A bodily injury claim can be a sensitive issue because it deals with people being injured in a car accident. I am going to address it from an objective view and am going to address the topic from two sides.
The first side is for someone that has been injured in a car crash and the second side from the view of having someone make a claim against you for a car accident.
First scenario – You were hurt in a car crash:
If you sustained bodily injury as a result of a car accident, due to someone else’s negligence, then you can make a claim against their insurance. This claim will involve seeking compensation for the special and general damages you incurred.
Special damages = economic loss you suffered, or bills that can been seen on a piece of paper. For example: medical bills, wages lost due to the injury, out-of-pocket costs for anything you had to pay out for your injuries, and medical liens from Medicare or Medicaid, workers compensation, health insurance liens and hospital liens. This may not be a complete list, but these are the most common special damages claimed.
General damages = these are the expenses you cannot see on paper. The main two phrases you will hear on an auto insurance claim for general damages are “pain and suffering” and/or “time and inconvenience.”
I would imagine that someone is going to ask the question, “What about punitive damages?” If you do not know what punitive damages are, they are usually awarded to the victim in court in order to punish the wrongdoer for their offense. So you do not really see that in a normal car accident, however it might come up if the at fault driver was driving under the influence of drugs or alcohol when they caused the accident. There are other times punitive damages may come up on a car accident case, but I will leave it at that example just to keep things simple. On most policies, punitive damages are not covered by the at fault party’s insurance policy, that is why you will not hear another adjuster bring it up in most cases. If it comes up, the adjuster would probably tell you that they will not pay them and that the wrongdoer has to pay the punitive damages if they were awarded by the court. Remember I am saying “most”, and “usually” as every person, case and insurance company are all different and your situation may differ from others.
So what is the value of your claim? Oops, I cannot tell you the value of your claim. Sorry! I’m not trying to irritate you, but go back to what I said on the first page of my site. I am not an attorney so I cannot give you legal advise and for me to tell you how much you should ask for can be interpreted as giving you legal advise.
Now in a case when you are injured as a result of the accident, you have to ask yourself how you are going to pursue the claim? You could choose not to pursue it at all. I mention that because I do get asked that question by people who do not intend to pursue a claim.
If you are going to pursue the matter, you can contact the at fault party’s insurance company directly, or you can hire an attorney to help you. In my experience what you cannot do is have your own insurance company act on your behalf to pursue a bodily injury claim against the at fault party’s insurance company. Again, every insurance company is different so check with your insurance carrier regarding what they will do to help you.
What the other insurance company can do in some states, but not all, is pursue recovery against the at fault party’s insurance company to recover any Med Pay or PIP payments that they paid to their insured as a result of the accident. This all depends on what state the accident happened in and what state the claimant’s policy is written for. Each state has their own laws and policies have their own rules about pursuing recovery for Med Pay and PIP payments.
The value of your case usually depends on how severe the injury was. I am not going to say a soft tissue injury claim is not worth a lot, however a lot of people might think a person who has broken bones, been paralyzed or even died in a car accident is going to have a higher value than a typical soft tissue neck and back injury. Keep in mind that every claim and situation is different and your case may be different from the norm.
So, should you get an attorney or not? I get asked this question all the time and I always answer it the same way, “it’s up to you, and I cannot tell you what to do.” If you did not get an attorney in the beginning but have not been able to settle the claim, as long as you are within the statute of limitations, you may still be able to get an attorney that will be able to step in and help you settle. I cannot tell you how to prove your case but an attorney can. This is what they do for a living and since it is their business, they have to be compensated for giving you the legal advise which you are seeking. In my experience, many auto injury attorneys will not charge you by the hour or on a retainer and they will even give you a free consultation in the beginning where you and the attorney can discuss whether it is in both of your best interests for the attorney to take on the case. Just so you know, I have used an attorney for personal reasons when I need legal advice, so I am not against using attorneys for an auto accident. Some may think as a claims adjuster that I would have a bias toward an attorney, but the truth is, I really do not care if the claimant is calling me directly or if I am dealing with the attorney.
If you cannot settle the claim, you have to decide if you want to file a lawsuit against the at fault party. What I have learned about court is that it is a gamble for everyone, and what I mean is you may win a good settlement, or you may not win a settlement at all. It will all be up to the jury after the evidence is presented to them. I am not going to stick up for other adjusters, but I will say that for me, if I can settle a claim that I know will be a loser for us in court, I am not going to waste anyone’s time. Also on the flip side of that, I have denied liability on injury claims that have gone to court and my insured’s have won because the claimant was not able to prove their case.
Whatever you decide to do with regards to your bodily injury claim, remember that you can find a lot of resources and information out there and only you are going to know how the injury effected you and what that is worth to you, so you have to decide what a fair resolution is and how you are going to achieve that resolution. I wish you well in that endeavor!
Second scenario – Someone is making a bodily injury claim against you:
Step one, please contact your insurance company and make sure they are handling the claim for you. A lot of people do not do this and they think it will go away. Most states require you carry a liability policy with the state minimum limits, and you probably pay for that policy by way of your insurance premium, so you can contact the company which you pay those premium dollars to in order for them to open a claim and help protect your assets. If you are not a claims adjuster or a bodily injury attorney then you might not be the best person to defend your liability against someone claiming they were injured by you in a car accident. Even myself, who has been an injury adjuster for a long time, would not attempt to defend myself against a claimant. I have seen people do the wrong thing when trying to settle the claim with the other party in order to avoid calling their own insurance company and it usually ends up costing them more money in the long run. Also, the other party may contact your insurance company any way, no matter how many times they say they wouldn’t. If you think they won’t find out who you are insured with if you do not give them the information, I will let you know there are databases that can be used to find that information. So I really do recommend you get your own insurance company to handle your case. If you are not confident that your insurance company can properly handle the claim being made against you, or that your limits you have on the policy may not be enough based on the assets you own, then you might want to start looking for a new insurance company or consider increasing your liability limits.
Step two, once your insurance company is handling the claim with the claimant, they most likely will be working to investigate the injury claim by reviewing the damages to both vehicles involved, the way the accident happened, liability, and the medical records and bills submitted by the claimant. If your adjuster deems that a settlement should be offered to the claimant, he will come up with the value of the claim based on the special (medical bills, wage loss, etc.) and general (pain and suffering) damages, and then make the offer to the claimant. Usually, in order for your insurance company to pay the other party out on bodily injury claims, the claimant not only has to accept the offer, they have to execute a Release of All Claims form. This form is a contract in which the claimant agrees to accept the offer listed on the release and at the same time agree to never come after you again for anything related to this accident. If the claimant executes and sends the form back to the insurance company, then the insurance company will pay the money to the claimant and your claim is done, thus the claimant cannot sue you or go after your assets like your house or business.
In cases where the claimant does not agree to the settlement and they serve you with a lawsuit, you should contact your insurance company immediately. They should refer the claim to their litigation department at that point to get their defense attorneys to start helping prepare a defense of your claim. Now the claim may still settle outside of trial, but just know that most insurance policies have a clause in them where that insurance company may provide a defense for you up to the limits on your policy. So your insurance company cannot go after anyone for you, but they can help you if someone is coming after you for a car accident. Refer to your policy for the specifics as policies do have exclusions listed in them. You can get your own attorney to defend you also, but usually that is at your own expense.
This is where I will stop because if your claim does go to trial, whether you are the claimant or the at fault party, you should be advised by the counsel you retained or being retained for you as far as the next steps and the best way to win your case. If you do not have an attorney or the case is going to small claims court, I cannot give you advise on how to win, however I wish you the best of luck!
If you are an attorney, claims adjuster or another type of expert in this matter, feel free to post your comments. I welcome them because there are people who are looking at this site that have never gone through this process and they are seeking answers.
*I am not an attorney. The information on this site is not legal advice and should not be taken as such by the reader. What I post on here are my opinions based on my experience as an auto claims adjuster.
mrhelper@bestcarwreckinfo.com
bestcarwreckinfo.com
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