Here’s what you need to know about personal injury claims and the role of insurance companies:
1. How Insurance Companies Are Involved in Personal Injury Cases
Insurance companies are typically involved in personal injury cases in one of two ways:
• Your own insurance policy: If the injury occurred in a car accident or workplace incident, your own insurance may cover medical expenses, lost wages, or other damages through personal injury protection (PIP) or medical payment coverage.
• The at-fault party’s insurance: In many personal injury cases, the insurance company of the party responsible for the accident will be liable for compensating you for your injuries. The insurance company will typically handle the claim, determine liability, and make an offer for compensation.
While insurance is supposed to protect you, the process can be frustrating. Insurance companies are businesses, and their primary goal is to protect their bottom line, often by minimizing payouts. Knowing how to deal with them can help you get the compensation you deserve.
2. What Insurance Companies Want
Insurance companies, whether you are the claimant or the defendant, operate under a business model that seeks to minimize their payouts. Here’s what they prioritize:
• Limiting liability: Insurance companies will often try to reduce the amount they pay for a claim. They may argue that you were partly at fault or that the injuries you sustained aren’t as severe as you claim.
• Settling quickly: Insurance adjusters may offer a quick settlement in the hope that you’ll accept the first offer. These initial offers are often much lower than what you are entitled to, which is why it’s important to avoid rushing into a settlement.
• Paying as little as possible: They aim to reduce their financial exposure, which means they may dispute the full extent of your injuries, downplay the incident’s seriousness, or question the need for specific treatments or medications.
3. How Insurance Adjusters Work
Insurance adjusters are the professionals hired by insurance companies to investigate, evaluate, and settle claims. They are tasked with:
• Investigating the incident: The adjuster will review police reports, witness statements, medical records, and other documentation to determine the extent of the insurer’s liability.
• Evaluating injuries: Adjusters assess medical records, treatment costs, and other evidence of injury to determine how much compensation is reasonable.
• Negotiating settlements: They will offer settlements based on their assessment of the case. Keep in mind that the initial offer may be much lower than what you deserve, so it’s important to negotiate and understand your rights.
4. Common Insurance Tactics to Watch Out For
Insurance companies are well-versed in tactics that aim to minimize the compensation you receive. Here are some common tactics to be aware of:
• Low-ball offers: After an accident, an insurance adjuster may offer you a quick settlement. While this may seem like a good solution, these offers are often much lower than what you’re entitled to. Don’t accept any offers until you have fully assessed the impact of your injuries.
• Delay tactics: Sometimes, insurance companies will delay responding to your claim or stall negotiations in the hopes that you’ll get frustrated and accept a lower offer or even give up on your claim altogether.
• Blaming you for the accident: The insurance company may try to argue that you were partially or fully responsible for the accident, in an effort to reduce their payout or deny the claim entirely.
• Questioning the severity of your injuries: Insurance adjusters may challenge your injuries by claiming they are pre-existing or questioning the necessity of certain treatments. They may even suggest that you’re exaggerating the extent of your injuries to increase the payout.
• Requesting recorded statements: Insurance companies often request that you provide recorded statements about the accident. Be cautious about giving such statements without consulting an attorney first, as your words could be used against you.
5. How to Deal with Insurance Companies After a Personal Injury Accident
To protect your rights and maximize your settlement, consider the following steps when dealing with insurance companies:
a) Document Everything
From the moment the accident happens, document as much as possible. This includes:
• Photographs of the accident scene, your injuries, and any damages to property.
• Medical records documenting the extent of your injuries, treatments, and recovery plan.
• Witness statements from anyone who saw the accident occur.
• Receipts and invoices for medical treatments, prescriptions, and any other expenses incurred due to your injuries.
Having this evidence can strengthen your case and provide leverage when negotiating with insurance adjusters.
b) Avoid Giving a Recorded Statement Without Legal Advice
Insurance companies may ask for a recorded statement, where they record your account of the incident. While this may seem like a standard request, be cautious before agreeing to it. Insurance adjusters may use your words against you or misinterpret them to reduce the payout. Consult with an attorney before providing a recorded statement.
c) Consult with an Attorney
A personal injury attorney can help protect your rights and guide you through the process of dealing with insurance companies. They can:
• Evaluate your case and estimate the amount of compensation you’re entitled to.
• Handle communication with insurance companies, ensuring that you don’t make statements that could harm your claim.
• Negotiate on your behalf to secure a fair settlement.
• If necessary, file a lawsuit against the at-fault party to get the compensation you deserve.
An attorney can also help you navigate complex legal language in insurance policies and ensure that you’re not taken advantage of by an insurance company.
d) Don’t Accept the First Offer
Insurance companies often offer a low settlement in the hope that you’ll accept it without negotiating. Don’t be rushed into accepting the first offer. Instead, take the time to evaluate the full extent of your injuries and the financial impact of the accident. If an offer is too low, your attorney can help you negotiate for a higher settlement.
e) Be Careful What You Post on Social Media
Insurance companies often monitor social media platforms to look for evidence that may undermine your claim. Avoid posting anything related to the accident, your injuries, or your recovery on social media, as it may be used to argue that your injuries are less severe than you claim.
6. When to Consider Filing a Lawsuit
If negotiations with the insurance company fail to yield a fair settlement, or if the insurance company denies your claim, it may be time to consider legal action. Filing a personal injury lawsuit can be a lengthy process, but in some cases, it’s the best way to ensure you receive the compensation you deserve. Your attorney can advise you on whether filing a lawsuit is necessary and guide you through the litigation process.
7. What Insurance Covers in Personal Injury Cases
Insurance policies vary, but common coverage in personal injury cases may include:
• Medical expenses: Including hospital bills, rehabilitation, and ongoing medical treatments.
• Lost wages: Compensation for time missed from work due to the injury.
• Pain and suffering: Compensation for physical pain and emotional distress caused by the injury.
• Property damage: If your property, such as a vehicle, was damaged in the accident, insurance may cover repair or replacement costs.
Each insurance policy is different, so it’s essential to thoroughly review your coverage and understand the terms and limitations.
Conclusion
Insurance companies play a crucial role in personal injury cases, but they often work to minimize their payouts. By understanding the tactics they may use and following the proper steps to protect your rights, you can increase your chances of receiving a fair settlement. Consult with an experienced personal injury attorney to guide you through the process and ensure that you get the compensation you deserve. Remember, never settle too quickly, and always be diligent about your rights when dealing with insurance companies.