Progressive denies claims if they are not covered by the policy. Common reasons why the claim may not be covered by the policy are if the policyholder failed to pay their premium by the due date or the end of any grace period, or if they did not have the type of insurance needed to cover the damages they are claiming.
Lack of coverage
If the policyholder does not have the type of insurance needed to cover the specific type of loss or damage in question, Progressive may deny the claim. For instance, if the policyholder filed a claim for damage to their vehicle after an accident they were responsible for, their claim may be denied if they don't have collision insurance.
If the accident was not the policyholder's fault, they can file a claim with the at-fault driver's insurance company. The at-fault driver's insurance company will typically cover the policyholder's accident-related expenses, up to the at-fault driver's policy limits.
Failure to make on-time payments
If the policyholder failed to make timely payments, their insurance company may view it as a violation of the terms and conditions of the policy. As a result, the insurer may have the right to deny the claim or even cancel the policy altogether.
Failure to disclose information
Insurance companies rely on accurate and complete information from policyholders to investigate claims. If the policyholder fails to disclose information or lies about certain details of the claim, the claim can be denied. For instance, if the policyholder claims vehicle damage that happened prior to the accident, the insurer has the right to deny the claim.
Exceeding the coverage limit
If the cost of the claim exceeds your coverage limit, Progressive may deny the claim or only pay up to the policy limit.
Progressive Claims Reputation
Progressive is not known for wrongfully denying insurance claims. However, Progressive only received a score of 819 out of 1,000 in the latest J.D. Power claims satisfaction survey, compared to the industry average of 873 out of 1,000. Additionally, Progressive receives more complaints than the average car insurance company its size, according to the NAIC.
What You Can Do If Progressive Denies Your Claim
If Progressive denies your insurance claim, you can try appealing your claim decision directly with Progressive. You can do this by sending a letter to Progressive that provides proof of why its decision was wrong or evidence it missed when coming to the first decision.
You can also consider filing a lawsuit against Progressive if you think your claim has been denied without justification or if your adjuster failed to investigate the claim enough. You could even sue Progressive if you receive an unreasonably low settlement offer.
To learn more, check out WalletHub's complete review of Progressive and guide to car insurance claims.
This answer was first published on 07/06/23. For the most current information about a financial product, you should always check and confirm accuracy with the offering financial institution. Editorial and user-generated content is not provided, reviewed or endorsed by any company.
FAQs
Fraud: In rare cases, Progressive may suspect fraud or misrepresentation related to your claim and deny coverage on that basis. Lack of coverage: They could deny the claim if it is determined you do not actually have coverage for the type of loss or damage involved.
Is Progressive good about paying claims? ›
Is Progressive good about paying claims? Progressive ranks below average in the 2023 J.D. Power Auto Claims Satisfaction Study.
Do insurance companies intentionally deny claims? ›
Companies will refuse to approve your request for compensation if your claim lacks support and evidence. The insurer may justify its denial by claiming that it believes your injuries were pre-existing at the time of the accident or that your own conduct made the injuries worse.
How to negotiate with Progressive Insurance? ›
How Should You Approach Progressive?
- Analyze your full claim to identify all sources of compensation.
- Gather medical records and objectively assess the extent of injuries.
- Inspect vehicle and property damage to document claim scope properly.
- Challenge any unjust liability denials or premature conclusion of claims.
Claim denial rates by insurance company
| Company | Claim denials |
|---|
| UnitedHealthcare | 32% |
| Anthem | 23% |
| Aetna | 20% |
| CareSource | 20% |
1 more rowMay 15, 2024
Insurers may not drop a customer after their first one or two incidents. The first step is often to increase your car insurance rate. From there, if a customer has another accident or files more claims, the insurer may send a notice that they won't be renewing the policy at the end of its term.
How long does Progressive Insurance take to settle a claim? ›
We resolve many property damage claims within 7 to 14 days, but repair times can vary greatly based on your vehicle, the damage, etc. No matter what, we'll work quickly and efficiently so you can get back to your normal routine.
Does Progressive Insurance go up after a claim? ›
Your rate may go up if you have comprehensive auto coverage and file a claim for incidents like car theft and vandalism, hitting a deer, fire, glass breakage (including a cracked windshield), hail/weather-related damage, and other acts of nature.
How much does Progressive pay in claims? ›
How much does a Progressive Claims Adjuster make in California? As of Jun 4, 2024, the average annual pay for a Progressive Claims Adjuster in California is $66,444 a year. Just in case you need a simple salary calculator, that works out to be approximately $31.94 an hour.
What is a typical reason for a denied claim? ›
The claim has missing or incorrect information.
Whether by accident or intentionally, medical billing and coding errors are common reasons that claims are rejected or denied. Information may be incorrect, incomplete or missing.
Nearly 15 percent of medical claims submitted to private payers for reimbursem*nt are initially denied, according to a new national survey of hospitals, health systems and post-acute care providers conducted by Premier, Inc.
What is a common reason a car insurance claim could be denied? ›
One example of that would be driving without a valid license. Another is if you were driving while intoxicated. Additional reasons: An insurer can also deny a claim on the grounds that the accident was avoidable on your part or if they believe your claim is fraudulent.
Does Progressive deny claims? ›
One possible reason for your accident claim being denied by Progressive could be a lack of sufficient evidence to support your case. When filing a claim, it is crucial to provide all necessary documentation, such as police reports, medical records, and witness statements.
Can you haggle with Progressive? ›
The first settlement offer you receive will often be much lower than what you might deserve. Before you accept the first offer, you should know that you can negotiate the amount. Never accept the first offer. The first step will be to understand how much your car is worth.
Where does Progressive rank in insurance? ›
Is Progressive Car Insurance Good? In our rating, Progressive tied for the No. 9 spot among the companies we researched. Progressive's overall average rate was lower than the national average – it offers the sixth-lowest average rates of the companies in our analysis.
What is one of the most common reasons for a claim being rejected by an insurance company? ›
Process Errors
- The claim has missing or incorrect information. Whether by accident or intentionally, medical billing and coding errors are common reasons that claims are rejected or denied. ...
- The claim was not filed in a timely manner. ...
- Failure to respond to communication. ...
- Policy cancelled for lack of premium payment.
Many claim denials start at the front desk. Manual errors and patient data oversights such as missing or incorrect patient subscriber number, missing date of birth and insurance ineligibility can cause a claim to be denied.
How often do insurance companies deny claims? ›
“Americans deserve information and data that has relevance to their own personal health and circ*mstances.” The limited government data available suggests that, overall, insurers deny between 10% and 20% of the claims they receive.
How does Progressive handle claims? ›
When you report a claim, we'll gather some basic information, then assign a claims rep to you. They'll provide more details on the claims process and answer any questions. You can file a claim by logging in to your policy, using our mobile app, or by calling our claims center.
