Filing an insurance claim often comes at a stressful time — an accident, damage, or unexpected loss. At Bulger Insurance, we know that understanding how the process works before something happens can give you confidence when you need it most.
That’s why we’ve put together this guide to key insurance concepts and terms you may encounter when making a claim. Whether you’re in Edmonton, Calgary, or anywhere in Alberta, having a handle on the basics can make a big difference.
Who’s Who in the Insurance World
Independent Insurance Broker
An independent broker (like us!) is licensed to work with multiple insurance companies — not just one. That means we can shop around for the best coverage options and price points for your unique needs. We work for you, not the insurer.
Independent Insurance Brokerage
This is the business we operate under — a brokerage that employs independent brokers who offer products from several different carriers.
Insurance Agent or “Captive Agent”
Unlike independent brokers, captive agents represent just one insurance company. They can only offer you that company’s products.
Insurance Company or “Carrier”
This is the company that underwrites your policy and pays for covered losses in exchange for your premium payments.
What Happens When You File a Claim?
Underwriting & Risk Rating
Before you’re insured, underwriters assess how risky you are to insure — looking at factors like your claims history or driving record. This helps determine your premium. After a claim, your risk rating may change.
Claims Representative
Once you file a claim, you’ll work with a claims representative from the insurance company. They’ll coordinate the process — from assessing your policy to approving (or denying) payments.
Claims Adjuster
This is the person who investigates your claim to determine how much the insurance company owes you. They might work directly for the insurance company or as an independent contractor.
Independent Insurance Adjuster
Feeling like the insurer’s adjuster isn’t fully accounting for your loss? You can hire an independent adjuster to advocate for you, review your coverage, and negotiate a better outcome.
Costs, Coverage & Claims: Key Terms
Premium
Your premium is the amount you pay (monthly or yearly) to keep your insurance policy active — even if you have a claim in progress.
Deductible
This is the portion you pay out of pocket before your insurance kicks in. For example, if you have a $1,000 deductible on a $5,000 auto claim, your insurer pays $4,000.
Document Submission
You’ll need to provide proof to support your claim. This could include photos, police reports, receipts, or witness statements.
Understanding the Claim Process
Claim Status & Timeline
Claims can take anywhere from a few days to several weeks depending on complexity. You may receive updates via email, text, or a self-service portal — or you can call your claims rep or broker anytime.
Claim Rejection
If your insurer denies your claim, they must explain why and reference the section of your policy used in the decision.
Claim Appeal
You can appeal a denial, typically within 14 days. Consult your broker, a public adjuster, or legal advisor to help you through the process.
Claim Approval
If your claim is approved, the insurance company will offer a payout. If you agree to the settlement and sign off, the claim closes. If you disagree, you may contest the offer.
Claim Cancellation
Once a claim is filed, it cannot be undone. It stays on your record. Not sure whether to file? Call your broker first — we can help you decide.
Other Useful Insurance Terms
Loss
The damage, injury, or other impact that results in your claim.
Third Party
Someone outside of you and your insurance policy — like the other driver in a car accident or a neighbour whose property was accidentally damaged.
Exclusion
Events or risks your policy doesn’t cover. For example, standard home insurance policies in Alberta often exclude flood damage.
Endorsement
Also called a “rider,” this is added coverage to fill in gaps — like sewer backup or overland water protection.
Peril
The specific cause of damage — such as fire, vandalism, or hail.
What About Replacement Costs?
Replacement Value (RV)
The amount it would cost to replace an item with a new one of similar kind and quality — regardless of how old your original item was.
Actual Cash Value (ACV)
This is the depreciated value of your item. For example, if your 5-year-old TV is stolen, your insurer may calculate the payout based on its reduced value — not the cost to buy a new one.
Additional Living Expenses (ALE)
If your home becomes uninhabitable due to a covered loss, ALE coverage helps pay for temporary housing, meals, and other essentials. Some policies include ALE automatically, while others require it to be added as an endorsement — a good thing to confirm with your Alberta broker.
Need Help Navigating a Claim?
This list isn’t exhaustive, but it covers many of the terms you’ll encounter when filing an insurance claim in Alberta.
Not sure if you should file a claim? Have questions about what’s covered?
📞 Call Bulger Insurance. We’re here to help.
This article is for general information only and not legal or financial advice. For questions about your specific situation, consult your broker or a qualified advisor.
