Dealing with Insurance Companies During a Personal Injury Case

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Dealing with Insurance Companies During a Personal Injury Case

Insurance companies often play a major role in personal injury litigation. In car accidents, the insurance provider of the party at fault will negotiate settlements. For personal injury cases at the workplace, the employer’s insurance company will deal with the plaintiff. In a personal injury case that results from medical malpractice, it is possible that insurance companies representing both the doctor and the healthcare facility will talk with the plaintiff and the plaintiff’s attorney. Understanding how insurance companies handle personal injury cases will help you achieve the best possible outcome.

Insurance Negotiations

Once a claim is filed and a letter is sent detailing the amount of money being sought to cover the personal injury, the negotiation process begins. Typically, an insurance adjuster will contact the plaintiff within a couple of weeks of receiving the letter, depending on the complexity of the case. If no response if given from the insurance company, it is important to follow up on the letter.

Reservation of Rights

In response to the letter of demand, an insurance adjuster will lead off with a reservation of rights. At its heart, the reservation of rights is a letter from the insurance company that informs the injured party that an investigation is open into the claim, and that the insurance provider can withhold payment if the injury is not covered by the policy. This protects the insurance company against any future claims while simultaneously pushing the injured party to agree to a lesser settlement.

Subjects of Negotiation

Insurance adjusters ask a number of questions when investigating a claim, and will object to certain facts in order to lower the amount of compensation. The major points of contention that will be raised by the insurance adjuster include:

  • Insurance coverage: This is to determine whether the policy covers the injuries claimed.
  • Liability: The insurance adjuster will go over who is at fault, and if the plaintiff bears any negligence for the injury.
  • Severity of injuries: Determining whether the injuries resulted in temporary or permanent disabiltiy.
  • Medical treatment: The insurance adjuster will go over whether the medical treatment received was necessary, taking into account any pre-existing conditions.

After the investigation has concluded, the insurance adjuster will offer a settlement amount. If accepted, a contract will be drawn up and the case will not go to trial.

Claim Denials

Insurance companies can deny claims for a number of reasons, such as failure to provide information relevant to the claim; false claims which can negatively impact any future compensation; unlawful acts, such as injuries received while driving recklessly or intoxicated; or if the policy does not cover the injury detailed in the claim. It is important to adhere to the requirements of the insurance company while also being thoroughly familiar with provisions and exclusions in the policy.

What to Avoid When Negotiating with an Insurance Company

Insurance companies are not eager to see personal injury cases go to court, nor do they want to give money to cover every claim filed. It is important when negotiating to avoid these common mistakes:

  • Do not give a recorded statement: You are not obligated to provide a recorded statement that the insurance company can use against you at a later date.
  • Stay focused: Extraneous information that is not relevant to the case can be taken out of context and misconstrued to dismiss or lower the claim.
  • Sign medical releases only when you have to: Signing medical releases prematurely will lead to a lower compensation award.
  • Don’t settle too fast: Insurance adjusters count of claimants being eager to settle. Remember that the full extent of damages from an injury may not become apparent until much further on down the road. Immediate injuries can lead to complications and long-term disabilities, plus anxiety and depression that won’t make themselves known for weeks or months after the accident. Settling too early will undercut the compensation you need and deserve.

Don’t Negotiate Alone

Insurance companies and claim adjusters will try to do everything to avoid having to pay claims for personal injuries. Negotiating alone with an insurance company is like representing yourself in court, and you should have someone by your side in both situations to make sure you achieve the right outcome. At Goodwyn Law Firm LLC, we have years of experience negotiating with insurance companies and representing our clients in personal injury cases. Contact our team, and put our expertise to work for you.

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