Settling a Personal Injury Claim with an Insurance Company
The days and weeks following a car accident can be painful, confusing, and stressful.
You may need surgery because of your injuries, or you might need physical therapy to recover from your injuries.
In either case, you could be out of work and incur substantial medical bills because of the car accident. Who is responsible for compensating you for your financial losses, pain, and suffering?
In most cases, the at-fault driver is financially liable for damages caused by a car crash. The process of recovering compensation for an accident claim generally begins with filing an insurance claim with the at-fault driver’s insurance provider.
Mandatory Liability Car Insurance in Texas
Texas laws require motorists to have minimum amounts of liability insurance coverage for motor vehicle accidents. Liability insurance pays accident victims for damages caused by an insured driver.
Before a victim can recover compensation for a car accident claim, the victim must prove that the insured driver caused the car wreck, and the crash caused the victim’s injuries and damages.
The minimum liability insurance coverage required in Texas is:
- $30,000 for bodily injury to one person in an accident
- $60,000 for bodily insurance to two or more people in an accident
- $25,000 in property damage coverage per accident
You may purchase higher amounts of liability insurance to protect yourself and your assets if you cause an accident.
Steps in Filing and Settling an Insurance Claim
Before you file and settle a personal injury claim with an insurance company, you need to know what to expect. Knowing what to expect can help you maximize your settlement amount.
Below are the general steps in filing and settling a personal injury claim with an insurance company. The steps apply to a car accident claim, but they also apply in slip and fall accident, dog bite, and other personal injury cases.
Step One: Report the Accident or Injury
Notify the insurance company of the accident or injury. In most cases, the other driver’s insurance information should be on the police report and accident report. When you file a claim, write down all information provided by the insurance company, including your claim number and the insurance adjuster’s name and telephone number.
The time you have to file a claim depends on several factors. In most cases, it is best to file a notice of claim with the driver’s insurance company as soon as possible to protect your legal right to pursue a lawsuit, if necessary. Also, some claims could be denied if you wait too long to notify the insurance company of the claim.
During the claims process, be prepared to provide information about the accident when you contact the insurance company.
Information you need to have in hand when you contact the insurance company includes:
- Your name and contact information
- The date, time, and location of the accident or injury
- A brief description of your injuries and property damage
Avoid providing a written or recorded statement or answering specific questions about how the accident occurred. You will do this in your demand letter. For now, you only want to notify the insurance company that you have a claim.
Step Two: Gather Information and Evidence
After an accident, gather as much evidence and information as possible. Taking photographs and making videos of the accident scene and your injuries can help prove your case. Keep copies of all correspondence, bills, invoices, and medical records related to your case.
Step Three: Complete Medical Treatment
Do not settle your insurance claim until you complete medical treatment. Your doctor needs to release you and provide a prognosis for any permanent impairments or disabilities. Until you complete treatment, you cannot be sure whether you sustained disabilities or impairments because of the accident.
If your injuries are severe and treatment may be lengthy, you need to double-check the statute of limitations for your case. The statute of limitations is the deadline for filing a personal injury lawsuit. The deadline could be different under some circumstances, including cases involving minors or government entities.
Step Four: Identify Damages and Calculate Value of the Claim
You may be entitled to compensation for your economic and non-economic damages. The damages in your case depend on the specific facts and circumstances surrounding your accident and injury.
Common damages in personal injury claims include, but are not always limited to:
- Medical bills
- Lost wages
- Loss of benefits
- Physical pain and suffering
- Mental and emotional distress and trauma
- Scarring and disfigurement
- Impairments and disabilities
- Personal care costs
- Future damages for permanent impairments
- Loss of enjoyment of life
- Other out-of-pocket expenses related to the accident or injury
- Special damages
Calculating the value of your claim can be challenging. Your economic damages equal the total of your financial losses. However, your non-economic or “pain & suffering” damages are much more difficult to value.
There is not a standard formula for calculating pain and suffering damages. However, many insurance companies use a multiplier to value non-economic damages. The total financial loss is multiplied by the multiplier to value pain and suffering damages.
The multiplier is a number between 1.5 and five. Higher multipliers are used for cases involving permanent impairments, disabilities, and catastrophic injuries. Generally, minor injuries that heal within a few months have a lower multiplier.
Step Five: Prepare and Submit a Demand Letter
Your demand letter summarizes the facts of the accident. You need to convince the insurance company why the other party is responsible for your injuries. You must also provide proof of your injuries and damages.
You may need to include evidence with your demand letter, such as:
- Accident reports and police reports
- Photographs and videos of the accident
- Photographs of your injuries and property damage
- Eyewitness statements
- Medical records and reports
- Letter from your employer detailing the loss of income
- Statements from your doctor
- Copies of receipts, bills, invoices, or other proof of expenses and costs
Be careful not to say anything in the letter that could be construed as admitting fault or used against you to claim that you are partially at fault for the cause of the accident.
At the end of the letter, include your demand for settlement. Ask for more money than you are willing to accept for settlement to allow for negotiations with the insurance company.
Step Six: Consider the Insurance Company’s Response
The insurance company completes an investigation of the accident and considers your settlement demand. The company may deny the claim, pay the claim, or submit a counteroffer. Unless liability is disputed, the company is likely to submit a counteroffer.
Step Seven: Submit a Counteroffer
You may accept the insurance company’s counteroffer, or you may submit a counteroffer.
When considering whether to accept the offer, ask yourself this question: Does the offer cover all my financial damages and provide adequate compensation for pain and suffering?
If the answer is no, make a counteroffer. Most insurance companies offer a very low amount to begin negotiations. There is often room for negotiation for a higher settlement offer.
When you make the counteroffer, emphasize the severity of your injuries and how the injuries have negatively impacted your life, including your pain and suffering. Stress how the other party is at fault for the cause of your injuries, suffering, and damages.
Step Eight: Review Final Settlement Offer
The insurance company will make a final settlement offer. If you accept the settlement offer, you agree to release all parties from all claims and future liability. The release includes known and unknown parties, claims, and damages.
Therefore, you need to consider the final offer very carefully before accepting the offer. Once you sign the settlement agreement, you give up your legal right to demand more money for your claim. Even if you discover additional damages or injuries, you are barred from seeking compensation.
Step Nine: Ask for Help
There are some instances in which you might want to seek help with an injury claim.
Instances that indicate you might want to talk with a lawyer include, but are not limited to:
- The insurance company fails to respond or is dragging out the claim
- The company denies your claim without providing any justification for its decision
- The insurance provider refuses to negotiate in good faith
- The claim involves a traumatic injury or permanent impairment
- Your child was injured in the accident
- The case involves a government entity, multiple parties, trucking company, or defective product
If you have any doubts about whether to accept a settlement offer, it can be helpful to have an experienced personal injury attorney review your case.
Contact Our Fort Worth Personal Injury Lawyer for a Free Consultation
Dealing with an insurance company can be frustrating. The company has a team of professionals to protect it. If you have questions or concerns about an injury claim, contact us to schedule a free consultation with a Fort Worth personal injury lawyer.