our clients, and respect the privileged nature of investigation content. For these reasons, there are limitations on sharing detailed investigation results:

  • Fairness to All Parties: To ensure equitable treatment of all involved parties, we maintain a neutral stance in our investigations. Disclosing full investigation details could inadvertently bias the claims process.

  • Client Directives and Policies: Our operations align closely with the specific directives and confidentiality policies set forth by our clients. These guidelines often restrict the sharing of detailed investigative findings to protect the interests of all parties and maintain the integrity of the claims process.

  • Privileged Nature of Investigation Content: The information gathered during our investigations often contains privileged content that, if disclosed, could compromise the privacy and legal rights of individuals or entities involved.

Our commitment to these principles is fundamental to our role as a trusted partner in the claims management process. While we understand the desire for transparency, our primary obligation is to ensure that our investigations uphold the highest standards of fairness, confidentiality, and legal compliance.

What should I do if I have additional evidence or information after I've already filed my claim?

If you come across additional evidence or information that could impact your claim, it's important to share this with your ACM adjuster as soon as possible. You can do this by contacting your adjuster directly via email or phone. Providing new evidence promptly can help ensure that your claim is assessed accurately and fairly, considering all relevant information.

How will I be informed of the decision on my claim?

Once the investigation is complete and a decision has been made regarding your claim, your ACM adjuster will contact you directly to inform you of the outcome. This communication might be through a phone call, followed by an official letter or email that outlines the decision, the reasons behind it, and any next steps, including information on compensation if your claim is approved.

If my claim is approved, how and when will I receive compensation?

If your claim is approved, the compensation process will begin. The timing and method of payment can vary depending on the specifics of your claim and the policies of the insurance company or self-insured entity responsible for payment. Your ACM adjuster will provide you with details regarding the expected timeline for receiving compensation and any actions you might need to take to facilitate the process.

What can I do if I disagree with the decision made on my claim?

If you disagree with the decision made on your claim, you have the right to appeal. The first step is to contact your ACM adjuster to discuss your concerns and understand the basis for the decision. If you still believe the decision is incorrect, you can formally appeal by submitting a written request that outlines your reasons, accompanied by any additional evidence you wish to present. Your adjuster will guide you through the appeal process, including any specific deadlines or procedures to follow.

Who can I contact at ACM for questions or concerns about my claim process?

For any questions or concerns about your claim process, you should first try to contact your assigned ACM adjuster, as they are most familiar with your case. If you need further assistance, or if you're unable to reach your adjuster, you can contact ACM's customer service or claims department directly. The contact information for these departments is available on our website, in your claim documentation, or can be provided by your adjuster.