When individuals and entities behave negligently, serious accidents and injuries may result. When dealing with insurance companies, however, adjusters frequently try to deny or undervalue claims to avoid a significant monetary payout.
A skilled personal injury lawyer can fight the insurance company on your behalf and aggressively negotiate for the settlement compensation you deserve. Moreover, if the insurance company does not make a reasonable settlement offer, your attorney can pursue litigation in the state court system and, if necessary, take your case to trial or alternative dispute resolution.
Types of Personal Injury Claims That Arise from Others’ Negligence
Personal injury claims often arise when someone is harmed due to the negligence or carelessness of another person or entity. Negligence occurs when an individual fails to act with the level of care that a reasonable person would in a similar situation, leading to injury or harm. Several types of personal injury claims can result from such negligence.
- One of the most common types of personal injury claims is related to car accidents. These collisions occur when a driver is reckless, distracted, or violates traffic laws, leading to a collision. For instance, a driver texting while driving may not notice a red light, causing a crash that injures another person. In such cases, the injured party can file a claim against the negligent driver to recover compensation for damages including medical bills, lost income, and pain and suffering.
- Another frequent type of personal injury claim involves slip-and-fall accidents. These accidents happen when someone slips, trips, or falls on someone else’s property due to a hazardous condition, like a wet floor or uneven pavement. If the property owner knew or should have known about the danger and did not fix it or provide a warning, they may be liable for the injuries that occur as a result.
- Product liability claims are another area of personal injury law. These claims arise when a defective or dangerous product injures someone. If a product is poorly designed, improperly manufactured, or lacks adequate safety warnings and causes harm, the manufacturer, distributor, or retailer may be responsible. For example, if a child’s toy contains small parts that pose a choking hazard and a child suffers an injury, the parents can file a product liability claim.
- Dog bites and animal attacks also lead to personal injury claims. If a dog bites someone, the owner may be liable, especially if the dog has a history of aggressive behavior or if the owner failed to control the animal properly.
- Workplace accidents are another common source of personal injury claims. Employees who suffer injuries on the job due to unsafe working conditions, inadequate training, or faulty equipment may be entitled to compensation. Employers have a responsibility to maintain a safe work environment, and failure to do so can result in liability if an employee is harmed.
How Insurance Companies Try To Avoid Paying a Personal Injury Claim
When someone files a personal injury claim, insurance companies often try to avoid paying the full amount or deny the claim altogether. They use various tactics to protect their profits, even if it means shortchanging the injured party. Here are twelve common tactics insurance companies use to try and avoid paying a personal injury claim:
- Delay Tactics – Insurance companies may intentionally delay processing a claim, hoping that the claimant will become frustrated or desperate enough to accept a lower settlement or give up entirely.
- Denying Liability – Insurers may argue that their policyholder was not at fault, even when it is clear they were. They may claim that the injured party was partly or fully responsible for the accident.
- Disputing the Severity of Injuries – Insurance adjusters often downplay the severity of injuries, claiming that the injuries are not as serious as reported. They may request unnecessary medical exams to try to prove this.
- Lowball Settlement Offers – One of the most common tactics is offering a low settlement early in the process. They hope the injured party will accept the offer without realizing they can be entitled to much more.
- Requesting Excessive Documentation – Insurance companies may ask for unnecessary or overly complicated documentation, hoping the claimant will be unable to provide it, giving them an excuse to deny the claim.
- Misrepresenting Policy Terms – Sometimes insurers mislead claimants about what their policy covers. They may suggest that certain damages or injuries are not covered when, in fact, they are.
- Blaming Pre-Existing Conditions – Insurers may argue that the injuries were due to a pre-existing condition rather than the accident itself, trying to avoid paying for the damages.
- Recording Statements – Adjusters may ask for recorded statements soon after the accident, hoping the claimant will say something that can be used against them later.
- Pressuring for Quick Settlements – Insurers may pressure claimants to settle quickly, often before they fully understand the extent of their injuries or the long-term costs involved.
- Hiring Private Investigators – Insurance companies sometimes hire investigators to follow the claimant, looking for evidence that contradicts their injury claims.
- Using Complex Legal Language – Adjusters may use complicated legal jargon or confusing forms to intimidate or mislead claimants, hoping they will make a mistake.
- Exploiting Financial Difficulties – If the injured party is in financial distress, insurers may use this circumstance to their advantage, offering less money than the claim is worth, knowing the claimant may accept out of desperation.
These tactics highlight the importance of being informed and seeking prompt legal advice to ensure a fair settlement.
Fighting the Insurance Company in a Personal Injury Case
When you are facing an insurance company after a personal injury, it can be overwhelming to deal with their tactics aimed at minimizing your compensation. An experienced personal injury lawyer can take several important steps to fight the insurance company on your behalf, ensuring that you receive the compensation you deserve.
- First, gathering evidence is vital. A skilled personal injury attorney will collect all relevant evidence to build a strong case, including obtaining police reports, medical records, witness statements, and any available photos or videos of the accident scene. The lawyer may also work with experts, such as accident reconstruction specialists, to strengthen your case.
- Second, an attorney will handle communication with the insurance company. Insurance adjusters are trained to ask questions and make statements that can weaken your claim. By letting your lawyer manage these communications, you can avoid saying something that can be used against you later.
- Third, an experienced lawyer will negotiate aggressively on your behalf. Insurance companies often make lowball settlement offers, hoping you will accept less than you are entitled. A personal injury attorney understands the true value of your claim and will fight for a fair settlement, considering all your damages, including medical expenses, lost income, pain and suffering, and future costs related to your injury.
- Fourth, if the insurance company refuses to offer a fair settlement, your lawyer can file a lawsuit. This step shows the insurer that you are serious about getting what you deserve, and it can pressure them into offering a better settlement. If the case goes to court, your attorney will present the evidence and argue your case in front of a judge and jury.
- Fifth, a lawyer will challenge any unfair tactics the insurance company uses. This includes disputing any attempts to downplay your injuries, deny liability, or claim that you were partially at fault. An experienced attorney can counter these tactics with solid evidence and legal arguments.
- Finally, a lawyer will keep you informed throughout the process, explaining your rights and options at every stage. This guidance is invaluable in helping you make informed decisions and reducing the stress of dealing with a complex legal process.
By taking these steps, an experienced personal injury lawyer can effectively fight the insurance company, giving you the best chance at receiving full and fair compensation for your injuries.
Legal Elements of Proof in a Personal Injury Claim or Lawsuit
To successfully recover compensation in a personal injury claim or lawsuit, you must satisfy certain legal elements of proof. These elements establish that the at-fault party’s (defendant’s) actions or negligence caused your injury and that you are entitled to damages. There are four main elements: duty, breach, causation, and damages.
- First, you must establish that the defendant owed you a legal duty of care. Duty of care means that the defendant had a legal obligation to act with a certain level of caution and responsibility toward you. For example, drivers have a duty to follow traffic laws and drive safely to prevent harming others on the road. Similarly, property owners must maintain their premises to ensure the safety of visitors. In a personal injury case, you need to demonstrate that the defendant had a duty to act in a way that would avoid causing you harm.
- Second, you must show that the defendant breached this duty of care. A breach occurs when the defendant fails to meet their legal obligation and can involve speeding, running a red light, or failing to repair a hazardous condition on their property. To prove a breach, you need to provide evidence that the defendant acted carelessly or recklessly and that these actions were not in line with what a reasonable person would have done in the same situation.
- Third, you must establish causation, which means proving that the defendant’s breach of duty directly caused your injury. There are two types of causation: actual cause and proximate cause. Actual cause, or “cause in fact,” means that the injury would not have occurred but for the defendant’s actions. Proximate cause involves showing that the injury was a foreseeable result of the defendant’s breach. You must demonstrate that the defendant’s actions were the primary cause of your injury and that it was not due to some other factor.
- Finally, you must prove that you suffered damages as a result of the injury. Damages refer to the losses you have incurred, such as medical bills, lost income, pain and suffering, and emotional distress. You need to provide evidence of these damages, such as medical records, receipts, and testimony from experts or fact witnesses.
By satisfying these four legal elements – duty, breach, causation, and damages – you establish the foundation of your personal injury claim, increasing your chances of recovering the compensation you deserve.
Recoverable Damages in a Personal Injury Claim or Lawsuit
In a personal injury claim or lawsuit, the injured party can recover compensation for losses, which are generally categorized into economic and non-economic damages. These damages are intended to make the injured person “whole” again, as much as possible, by covering both financial losses and the effect on their quality of life.
Economic damages are the tangible, quantifiable losses that result from the injury. These damages include:
- Medical Expenses – This compensation covers all costs related to medical care, both immediate and long-term. It includes hospital bills, doctor visits, surgeries, prescription medications, physical therapy, and any future medical treatments that may be necessary due to the injury. If the injury requires ongoing care or specialized equipment, those costs can also be included.
- Lost income – If the injury caused you to miss time from work, you can be compensated for the income you lost, including both the earnings you have already lost and any future income you may lose if the injury affects your ability to work –or requires you to take a lower-paying job.
- Property Damage – If your personal property, such as a vehicle, was damaged in the incident, you can recover the costs of repairs or the replacement value of the property.
- Out-of-pocket Expenses – Any additional costs directly related to the injury, such as transportation to medical appointments or hiring help for daily activities, can be included in your economic damages.
Non-economic damages are less tangible and more subjective, but they are just as important. Non-economic damages include
- Pain and Suffering – This compensation covers the physical pain and discomfort you have endured due to the injury. It also accounts for the emotional distress that often accompanies physical pain, such as anxiety, depression, or trauma.
- Emotional Distress – Separate from pain and suffering, emotional distress can include compensation for severe psychological effects, like post-traumatic stress disorder (PTSD), that affect your mental health and overall well-being.
- Loss of Enjoyment of Life – If your injury has limited your ability to enjoy activities and hobbies you once loved, you can be compensated for this loss of enjoyment.
- Loss of Consortium – If the injury has affected your relationship with your spouse, you can recover compensation for the loss of companionship, affection, and support.
Call an Experienced Personal Injury Lawyer in Your Area Today
If you recently sustained injuries in an accident due to another person's negligence, a skilled personal injury attorney can handle the entire process for you. More importantly, your attorney can fight the insurance company for you and, if necessary, pursue litigation to maximize your overall monetary recovery. Don't delay, contact a skilled personal injury attorney today.