When it comes to Personal Injury, we've been there, done that, now serving 119 tips in 8 categories ranging from Birth Injury to Wrongful Death.
As you are recovering from an injury, televised attorney ads seem so believable. What they are not telling you is that they will take 1/3 of your settlement money (if the case is settled, if not, they may take 40 percent if it goes to trial), and that there is no guarantee that the other party legally owes you ANYTHING. You may wind up paying the attorney fees you wouldn't have otherwise incurred. Whenever you see the motto, "Large and small, we take them all" on an attorney's billboard, know that they take every case, because every case is a gamble, and you are the dice. Adjusters see some attorneys repeatedly, using the same doctors over and over. These doctors use the same diagnostic codes, the same treatments, and the same reports, without fail. You did not win the lottery if you get rear-ended in your car. You got a damaged car, an injury, and a hassle. You can lessen the hassle for yourself and others by getting your car fixed, going through your own carrier, having your carrier subrogate, notifying the other driver's carrier of your injury, if they haven't contacted you already (and they should have), and keeping them informed of your treatment. Open lines of communication always work. Don't get frustrated if the adjuster doesn't immediately return calls. On a bad weather day, he or she may receive thirteen new losses, with at least 26 new people to contact (both drivers) with auto inspections to be set up, plus passengers, witnesses, etc., along with any other liability clams the adjuster receives, making it extremely difficult for contact to be made. This is reality. However, keeping your emotions under control and remaining a reasonable individual to deal with will help all involved and will make the claim process go smoothly.
Depending on the type of personal injury you have, you may have to finish treatment for your injury prior to settlement, if the company is going to settle on behalf of their insured. Coverage for injuries may fall under different types of policies, and some benefit types may be first party, meaning you are entitled to those benefits, after a review of the reasonableness of your treatment. Policies cover injuries where, when, and how they happen, and sometimes why they happen. You may also file claims under your health carrier. However, health insurers, some carriers have subrogation clauses stating if you collect a monetary settlement from another carrier, you must re-pay the health insurer. As to personal injury third party liability claims, you usually must finish treating for your injury prior to any liability settlement, and a release signed prior to any payout. If it is an auto accident and you are a passenger, you may collect benefits under either first party Medical Payments (MP) coverage for your medical expenses from the driver's policy, or become a claimant against the driver if the driver is at fault. On a premises claim, if there is no liability found on the part of an insured, a company may cover bills up to a certain amount under the same type of first-party MP coverage some companies carry for incidents occurring on their premises. The adjuster may pay your bills as expenses incur, but, do not expect a "general damages" (otherwise known as pain and suffering) settlement in addition.
Ads from attorneys claiming trained insurance adjusters do not pay or pay as little as possible on claims is ludicrous. Also ludicrous is the fact that when attorneys get involved, the claim process moves faster, and claims have an inflated value. They do not. The only inflated value is the cost that the claimant must pay the attorney, which is supposedly thought to be paid by the insurance company. Cases where claimants are left holding the bag, after trials found no compensable damages and/or liability, are ones which are not advertised. An inflated claim costs the insurance company money, the company that purchased the policy money, and ultimately, the consumer pays through increased prices. Therefore, everything is inflated when insurance adjusters pay "large cash settlements" that are unwarranted. The reality is, no insurance adjuster pays a "large cash settlement".
If the other driver in an automobile accident did not carry insurance, you may make a claim against your own personal auto policy. However, understand that you then become the claimant, and if you are attorney-represented, it will delay matters further. You may find out the other driver does not carry insurance. You must tell your own carrier this, and go through your carrier to repair your car if you wish, less your deductible. If you are a pedestrian and are struck by a driver, you may also make a claim under the uninsured motorist section of your policy. If your damages for personal injury (monetary, for medical bills and treatment, and general damages - pain and suffering), exceed the liability limit of the other person's carrier, you may also turn to your own policy if you carry this type of insurance. The same standards apply. treatment length, whether it is accident-related, and whether it will have some permanent impact on your health are all factors to consider when the company will settle with you. The company will settle with you, whether you have an attorney or not. They will not pay you more money if you have an attorney. They should pay you what they owe you. You may wind up with less if an attorney gets involved, due to the agreed-upon fees charged by the attorney by you.
In different states, liability statutes vary. Comparative negligence is a factor in percentage rates. For example, if you are 80 percent at fault, don't expect to receive anything other than a denial letter from the other person's insurance carrier. Each state has its own jurisdicational guidelines, and its own judicial interpretation of those statutes. You do not need a lawyer to explain them to you. Your personal auto agent can explain why you can or cannot expect to collect from the other party's carrier. If you have first party collision coverage on your own policy, you may make a claim against your policy, repair your vehicle, less your deductible, and have your insurance company attempt to collect your deductible from the other carrier via your insurance carrier's subrogation department. However, it may be awhile before they are able to do so. In some instances, liability is usually accepted by the other person's carrier. For example, rear-end accidents, pedestrian hits, and hitting parked and unoccuppied vehicles are usually paid in full. Left turns, intersection accidents, multiple car accidents, or where conditions weren't clear at the time (be they weather, who was driving, if there was coverage at the time) are harder to determine, and may be harder to determine. Coverage issues with the other party are totally out of your control, so it is usually best to go through your own carrier, as the coverage issue may not be sorted out in time for your vehicle to be repaired without you meeting the burden of mitigating your own damages, which is what the other party's company expects you to do. Again, you are expected to take action in a way that any reasonable person would do to mitigate, or lessen, his or her damages, and not incur excessive expense.
Reporting a false claim is against the law. You can be fined and jailed for it. It is called insurance fraud. As it costs everyone millions of dollars of annual premiums, insurance companies, authorities, and special investigation units have created networks and other systems to identify possible insurance fraud. Reporting a false or suspicious claim is not worth any monetary settlement you may receive. The consequence of being caught far outweigh any compensation.
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Barbara Gibson |