How your claim is actually processed
A five-part series built on court opinions, regulator publications, and documents insurers released themselves. It describes the process you are inside of — not the person on the phone. General information, not legal advice.
Where we stand. NowAccident exists for people who were in a crash. Everything on this page is free and sourced to court opinions, state regulator documents, and published research.
Start here: the one-paragraph version
If you were injured in a car crash, the first number you are offered was not calculated by the person who called you. It came out of a process: consultants redesigned how bodily injury claims are handled in the 1990s, valuation software converts injuries into severity points and points into dollars, and the dollar value of a point is tuned using what similar claims recently settled for. Regulators examined this in 2010 across nearly two million claims — without opening a single individual file. By 2026, twenty-five jurisdictions have adopted AI governance rules for insurers, and none of them gives you the right to ask whether an automated system touched your claim.
That is the whole series in one paragraph. Below is the evidence, and the five things you can actually do.
The five things this series asks you to do
If you read nothing else, do these. Each takes minutes, each is free, and none requires hiring anyone.
| # | Action | Why it matters |
|---|---|---|
| 1 | Start a claim log — date, time, name, company, claim number, what was asked, what was offered, what you said | Memory of the weeks after a crash degrades fast. Contemporaneous notes do not. |
| 2 | Read your own medical records and correct what is missing or wrong | The system cannot price what is not written down |
| 3 | Look up your insurer's official complaint record and note your filing deadline | The regulator's own scoreboard, plus the one date that cannot be fixed later |
| 4 | Send one short written request asking for status, what is outstanding, and a written breakdown of any offer | Written requests create dates. Phone calls do not. |
| 5 | Check what your state has actually adopted on insurer AI, using the regulator's own map | Twenty-two states have published nothing. Knowing which is which is worth ten minutes. |
The single most important one is your filing deadline. Everything else on this page can be fixed later. That cannot.
Were you in a crash? Start a free accident record at nowaccident.com. No signup, no email, nothing sold. This site is free and carries no advertising. It exists because the information below took months to assemble from primary records, and nobody else had put it in one place for the people who actually need it. If it helps you, send it to someone else who was in a crash.
- Roughly 12,500 consultant slides, described in published opinions by appellate courts in three states
- Policies aimed at claimants handling their own claim without a lawyer — the theory the Montana court called "critical"
- "Good hands" vs. "boxing gloves": a characterization from an attorney's book, not a court finding
- Claim-evaluation software built in the early 1990s on roughly 600 injury profiles and about 10,000 rules
- Depositions unsealed in Arkansas litigation describe the dollar rate — "tuning" — as adjustable toward a savings target
- Medical bills, lost wages and any comparative fault percentage are entered by a person, not calculated by the software
- Anything absent from your medical record is absent from the number — including a treatment gap you took because you could not afford the copay
- A joint market-conduct examination led by Florida, Illinois, Iowa and New York
- Over a million pages and data on nearly two million bodily injury claims, across more than 8,500 examiner hours
- The examiners did not identify institutional underpayment — and they never opened an individual claim file
- Recorded in the findings and almost never reported: the dollar curve is re-tuned on past settlements, across 119 geographic regions
- That notice duty ran to December 31, 2015, covered one company, and no industry-wide rule replaced it
- No general US rule we could verify requires an insurer to tell you whether software priced your injury
- California, 10 CCR § 2695: 40 calendar days to accept or deny, then written updates every 30 days
- An insurer may not condition settlement on your dropping a complaint to the regulator
- The NAIC adopted its Model Bulletin on the Use of Artificial Intelligence Systems by Insurers on December 4, 2023
- 25 jurisdictions have adopted it as of the NAIC's own map dated August 6, 2026 — 24 states plus the District of Columbia
- California, Colorado, New York and Texas run their own insurance-specific AI guidance instead; 22 states have neither
- The laws that require a human to review an AI-driven denial are, so far, health insurance laws
Does this apply outside California?
Yes, for most of it. The records this series is built on are national: consultant documents litigated in Montana, Washington and Indiana; a Florida regulator's subpoena; software depositions unsealed in Arkansas; a multi-state examination led by Florida, Illinois, Iowa and New York; and a 51-jurisdiction map of state AI rules.
Two things do vary by state, and we flag them wherever they appear:
- What your regulator publishes about insurers. California is at the strong end — state law requires a ranked complaint study. Other states publish more or less. Start with your own department of insurance.
- Claims-handling regulations. Part 4 cites California's, because rules are written state by state. Most states have an equivalent, usually called unfair claims settlement practices regulations. Same structure, different numbers.
Everything else — how the process was designed, how the software prices an injury, what the 2010 examination found, and what AI regulation does and does not give you — applies wherever you live.
What this series is, and what it is not
It is: a description of documents that exist — published court opinions, a regulator-hosted agreement, state regulations, an insider report, and two books by investigative journalists and a law professor.
It is not: an accusation that any company is breaking the law today. Where courts disagreed, we say so. Where regulators found nothing, we say that too — Part 3 leads with it. Where we could not verify a widely circulated statistic, we left it out and told you which one.
We publish what cuts against us. That is not modesty; it is the only reason anything else here should be believed.
Frequently asked questions
Why does an insurance adjuster call so soon after a car accident? Court-released records from the 1990s describe early contact and a prompt settlement offer as designed steps in a redesigned claims process, aimed in part at reducing the likelihood a claimant hires a lawyer. Two days after a crash most people do not yet know the extent of their injuries, which is what makes an early number easy to calculate and hard to evaluate.
How do insurance companies decide what my injury is worth? Much of the US auto insurance industry uses claims valuation software. Injuries are assigned codes from a set of roughly 600 profiles, severity points are calculated from about 10,000 rules, and those points are converted to a general damages range using a mathematical curve. Medical bills, lost wages, and any comparative fault percentage are entered manually by a person, not calculated by the software.
Where does the dollar value in claims valuation software come from? According to findings recorded in the 2010 multi-state regulatory agreement, the curve converting severity points to dollars is periodically re-tuned using recent settlement data. The values therefore reflect what comparable claims recently settled for, rather than an independent measure of what an injury costs the injured person.
Does my insurance company have to tell me if software or AI was used on my claim? Not under any general US rule we have been able to verify. A 2010 agreement required one insurer to send such a notice; its term ended December 31, 2015 and it bound only that company. The NAIC's AI model bulletin sets expectations for insurers' internal governance and does not create a consumer right to ask.
Do I need a lawyer for a car accident claim? Not necessarily, and we have no stake in the answer. Many people handle claims themselves. The insurance industry's own research has reported that representation is associated with substantially longer resolution times and, net of fees, not automatically higher compensation. Representation tends to matter most where injuries are unresolved or permanent, fault is disputed, a filing deadline is near, a government entity is involved, or you are being asked to sign a release you do not fully understand.
Can I reopen a claim after signing a settlement release? Generally no. A settlement release typically ends the claim permanently, even if your condition later worsens. That finality is why many people have a release reviewed before signing.
Does negotiating with an adjuster pause the statute of limitations? No. Filing deadlines continue to run while a claim is being negotiated. In California the period for most personal injury claims is two years from the date of injury, with exceptions, and claims involving government entities commonly require formal notice within a far shorter period.
How long does an insurer have to accept or deny my claim in California? Under 10 CCR § 2695.7(b), an insurer must accept or deny a claim, in whole or in part, no later than 40 calendar days after receiving proof of claim. If more time is needed, § 2695.7(c)(1) requires written notice within that period specifying what additional information is required, followed by written updates every 30 calendar days. Specific exceptions apply.
Is NowAccident a lawyer referral service? No. We do not sell leads, we are not paid if you hire an attorney, we require no signup, and we do not collect email addresses. This site exists for people who were injured in a crash.
Sourcing
Every factual claim in this series traces to one of the following categories, and each part lists its own sources with links:
- Published court opinions — Jacobsen v. Allstate Ins. Co., 2013 MT 244 and 2009 MT 248; McCallum v. Allstate (Wash. Ct. App. 2009); Allstate Ins. Co. v. Scroghan, 851 N.E.2d 317 (Ind. Ct. App. 2006)
- Regulator documents — the 2010 Multi-State Market Conduct Regulatory Agreement, hosted by the Oregon Division of Financial Regulation; California Department of Insurance Bulletin 2022-5 and the Consumer Complaint Study; the NAIC's AI model bulletin adoption map
- State regulations — California Code of Regulations, Title 10, § 2695 et seq.
- Books by journalists and academics — When McKinsey Comes to Town (Bogdanich & Forsythe, 2022); Delay, Deny, Defend (Feinman, 2010)
- Research organizations, disclosed as interested where relevant — Consumer Federation of America; Insurance Research Council
Never used as sources: law firm marketing pages, settlement-estimate services, and circulating lists of insurers said to use particular valuation software.
What we are building next
The gap we hit in every part of this series is the same: nobody has systematically mapped what an ordinary claimant is allowed to find out, state by state. So that is the next project — all 51 jurisdictions, three questions each:
- Does your regulator publish insurer complaint data, and can you compare companies?
- Has your state adopted an AI framework for insurers?
- Can you ask whether an automated system touched your claim, and get an answer?
We will publish the map, the table, the methodology, and the raw dataset — including the blanks.
Reviewed by: Alex Song, Ph.D. — Researcher
Last updated: August 8, 2026
This is general information, not legal advice. It does not create an attorney-client relationship. Laws vary by state and change over time. Consult a licensed attorney in your state.
Think something here is wrong? Tell us and we will correct it: support(a)nowaccident.com
General information only. NowAccident is not a law firm and does not provide legal advice. Each part lists its sources; court opinions and regulator publications are cited directly.