Category Archives: Injury claim process

What Happens if I Fire My Personal Injury Attorney
Injury claim processPersonal Injury

You have suffered an injury and are now fighting for your rights with a personal injury attorney. But now, time has gone by, and you are no longer satisfied with how your case is going. You may be wondering- what happens if I fire my personal injury attorney? You should not accept poor representation and deserve the best chance to receive the compensation you deserve for your injury. It is your right to change attorneys if you are not being represented at the level of excellence and dedication you expect and deserve.

When Should I Think About Changing Attorneys?

Switching attorneys is not uncommon. Client’s fire and hire new attorneys all the time and for different reasons. Red flags that you have hired a bad attorney or need to hire a new attorney include:

  • Poor Communication: Consistent and clear communication is fundamental. Attorneys should always “keep the client reasonably informed about the status of the matter.” An attorney who does not respond to emails, calls, or questions is not just frustrating; it can jeopardize your case. You should not have to beg your attorney for information.
  • Trust Issues: The attorney-client relationship is built on mutual trust. You should feel that your attorney is doing everything in their power to maximize your settlement. That is their job. If you are doubting your attorney’s commitment, reevaluate your choice.
  • Unprofessional Conduct: Missed meetings, lack of preparation, and forgetfulness can indicate deeper issues like missing hearings, poor trial preparation, and mismanagement of settlement funds.
  • Strategic Issues: You hire an attorney because he or she is supposedly an expert in personal injury cases. You put your trust in this attorney. However, if he or she cannot effectively communicate what they are doing and why they are doing it, this is a red flag that you should consider hiring a new attorney. As the client you deserve to know why certain actions are being taken or not and your attorney should ask for your input. Remember, this is YOUR case. You should never be left wondering if your attorney took your settlement or feel out of the loop regarding decisions made with your funds.
  • Disciplinary Actions: If your attorney has been disciplined or disbarred, you should immediately consider finding a new attorney.

Can You Switch Attorneys, or Even Fire Your Attorney, in the Middle of a Case?

You certainly can. Plus, when you do so, you have the right to take your file and all your documents, medical records, and pleadings with you; even though the attorney you are discharging may try to mislead you into thinking the file belongs to him or her. You have a right to your file and an attorney cannot hold your file hostage or tell you that switching attorneys will hurt your case to deter you from leaving.

After the Lawsuit Has Started

You have the right to change attorneys even after your lawsuit has been filed. But there are a few more things to consider if you are changing attorneys once the lawsuit is underway:

  • Check the Rules: The rules governing attorneys in your state may require that you get approval from a judge to discharge your current attorney and add a new one. Your new attorney can file a substitution of counsel request with the court. Judges usually give their approval to such a change. But if your case is close to trial and changing attorneys could cause a delay, a judge might not allow the switch.
  • Expect Delays: Changing personal injury attorneys after your case is filed might cause a delay. Your new attorney will need to spend time getting fully informed about your case so they can give you their best legal advice. This may include contacting your doctors, family members, and any witnesses to hear firsthand that they have to say. If your case needs an expert witness, your new attorney will have to start the search process. Your attorney will need to read all the pleadings and discovery already exchanged by the parties. If there are interrogatories or document requests you need to answer, your new attorney may have to get an extension of time to get those ready. There is a lot for an attorney to do when taking on a case already in progress. Be patient while your new attorney does everything necessary to prepare to represent you. Still, if your relationship with your current attorney is unacceptable, this delay should be worth it.

Steps To Take When Switching Attorneys:

  • Before you fire your current attorney, you should have another attorney lined up who has agreed to take over your case.
  • Sign a retainer agreement with your new attorney. This is a simple form that gives the new attorney the legal authority to represent you.
  • Your new attorney will then prepare a form called a “Consent to Change Attorney.” This form tells the Court, your present attorney and all the other parties involved that you have switched attorneys.
  • Your new attorney will also prepare a “stop work” letter to send to your previous attorney. This directs that attorney to stop working on your case and to forward the case file to your new attorney.

Is Switching Attorneys Worth It?

You might think it is too much effort or time to change attorneys, especially if you are far into your case. Ultimately, your needs and recovery come first. Whether you wish to change attorney’s is up to you. Catching your new personal injury attorney up to speed might take time, pushing your case back further. However, changing representation could be the difference between disappointment and success.

Will I Have Trouble Finding a Second Attorney?

Many fear that since their new attorney must split their attorney fee with the old attorney, they will have a hard time finding a new attorney to take on their case. This is typically not true. An attorney fee is divided between the law firms that represented you based on “quantum meruit,” which means the reasonable value of their services. In other words, how much work each firm did will decide what percentage of the fee they will be granted. If the two firms did approximately the same amount of work, they will divide the fee equally. If your second personal injury attorney did most of the work, they will be granted the larger chunk of the fee. However, if the first attorney handled your case for quite some time and completed a substantial amount of work, a second attorney may be tentative about taking on the case. But it is important to note that if the case has significant value, even if the initial attorney did a lot of work on the file, the second attorney will likely not be deterred from taking the case. Ultimately how the attorney fee is divided is worked out after the case is resolved by the two law firms, and is of little concern to the client.

How Long Do Car Accident Settlements Take
Auto AccidentInjury claim process

After being wrongfully injured in a car collision, it is your right to seek compensation for the damages you have incurred. However, many accident victims often wonder how long it will take for their car accident case to be resolved. Well, that depends. The timeline for a personal injury settlement is affected by many things. The severity of your injuries, ranging from mild sprains or cuts to catastrophic spinal cord damage or brain trauma, all impact how long you may need medical treatment, which in turn influences court proceedings. Complicated matters involving multiple parties or insurance company disputes could also drag litigation out for years instead of months.

Factors That Influence the Timeline of a Car Accident Claim Settlement

There are several factors that can affect the timeline of settling a car accident claim. One of the key factors is the severity of the accident. If the accident resulted in serious injuries or extensive damage to the vehicles involved, it may take longer to gather all the necessary evidence and assess the full extent of the damages. Another factor is the cooperation between the parties involved. If both parties are willing to work together and reach a fair settlement, the process can be expedited. However, if there is a dispute or disagreement, it may require legal intervention and prolong the settlement process. Additionally, the complexity of the case, such as multiple parties or legal issues, can also impact the timeline. Overall, the timeline of settling a car accident claim can vary depending on these factors and should be approached on a case-by-case basis.

Ways To Settle a Car Accident Claim

Reaching a settlement occurs in one of three ways, each with a different answer to the question, “How long does a car accident settlement take?” Direct negotiation, arbitration, or a lawsuit all carry different timelines.

Direct Negotiation: You begin the direct negotiation process by contacting the involved party’s insurance company to request a settlement. Negotiation can be done without any outside legal help and starts with a formal demand letter. A demand letter is a written communication explaining the amount of compensation you want and why, sent directly to an insurance company. It includes a reasonable settlement amount based on the estimated costs of medical bills and other damages you have suffered. Once the insurance company receives the demand letter, it sets in motion the negotiation process involving certain steps, including:

  • Insurer issues written acknowledgment of demand letter within 15 days
  • Provides start date of claim investigation
  • Issues request for additional documents
  • Sends written updates every 30 days when extensions are needed
  • Approval or denial is issued within 40 days of the final documents being received

Without a written explanation, an insurance company cannot deny or offer an unreasonably low settlement. Insurance companies are eager to avoid a court battle, making direct negotiation a promising option. Typically, direct negotiation will reach an agreement in 85 days, and you will receive payment around six weeks after that.

Arbitration: Some insurance companies have contracts requiring arbitration to settle claims. Arbitration has both sides meeting with a neutral party, the arbiter, and presenting evidence to support their position. Arbitration’s goal is to find a settlement acceptable to all parties. Arbitration is like direct negotiation but with a legal third party, helping the process run smoothly. This can be done without an attorney. You might want to look up legal specifics for your jurisdiction to prepare, which can easily be done over the course of an afternoon or two. Due to the low cost and minimum time requirements, arbitration is a favored form of negotiation and should take one to three months from start to finish.

Filing a Lawsuit: Filing a lawsuit in court is the final way to obtain a settlement for an auto accident claim. This is a legal action against the other party and involves discovery or information sharing, building a case based on evidence, and presenting your case in front of a judge or jury. The average car accident settlement timeline for a lawsuit is nine to 18 months, but it often takes much longer. This is more difficult to undertake on your own. You may consider getting advice from legal counsel or even hiring an attorney to help you through this process, though the self-help center at the courthouse may also be sufficient for you to proceed.

Factors That Influence Duration

Several factors can impact the duration of a car accident lawsuit. It is essential to recognize that each case is unique, and these factors interact in complex ways:

  • Complexity of the case: More complex cases, such as those involving severe injuries or disputed liability, can take longer to resolve.
  • Negotiations: The willingness of both parties to negotiate and reach a settlement can significantly affect the timeline. Quick settlements typically shorten the process.
  • Court Backlog: The caseload of the local courts can create delays. Overcrowded court schedules may result in longer waiting times for trial dates.
  • Legal representation: Experienced attorneys can streamline the legal process. Having skilled legal counsel can expedite your case.
  • Insurance company involvement: If insurance companies are involved, their processes, policies, and willingness to settle can affect the timeline.

How Long Do You Have To File a Car Accident Lawsuit?

If you decide to file a lawsuit, you must act within your state’s statute of limitations. While this can vary by location, it is usually within two to four years of the time of the accident. Waiting longer than this means your claim will not be able to move forward, so keep this in mind when considering your auto accident settlement timeline.

A Few Things To Remember So, how long does a car accident settlement take? Depending on the resolution process, anywhere from a couple of months to multiple years. No matter how you do it, everyone wants to find the quickest, most reasonable solution. How long your settlement takes can be affected by the complexity of the case, the clarity of the evidence, or an insurance company’s willingness to settle. 95% of all car accident settlements are solved without stepping foot in a courtroom, so it is very likely yours will be, too

Personal Injury Settlement
Injury claim processPersonal Injury

The typical personal injury settlement value varies depending on the specific factors and circumstances of each claim. A personal injury valuation is determined by many criteria, including the degree of the bodily damage, the kind of injury, the amount of available insurance coverage and the jurisdiction in which the case is being handled. There is no such thing as an “average” settlement amount. Settlements for minor injuries, such as soft tissue injuries or bruising, may vary from a few thousand dollars to tens of thousands of dollars. Settlements for more serious injuries, such as lifelong disability or long-term medical issues, may reach hundreds of thousands, if not millions, of dollars. As mentioned, the amount of compensation given is also determined by the facts of the case. For example, if the defendant was plainly at fault and behaved carelessly or maliciously, the settlement sum may be increased. If the plaintiff was partly to blame, compensation might be decreased. Ultimately, depending on the individual circumstances of each case, the typical personal injury compensation might vary from a few thousand dollars to millions of dollars.

Why Individual Case Factors Result in Varying Settlements?

Several factors affect the final settlement of a personal injury case, including the following:

  • How badly you were injured. The worse your injuries and the longer they take to heal (f ever), the higher your medical expenses and the greater the impact on your ability to work or care for your family.
  • Whether you were rendered disabled. If the accident results in a permanent disability, your non-economic compensation is usually higher to account for these harms and losses.
  • Whether you can live independently. Some people may require accommodations in a skilled nursing facility or assisted living facility. Your settlement can cover these costs.
  • The limits of the defendant’s insurance policy. The at-fault party’s insurance provider pays most personal injury settlements. The amount you receive may be affected by the limits of the liability policy.

How To Calculate the Cost of Pain and Suffering?

It can be hard to quantify non-economic compensation for pain and suffering and harder still to place a dollar value on your mental well-being. Many personal injury attorneys use one of two methods to calculate the cost of pain and suffering. The multiplier method of calculating your pain and suffering compensation starts with your total economic losses. Your attorney tallies your economic losses and then multiplies them by a factor based on the severity of your losses to determine your total compensation amount. The per diem method assigns a daily rate to the number of days your life is affected by the pain and suffering from your accident injuries. The daily rate is multiplied by the number of days your injuries and pain affected your life. For example, if your per diem rate is $200, and your accident leaves you in pain for 50 days, your non-economic compensation would be $10,000.

What Formula Do the Courts Use for Pain and Suffering?

Sometimes claimants and insurance companies cannot reach a settlement agreement. One of the most common areas of dispute is pain and suffering, which is subject to less precise calculation and greater interpretation than the more hard-and-fast economic damages. At trial, the court is not obligated to use a particular formula when assessing pain and suffering damages. Rather, the pain and suffering calculation will be made on a fair and reasonable basis according to the evidence. Insurance companies know that the math changes if your case goes to court. Awards for damages can be much higher at trial than what they would have been if the case settled. Nonetheless, it is not uncommon for insurers to hold out and refuse to settle if they think they can win in court or believe that their assessment of contested damages (such as pain and suffering) is accurate. The key to reaching a favorable settlement often rests on your personal injury lawyer’s ability (should you decide to hire one) to persuade the insurance company that any lowball settlement offer will not withstand a court’s scrutiny.

How Much Is a Personal Injury Lawsuit Worth?

There’s a joke that most law school students hear early on: the answer to every legal question is “it depends.” When it comes to figuring out the value of a personal injury lawsuit, unfortunately, the old law school joke holds true. It depends on the specific facts and circumstances of the case.

Typical Settlement Amounts

Every personal injury lawsuit has different factors which make it nearly impossible to determine with any precision how much a specific personal injury settlement will be worth. Because settlement amounts can vary based on every factor involved in a case, it can be difficult to predict a case’s value.

A study by the Bureau of Justice Statistics in 2005 found that:

  • Half of all plaintiffs received $24,000 or less.
  • The median amount awarded in auto accident cases was $16,000.
  • The median award in premises liability cases- cases involving injuries sustained due to the condition of the property- was $90,000.
  • The median payout for product liability cases- cases involving flawed products like faulty brakes or dangerously designed toys- was $748,000.
  • The median award was $31,000 for all cases studied.

Keep in mind, however, that this study was from nearly 20 years ago. The study also found that the average success rate for plaintiffs was only about 50%, making it entirely possible that a plaintiff wouldn’t get any settlement or other payment at all.

How Are Personal Injury Settlements Paid Out?

Personal injury settlements are usually paid out in one of these ways:

  • A lump sum settlement is a one-time payment provided in full to the plaintiff that resolves all claims originating from the accident.
  • A structured settlement is a sequence of payments provided to the plaintiff over time, which may be made in regular installments or in a single amount.
  • A Medicare Set-Aside (MSA) is a part of a settlement set aside to compensate for future medical bills linked to the injury.
  • An escrow account is a third-party neutral account that stores settlement payments until they are distributed to the plaintiff.
  • The manner of payment is often flexible between the parties. It may be impacted by various circumstances, such as the amount of the settlement, the plaintiff’s future medical expenditures, and tax concerns.
bodily injury claim
Injury claim processPersonal Injury

A bodily injury is a physical injury that can result in intense pain, disfigurement, and reduced organ or body part functioning. Personal injury accidents, such as car, truck, and motorcycle accidents, can cause direct trauma to the body and result in significant injuries. Fortunately, federal and state laws allow accident victims to pursue financial restitution for harms and losses following a personal injury accident. One way to achieve this is by filing a bodily injury claim with the at-fault driver’s auto insurance company. Bodily injury claims allow those injured in car accidents to recoup costs for medical treatment, legal fees,  lost wages, and other associated harms and losses.

What Is the Difference Between a Bodily Injury and a Personal Injury?

If you are not a part of the legal community, you may use the terms “bodily injury” and “personal injury” interchangeably. This is understandable since there is a great deal of overlap between the two types of injury. But they do differ in a few critical ways.

Personal injury is a component of civil law. Injuries may arise due to auto accidents, premises liability, medical or professional malpractice, defective products, and other incidents. The common element in personal injuries is that the accidents are not intentional or criminal in nature; rather, they result from negligent or careless actions. 

Bodily injury, on the other hand, tends to be seen most in an insurance context, rather than in a criminal context. “Bodily injury” is the precise term insurance companies ascribe to a particular kind of liability. The defining characteristic of a bodily injury is that another person causes this type of injury, to a particular location on the body, usually from a car accident. In an insurance context, bodily injury is a type of insurance policy that compensates the injured victim through the at-fault party’s insurance policy (typically). To help illustrate this concept, let us say I was t-boned in an intersection by a negligent driver who breezed through a red light while responding to a text message. In this example, the at-fault driver was the cause of the accident, and thus, the cause of any injuries that I, the injured party, sustained. This could reasonably be categorized as a bodily injury, and filing a bodily injury claim would enable me to pursue rightful financial compensation for my damages and losses.

What Is Covered Under Bodily Injury Coverage?

Bodily injury liability insurance covers a range of costs associated with car accident injuries

Medical costs

Many kinds of medical costs are covered for other people involved in an accident you cause, such as emergency care, ongoing medical care, and hospital fees.

Legal fees

If someone who is injured in the accident sues you, this liability insurance will cover your legal defense fees, court costs, judgments, and settlements, up to your policy limits.

Loss of income

In cases where a person is injured in an accident you caused and they miss work because of it, bodily injury liability insurance can cover the income they lose as a direct result of the accident.

Funeral expenses

If the accident results in the fatality of another driver or one of their passengers, liability insurance can pay for funeral costs.

Three Factors Affecting Payouts for Bodily Injury Claims

Factor 1: Damages

The damages you have incurred from your injury will account for a substantial amount of the compensation you will receive. The primary damages an insurance adjuster will look at include:

  • Medical bills
  • Physical therapy
  • Out-of-pocket expenses related to the injury
  • Lost income or wages
  • Pain and suffering

The total estimate of your damages will make a good approximation of your bodily injury claim’s value.

Factor 2: Accident Location

Insurance claims adjusters frequently consider the location of the accident as well. Insurance adjusters will often research the “venue” or the location where your bodily injury claim will go to trial (if it goes to trial, that is). Here, the adjuster may find that the venue has historically been favorable to large personal or bodily injury settlements. If that is the case, and the venue is well known to offer large payouts for injury lawsuits, then the adjuster is likely to offer more money to settle your claim to avoid going to court. Likewise, personal injury attorneys may research the venue, looking at previous personal injury cases to see how much compensation is typically awarded in injury cases.

Factor 3: Medical Costs

Higher medical costs tend to be associated with higher bodily injury claim payouts. However, insurance companies are only obligated to cover “reasonable and necessary” injury medical treatment bills. That means if your  treatments for medication or physical therapy are reasonable and necessary to facilitate your full recovery, they should generally be recoverable.

How Is a Bodily Injury Settlement Calculated?

Calculating the correct amount of compensation for a bodily injury settlement can be a complex process. There are several factors to consider, from the scale of injury and medical treatment to the additional damages of lost wages or affected lifestyle. There are two methods commonly used to calculate the amount for a bodily injury claim. However, other alternatives exist such as computer modelling and the use of previous claimants as a payout precedent.

The Multiplier Method

The multiplier method involves gathering a figure from the quantifiable damages, such as medical bills or lost wages. This figure is totaled and then multiplied by a number between one and five, depending on the extent of the injuries, with five representing the higher end of the severity scale. Permanent traumas such as paralysis or brain injuries have been known to receive a higher multiplier than five.

The Pier Diem Method

The Pier Diem method literally means ‘per day.’ This method entails calculating a monetary value for each day that the injury continued. Daily income is often used to calculate this, as it must be demonstrated to the court how you have arrived at your Pier Diem figure. Due to the specifics involved, it would be unwise to employ this method when dealing with a long-term injury.

To gain a better understanding of the damages you could reasonably pursue through an injury claim, consider speaking to legal counsel.

Hurt in house
Injury claim processPersonal Injury

Both business owners and homeowners sometimes have questions about what happens if someone gets hurt on their property. Under premises liability law, an injured person may have a case against the property owner or occupier if their injury was caused by an unsafe situation or condition on the property. As with other kinds of personal injury law, the most important issue is establishing fault. If you were negligent in fixing a hazard or failing to warn others about such a condition, a judge and/or jury may determine that you are liable for the victim’s harms and losses. Generally, fault is determined based on what a “reasonable person” would do in a similar situation. For example, if the roof starts leaking, a reasonable person would probably put a bucket under the leak, wipe or mop up any collected water, and call someone to get the roof repaired. If you just let the water puddle on the floor and fail to either clean it up or at least warn others on the property about it, it is likely such failure to take remedial measures could be interpreted to mean you did not take reasonable care (or due care) in this situation and are therefore liable for any harms and losses stemming from the hazardous condition.

Landlord Liability

As a landlord, you are responsible for providing “habitable housing” for your tenants, the definition of which varies slightly by state and leaves some room for interpretation by the courts. At its most basic, habitable housing is free of obvious and known hazards and defects. Habitable housing needs to have reliable heat and running water and a roof that protects the occupants from weather conditions and is reasonably secure from break-ins. Habitable housing also meets basic sanitary standards. It is not infested with rodents or bed bugs and is free of mold and other known health hazards.

Property Conditions

Property conditions that could lead to tenant injuries where you could be liable include:

  • A staircase with no handrail
  • Poor lighting in common areas
  • Loose railings on decks and balconies
  • Ripped or missing window screens
  • Uneven surfaces on sidewalks and driveways
  • Water leaks that could lead to mold
  • Broken or missing smoke and CO detectors

If a personal injury results from hazardous conditions on your property, you could be held liable even if the condition is temporary. A landlord who is aware of a hazardous condition but does not resolve it in a timely manner can be at fault for resulting injuries. When it takes some time to accomplish the repairs, you are responsible for warning tenants of the existing hazard.

What Is Legal Liability?

Liability is basically a person’s obligation or responsibility, under law, to compensate another person if their negligence led to that other person suffering a loss, such as a bodily injury or damage to their property. When it comes to rental properties, both landlords and agents have a duty of care to protect others from loss. Duty of care means “an obligation to take reasonable care to avoid foreseeable harm to another person on their property.” Landlords owe a duty of care to their tenants and to anyone else who is on their property, such as guests of the tenant, or even the grocery delivery person. Where agents are concerned, they have a duty of care to their landlord clients in addition to tenants and visitors of the property. (Tenants also have a duty of care to anyone present on the property. It is called occupiers liability.)

When Might a Tenant Be Liable for Accidents That Take Place on Their Property?

A tenant might behave in unsafe ways or may invite guests and they may engage in unsafe behavior while in the rental unit. In those cases, the tenant may be responsible for the resulting injuries. This means that the tenant may be found liable for these negligent actions. In general, when a personal injury accident happens in a rental property, both the tenant and the landlord may share legal liability if the actions or inactions of both parties contribute to the accident and injury. In these cases, comparative negligence applies, reducing the amount of compensation the injured party may receive if the blame is shared by both parties. To establish liability, it is important to evaluate the facts of the specific accident to determine how the law may apportion legal fault for the actions or inactions of the parties involved.

State Laws Vary

When considering whether a landlord may be held liable for a personal injury, it is important to remember that state laws on landlord responsibility vary. For example, some states may use a comparative fault method to determine liability, while others may rely on contributory fault. Ultimately, however, the legal determination on any injury situation may be different in one state when compared to another. The best way to understand this process for your area is to check the local landlord-tenant laws as well as personal liability claim filing rules.

When Do I Need Premises Liability Insurance?

The right time to seek premises liability coverage from your insurance company is as soon as you rent or own a property for your business. You are always at risk of an injured person filing a lawsuit that, even if you are not at fault, could still result in legal bills and settlement costs. Whether you rent or own your business property, premises liability law requires you to maintain a safe environment for visitors and to avoid an unreasonable risk of harm. Failure to do so can create premises liability and a potential lawsuit.

Proving Liability

For a landlord to be held liable, the tenant must prove the following:

  • Duty: The landlord had a duty to fix the dangerous condition within a reasonable amount of time.
  • Breach: The landlord failed to meet their duty to address the dangerous condition.
  • Causation: The cause of the injury was the failure to repair the dangerous condition, and the landlord’s negligence directly and foreseeably caused the injury.
  • Damages: Injuries (damages) resulted from the landlord’s behavior.

What Happens if the Landlord Is Negligent?

If a landlord or agent breaches their duty of care, the person who suffered a loss can pursue legal recourse.. Depending on the applicable circumstances and legislation, the tenant may be able to withhold rent, pay for repairs and deduct the cost from their rent, or terminate the lease.

Handshake negotiation
Injury claim processPersonal Injury

Before beginning negotiations with the insurance adjuster, have a minimum amount of damages in mind for your settlement. Draft your demand letter with that number in mind, but do not disclose it to the insurance adjuster or any representative of the insurance company. When the insurance company makes an initial settlement offer, it is often a lowball offer to see whether you know what your case is actually worth. The insurance company believes that, by saying your case is only worth the initial amount, you will accept it at face value and be done with it. Make the insurance adjuster explain their reasoning for the lowball offer. If the claims adjuster makes good points about the offer, consider lowering the settlement amount that you would accept before drafting your response and possibly making a counter-offer in a letter.

Take Your Time

The insurance company knows that if they offer you a low settlement quickly, you might accept it because you do not have all the information that you would have if you took the time to do adequate research. For that reason, and because insurance claims adjusters have a lot of cases and are therefore  busy with their work, they want to rush through their tasks to close as many cases as possible. Try to resist their persistent pushiness to get you to agree to their low settlement offer; instead, have patience. Wait until you receive all your receipts and estimates related to your accident. Wait until you’ve had the chance to get the necessary medical treatment and to understand the scope of the bodily damage you suffered as a result of the accident. Because you cannot renegotiate after you have signed an agreement, you should never agree to any settlement until you know the full scope and extent of your injuries and any future treatments or surgeries you may require. 

Initial Offer

Sometimes the insurance company will send an initial offer to the injured party before receiving the demand letter to try and settle the matter. However, it is crucial to get an accurate valuation of your injury claim before signing any settlement document since it might not include fair compensation for all the harms and losses you suffered.

Reservation of Rights Letter

The reservation of rights letter is a letter sent from the insurance company to confirm receipt of the claim filed by the injured party. It acts as a binder while the investigation of the claim is underway. It describes what the policy covers and notifies the injured party that it has the right to make no compensation if it rejects the claim.

Demand Letter

If you are having trouble reaching the insurance company that you believe is responsible through other means, a demand letter is often an effective way to reach out. A personal injury attorney will usually send such a letter as a first step (should you choose to hire one), even before the company’s adjuster has made an offer. A demand letter should include all known damages and an estimate of future harms resulting from the injury. It should be short and professional and include a demand for a specific dollar amount.

Negotiating the Settlement Amount

Ideally, you would like to get the full amount demanded in your letter. Likely you will get less. How much less depends on your negotiating skills and the strength of your evidence. All negotiations involve compromise, but there are ways to come out on top. Before beginning, figure out the minimum settlement you will accept. Never tell the adjuster how low you are willing to go. Hopefully, you will never get to that point. If the adjuster’s settlement proposal never gets above your bottom line, or they flat out deny your claim, you have several options, including filing a lawsuit.

Responding to Unacceptable Counteroffers

When you call the adjuster back, stay calm and focused. Get them to justify their counteroffer. The adjuster will want to continue negotiating from the low amount they offered. It is a common negotiation tactic, so be ready and do not go along with it. Instead, go back to your original demand and negotiate down from there. Ask the adjuster to break down each reason they used to justify the amount of their counteroffer. Take notes. If the adjuster talks faster than you write, ask them to repeat or slow down. Settlement negotiations are serious business, and everything is important. Then say you need a few days to review the reasons.

How To Prepare a Rebuttal

In all your rebuttals, stress the fact that you never asked for this. You did not ask to be hurt, need medical treatment, or miss time from work. This is a major impact on your life, and all of it was caused by the insured’s negligence. Use the correct medical terms for your injuries and explain clearly how your life was affected. Tell the adjuster your pain and suffering are real, and your treatment records back it up. As part of your response, lower your demand slightly. Remember, you are negotiating down from your demand and not up from the adjuster’s counteroffer. Lowering your demand by small increments is the proper way to negotiate. So long as you are willing to compromise, the adjuster should continue negotiating. Once you have lowered your demand, do not call the adjuster back right away and lower it again. Wait until you get a response. If you drop your demand before the adjuster has a chance to respond, you will be negotiating against yourself. A good negotiation strategy is to wait a bit after you get an offer. Allow a reasonable amount of time to consider the offer before responding with your counteroffer. You do not want the adjuster to think you are in a hurry. Take detailed notes during every round of settlement negotiations, including the date of each discussion, the amounts offered, and the adjuster’s arguments and reasons for their counteroffers.

Finalizing the Insurance Settlement and Release

After a few rounds of settlement discussions with the adjuster, you should reach a compromise on the amount the insurance company will pay to settle your personal injury claim. Write down everything you agreed on, and the date you negotiated the final settlement. Follow up by letter or email to confirm the amount and terms of the agreement. Do not settle unless you are fully recovered, or the negotiated settlement amount is enough to cover all your future treatment. If you settle and later need additional treatment, you cannot reopen the claim or ask for more money. Read the official settlement and release very carefully. Make sure it matches up with the agreement you made with the claims adjuster. The release is a legally binding document, and it is up to you to know what you are signing. The settlement check process begins after you sign and return the release agreement. Keep in mind that there is almost always a confidentiality clause included. Once you sign the settlement agreement and endorse the check, your case outcome is final.

Injury claim process

When you get seriously injured in an accident caused by  someone else’s negligence, you  will likely have costly medical bills. Unless you can afford to pay your medical costs out-of-pocket, you will likely have to use your health insurance or a portion of your settlement to pay your medical bills. The most important thing to know is that, if you get into an accident, you are generally responsible for making sure your medical bills are paid as you incur them, until any underlying insurance claim or lawsuit is resolved. The only exceptions are usually:

  • car accidents in “no fault” states
  • accidents that trigger “medical payments” (or “med pay”) insurance or similar coverage, and
  • workers compensation claims

When an injury claim is made under the above three kinds of coverages, you can usually submit your medical bills as they come in, and rolling claims can be paid out until the coverage limit is reached.

Medical Bills and Personal Injury Settlements

When you get seriously injured in an accident caused by  someone else’s negligence, you  will likely have costly medical bills. Unless you can afford to pay your medical costs out-of-pocket, you will likely have to use your health insurance or a portion of your settlement to pay your medical bills. The most important thing to know is that, if you get into an accident, you are generally responsible for making sure your medical bills are paid as you incur them, until any underlying insurance claim or lawsuit is resolved. The only exceptions are usually:

How Do Medical Bills Get Paid?

Four of the most common ways medical bills get paid after a personal injury accident are:

  • Your health insurance. The initial payment may come from your health insurance provider if you are insured. This includes Medicare and Medicaid insurance. If your health insurer pays your medical bills in advance of you receiving a settlement, you will have to reimburse the health insurer after resolving your case.
  • Your auto insurance. If you were injured in a car accident, your own auto insurance company may pay for the initial costs of your medical care. If you are at fault, you would need medical pay or personal injury protection insurance for first-party insurance coverage.
  • Insurance subrogation (if you were not at fault). If you were not at fault for the accident but your own auto insurance provider paid for your medical care upfront anyway, your insurer can pursue reimbursement from the at-fault party’s insurer through a process called insurance subrogation.
  • A third-party’s insurance carrier. If you were not at fault and your own insurance company does not pay your medical costs, you may qualify for coverage from the other party’s insurer. This may come in the form of a settlement or verdict won from the defendant, which you would then use to pay off your medical debt.

Your Settlement Must Cover Your Future Medical Bills

Your health insurance company will no longer be on the hook for the medical bills in the future because there will now be an alternate payer. The responsible party in your accident will have an obligation to pay your bills in the future. Your accident settlement should pay for both your past and future medical bills. While medical providers will send you bills, they will understand that you are an injured victim who cannot pay those bills right away. You will get a certain period to pay the bill. You can negotiate a payment plan with the medical provider. If you have a personal injury lawyer handling your case, they can speak with the billing provider on your behalf.

You Must Get Enough Money To Cover Past and Future Expenses

The fact that a provider can place a lien on your settlement, you must negotiate an adequate number to make sure you get full compensation. State laws might limit the liens that a medical provider can place to ensure you still receive some compensation after a settlement. In many cases, the size of the lien cannot exceed 25 percent of the personal injury settlement or award. However, the provider can ask you to sign a waiver that allows them to collect more than this amount. Should you obtain a personal injury lawyer, they can negotiate with the individual provider to help fully protect you.

Legal Requirements for Medical Liens

There are some requirements for medical liens:

  • The provider must file them in the county where the healthcare services occurred
  • Providers must file within a certain timeframe and before you receive your settlement
  • The provider must move to enforce the lien within one year after filing it, or they must re-file the lien

Who Gets Paid First Once the Settlement Is Over?

The healthcare provider gets their piece of the proverbial pie first. After the contract is signed, the medical provider will send out a notice of debt to all parties involved. This is called perfecting the lien and it guarantees that the lien holder will be paid first from the verdict or the settlement. For individuals who have no means of covering the cost of their medical treatment in case of an accident or an injury caused by another person, medical liens are a godsend. However, this legal remedy might not be available in all cases.

Can My Medical Bills Reduce My Settlement?

In some cases, your medical bills may reduce your settlement. This can happen if your medical bills are particularly high, and your settlement is not enough to cover all your expenses. In this case, your lawyer may negotiate with your medical providers to reduce your bills or work out a payment plan. Additionally, if you are found to be partially at fault for the accident, your settlement may be reduced by the percentage of fault assigned to you. This means that if you are found to be 10 percent at fault, your settlement will be reduced by 10 percent.

Demand Letter
Injury claim processPersonal Injury

If you get injured in any type of accident, recovering the compensation you deserve can be a challenge. One of the first steps in pursuing financial restitution is submitting an effective settlement demand letter to the correct insurance carrier. Your demand letter should be concise, compelling, and convincing for the best possible results.

What Is a Demand Letter?

A demand letter is the layperson’s version of a legal complaint. In it, you state what your dispute is, your harms and losses, and why you want to handle it in court. The demand letter must also contain the amount for which you are suing or the specific relief you seek. You submit this letter to the person with whom you have the dispute or the representative or adjuster for the other party’s insurance carrier.. While you do not need legal drafting experience to compose a demand letter, it should be clear and well organized. You will want to give a brief history of the dispute. Explain why there has been no agreement so far and your grounds for seeking compensation. Be polite and specific about what you want and what your next step will be if the problem is not resolved. If you are willing to accept a settlement, say so. If not, make that clear as well. Let the other person know that if you are not able to come to an agreement, your next steps will be escalating the matter and filing a lawsuit.

Components of a Formal Demand Letter

A good demand letter follows an orderly progression that tells the insurance company representative, or claims agent the following: who you are, how you were injured, the damages you sustained, who should pay for your damages, and the amount of money you demand for compensation.

Letter Heading: The heading will have information about you, the insured, the claim, and the reason for your letter.

Presentation of Facts: In the body of the letter, layout your facts clearly and concisely. After the salutation, begin by explaining the events that led up to your injuries. Then give a step-by-step description of the events that came together to cause the accident. Provide as much detail as you can. To avoid any technical arguments from the adjuster, you can use “approximate” language. For example, instead of saying, “Thursday at 4:03 pm,” you would say, “Thursday at about 4 pm.” This prevents the insurance company from denying your claim due to an incorrect time.

Description of Damages: The next step in your injury demand letter is an accounting of your damages. These include your hard costs, called “special damages” and your intangible losses, called “general damages.” Write this as if you were walking the adjuster through every step along your road to recovery. Clearly relate the levels of pain and discomfort you experienced. Hard costs are damages you can prove with tangible evidence, like medical bills, lost wage statements, and receipts for medications. Intangible losses cannot be objectively measured, so you will need to use vivid and descriptive language. This is the part of the demand letter where you emphasize the pain and suffering you experienced, often called “general damages.” Include specific details that show how your life was altered, such as canceling a vacation or an important business trip, or not being able to attend an important family event. Relate how the effects of prescription medication or the injuries themselves prohibited you from normal daily functions, and how you had to rely upon others. You can even describe relationships that were strained due to the limitations of your injuries.

In addition to listing your tangible and intangible damages, communicate to the adjuster that:

  • You never asked for these injuries and all the resulting problems
  • You had neither the time nor the desire to be laid up for weeks, having to miss work and endure constant pain
  • You loathe the emotional toll the accident has taken on your relationships

Liability: Although it may be understood between you and the adjuster, never take the insured’s liability for granted. In this part of the letter, you must bring all the facts together to show that your injuries happened because of the insured’s negligence, and through no fault of your own.

Compensation: Personal injury claims ultimately come down to money. Your next step in the demand letter is to detail the specific amounts of money you are demanding for all your special damages and general damages.

Closing: The closing paragraph should end by thanking the adjuster for their attention and placing a time limit on their response.

How Long Should the Letter Be?

There is no minimum or maximum length for a demand letter. However, aim to keep the letter concise and to the point. It should only be long enough to clarify your intent. A letter that gets to the point will show your opponent that you are serious about the lawsuit. It will also help the court clerk and the judges who are extremely busy. The less you give them to read, the better it will be for your case.

What Happens if the Defendant Does Not Reply to a Demand Letter?

If you do not get a response after sending your demand letter, you should be prepared to take further action. Depending on your situation, this could mean filing a lawsuit or preparing for mediation and discovery. If you choose to proceed with filing a lawsuit, be sure to research the process and understand what is involved in the lawsuit. Depending on the complexity of the issue, it may be beneficial to consult a lawyer before deciding how to proceed. Mediation is another option where both parties can come together, with or without legal counsel present, to discuss their differences and try to reach an agreement that works for both sides. Whether you choose lawsuit or mediation or even opt out of pursuing any litigation at all, it is important that all potential outcomes are considered when deciding how best to move forward.

filling up a work injury claim form
Injury claim processWork Injury

Every state has a statute of limitations in place that limits the amount of time available to file a lawsuit. Basically, the statute of limitations sets a hard deadline for when your claim must be filed. The applicable statutory period varies by state and by the type of legal action, but is usually between two and four years. If you do not file a lawsuit by the time the statute of limitations runs out, your claim will be time barred. You will not be able to take legal action, which means you will be unable to recover compensation for the harms and losses you  endured.

When Can You Sue Your Employer for a Work-Related Injury or Illness?

There are two primary scenarios in which you can sue your employer for a work-related injury or illness: (i) if your employer wrongfully denies you workers compensation benefits; or, (ii) if your employer does not provide workers compensation coverage.

Suing Your Employer: Limitations and Exceptions to Employer Immunity; Why Can’t Most Employees Sue Their Employers for Work-Related Injuries?

State workers compensation laws prevent employees from suing their employers for work-related injuries under most circumstances. The reason for this is that legislators have decided it is best for employees to have access to  financial benefits regardless of fault (in the form of workers compensation benefits) rather than requiring employees to prove that their employers are responsible for their injury-related losses. As a result, workers compensation laws establish what is known as “employer immunity.” Employers must pay workers compensation benefits regardless of fault; but, in exchange for taking on this responsibility, they are immune from most employee personal injury claims.

What Are the Exceptions to Employer Immunity for Work Injuries?

While employers have broad immunity from personal injury claims, this immunity is not absolute. The following are all examples of situations in which you may be able to file a lawsuit against your employer.

  • Your Employer Intentionally Caused Your Injury– In many states, if you can prove that your employer intentionally caused your injury, then you can seek full compensation for your injury-related losses.
  • Your Employer Was Grossly Negligent– In some states, employees can also sue their employers for job-related injuries and illnesses resulting from their employers “gross negligence.”
  • Your Employer Denied Your Workers Compensation Claim in Bad Faith– In some states, a bad-faith denial of workers compensation benefits provides grounds to sue your employer. However, you may need to exhaust your other remedies (such as filing an appeal with your state’s workers compensation board) before filing a lawsuit in court.
  • Your Employer Manufactured the Product That Injured You– If you were injured in an accident involving a defective product manufactured by your employer, you may be able to sue your employer under the theory of “products liability.”
  • Your Employer Has a Relationship With a Contractor or Subcontractor– If you suffered your injury in an accident involving a contractor or subcontractor, your employer may ultimately be liable based upon its business relationship with the contractor or subcontractor.
  • You Are an Independent Contractor- If you are an independent contractor (as opposed to an employee), then the company that you work for is not technically your “employer.” This means that employer immunity does not apply, and you can sue for full compensation based on the company’s (or one of its employees) negligence.

How Much Will You Recover if You Sue Your Employer?

If you file a lawsuit against your employer for a job-related injury, how much will you recover? The answer depends on the extent of your injuries. In personal injury claims, accident victims can recover financial restitution for their harms and losses. With that said, if your injuries are significant, your financial recovery could be substantial. An attorney will be able to help you seek compensation for all your outstanding and future medical bills, as well as your current and future loss of income. On the “non-financial” side, accident victims can recover compensation for their pain and suffering, post-traumatic stress, emotional trauma,  loss of enjoyment of life, and other life-altering impacts of their injuries. Compensation for financial losses is calculated based on actual and expected out-of-pocket costs. For non-financial losses, there is nothing to “add up,” so a couple of different methods are used- the per diem method and the multiplier method. With either method, personal injury compensation for accident victim’s non-financial losses will often far exceed their compensation for their expenses and lost wages.

Is It Worth It To Sue a Company for a Work Injury?

If you have grounds to file a lawsuit, it will almost certainly be worthwhile it pursue financial restitution from the  company for your work-related injury. This is because work-related injuries can be incredibly expensive. Your medical bills, lost wages, and other expenses can add up very quickly. Filing a lawsuit also allows you to seek compensation for your post-traumatic stress, pain and suffering, and loss of enjoyment of life.

Should I Sue My Employer or File for Workers Compensation Benefits?

When it comes to deciding whether to sue your employer or file for workers compensation benefits, the answer depends on your workers compensation eligibility. If you are eligible for workers compensation, then you typically are not eligible to sue your employer. The benefit of being eligible for workers compensation is that benefits are awarded on a “no fault” basis- while you need to be able to prove fault in order to file a lawsuit. However, while workers compensation benefits are limited, filing a lawsuit allows you to recover full compensation.

Workers Compensation Claims vs Lawsuits: Pros and Cons

A workers compensation claim can provide a quicker avenue to money and benefits to an injured worker. But temporary disability and permanent disability payments can be low, and do not compensate the worker for the full spectrum of damages that might be available in a lawsuit, including compensation for the injured person’s pain and suffering, and punitive damages that might punish an employer for poor safety protocols or dangerous conditions. You may also be able to receive government benefits such as Social Security disability insurance (SSDI or SSI) if your injury is disabling and prevents you from working.