No you shouldn’t try and file a claim by yourself and heres why, after an accident many injured people hesitate to hire a personal injury lawyer to help them seek compensation. After all, if someone else’s carelessness caused their suffering, isn’t it obvious that they need compensation? Isn’t that what the at-fault party’s liability policy should cover? How hard can the personal injury claims process possibly be?
In reality, insurance companies are in the business of making money, and that means avoiding high payouts on claims. The legal process is full of complexities that attorneys spend years obtaining the education and training to help their clients navigate. That’s why you need a personal injury lawyer to file your claim. You stand the best chance of success with legal counsel by your side. In short, if you plan to file a personal injury claim, you need a lawyer.
How Insurance Companies Make Money (and What They Do to Avoid High Payouts)
If you’re seeking compensation for injuries due to someone else’s negligence—such as a car accident caused by a distracted driver or a slip and fall caused by a store manager’s failure to clear the store of hazards— you will almost always file the claim against the at-fault party’s liability insurance policy. Most individuals cannot afford to compensate for medical and other expenses for those they’ve injured out-of-pocket.
For the past several years, insurance companies in the U.S. have made well over $600 billion a year in insurance premiums. After paying various expenses and even considering the number of payouts on claims they make, the industry still sees a profit of more than $60 billion after taxes.
Insurance companies protect their bottom line by hiring claims adjusters, whose job involves investigating and evaluating third-party claims to determine how much liability their insured had for the injury that resulted in the claim and how much the insurance company owes to the claimant—if any.
Make no mistake, however: The investigation made by the claims adjuster is not unbiased. The claims adjuster isn’t in the business to ensure a fair process. They help the insurance company pay as little as possible to claimants while they continue to make profits on premiums.
Insurance Company Tactics That a Personal Injury Attorney Knows All About
Claims adjusters are not required to explain their thought process or even make the claimant understand their mission. They rely on the fact that many claimants don’t seek the help of an attorney who will manage communications with the adjuster and provide information about how the process works.
Additionally, many claimants do not know what their case is worth without an attorney. If it’s early after your accident, no one knows how much your claim is worth, and that is when claims adjusters often make contact.
Some of the tactics commonly used by claims adjusters to reduce or eliminate the claims of people who have decided to pursue compensation without an attorney include:
- Offering an extremely low settlement early after the injury, when it is impossible to have a full picture of the types of expenses the claimant is facing. Often the claims adjuster puts an arbitrary deadline on accepting the claim and states that it represents the maximum amount of compensation available for the claim. While the initial settlement offer from a claims adjuster is almost always far below the value of the claim—even when the claimant has hired an attorney—by the time the attorney has valued the claim, they’ve also provided a wealth of information to show how much their claim is worth.
- Convincing the claimant to authorize the release of all of their medical records for evaluation. What they’re really doing is looking for pre-existing conditions that could let them off the hook for paying out some of the expenses involved in treating the injury. While individuals with pre-existing conditions can and do file personal injury claims, the insurer is only responsible for compensating for a worsening of the pre-existing condition. There are medical records that the adjuster needs to see, but these are very limited in scope. An attorney knows the records needed for the claimant’s consideration and can make those records—and only those records—available to them.
- “Schemey” telephone tactics. Many telephone conversations begin with one party asking the other how they’re doing and the other party responding with “fine” or “good.” Unfortunately, the claims adjuster can use anything the claimant says to evaluate the claim, even going so far as to insinuate that if the claimant was as injured as they claimed to be, they wouldn’t be “fine.” An attorney can manage communication with the claims adjuster on their client’s behalf and protect the claim from this tactic.
The Danger of Accepting a Settlement Offer Before You’ve Talked to an Attorney
Consider this scenario: Cindy was involved in a car accident caused by a distracted driver. While still in the hospital recovering from serious injuries, she receives a call from the at-fault party’s insurance company’s claims adjuster.
The adjuster seems very concerned, assures Cindy that the insurance company wants to “take care of her,” and offers $20,000 to compensate the claim. The adjuster states that she has a week to accept the offer and that there won’t be any additional money available.
Cindy, faced with being unable to work because of the injury, begins thinking that $20,000 is a lot of money and will see her through until she is well enough to work.
Cindy accepts the settlement and then suffers a complication from her injury that results in the need for a surgical procedure. When she reaches maximum medical improvement, her physician determines that her injuries are permanent and she can no longer perform her job duties.
While $20,000 would have perhaps been enough to compensate for the expenses associated with a minor injury, it only covers a fraction of the medical expenses associated with a serious injury involving surgery and hospitalization. It would likely not even scratch the surface of other costs, such as the cost of repairing or replacing her vehicle, wage loss, loss of earning capacity from permanent injuries, and the quality-of-life effects that accompany a serious injury.
However, because Cindy accepted the settlement offer, she was required to sign a document that releases the at-fault party and their insurer from any further legal claims pertaining to the accident, meaning she is legally barred from seeking any more compensation and must find a way to pay her additional expenses out-of-pocket.
How Personal Injury Claimants Without an Attorney Lose Their Right to Compensation
The insurance company’s tactics aren’t the only issue that makes pursuing the compensation you need without an attorney difficult. There is a legal process to contend with, as well. While personal injury claims are generally submitted first to the at-fault party’s insurance provider, if the provider fails to compensate the claim, there is the option of filing it as a personal injury lawsuit in court.
You must file suit must in court before the statute of limitations on your case expires. Each state’s lawmakers determine how long individuals have to file certain types of legal claims. For example, the statute of limitations on personal injury claims in California is generally two years from the date of the accident.
While most personal injury claims are resolved by settlement before the trial takes place, it is crucial to ensure the claim is filed in court before the statute of limitations has expired. Missing this deadline usually prevents you from using the court process when seeking compensation.
Unfortunately, if you do not have a settlement agreement when the statute of limitations expires, the insurance provider will not pay you.
One of the most important services an attorney provides is protecting your legal right to file a claim by filing it within the statute of limitations. However, an attorney can offer many other legal services that the claimant would likely find impossible to attempt independently.
Determining (and Proving) Liability
One of the cornerstones of a successful personal injury claim is proving that someone else was liable for causing the accident that resulted in your injury. An attorney can investigate the claim, determine all liable parties and their associated liability insurance policies, and begin gathering the evidence, witness testimony, and documentation to prove your claim.
Valuing Your Claim
The value of your claim is not merely the sum of your medical expenses or wage loss. Personal injury claimants are permitted to seek compensation for the injury expenses and the injury’s effects on their quality of life. The psychological impacts of a serious injury often make up a greater amount of the claim’s overall value than the monetary expenses. Factors that come into play when valuing a claim include the severity of the injury, whether the injury will permanently impair the claimant’s ability to earn an income, and how much insurance coverage the at-fault party has.
Generally, a personal injury attorney will wait until the claimant has reached maximum medical improvement before establishing the claim’s value. This is when your physician determines that you have reached the highest amount of recovery possible, even if treatment were to continue. At this point, there is a more accurate picture of the expenses you have incurred and a better estimation of future expenses you are likely to incur based on the permanence of your injuries.
Negotiating a Settlement
As mentioned, a claims adjuster will commonly make settlement offers that are far below the claim’s value. An experienced personal injury attorney understands how much is available through the at-fault party’s policy and the evidence necessary to prove liability and costs. They work to communicate this information to the claims adjuster to convince them to increase their offer.
While doing this, a personal injury attorney also has the responsibility to provide their client with the information necessary to make an informed decision on matters such as accepting a settlement offer or filing the claim in court.
Litigation
While most cases settle outside of court, the ability to file a claim and place the determination of liability and compensation in the hands of the court is a powerful tool to have when negotiating a settlement. This vital right is used if the insurance company does not provide the compensation you need and deserve.
However, court processes involve many formalities, from deposing witnesses and answering interrogatories to filing motions. Those not trained or experienced in the legal system won’t know they need to do them, or how. Without having to attempt to file a claim by yourself and struggling with all the legal hurdles while you are trying to heal, you can learn what a lawyer does by talking to one, schedule a free consultation today to discuss your claim.
Can You Afford a Personal Injury Attorney? Yes!
One of the biggest reasons people say they don’t want to hire a personal injury attorney is that they don’t think they can afford one. However, most personal injury attorneys work on a contingent fee basis. You do not have to pay for their services until you receive compensation through a negotiated settlement or a court award. To learn more about the “costs of hiring a lawyer” schedule a free consultation and ask one of our experienced team members yourself!
Additionally, most personal injury attorneys offer free consultations to provide injured people information about the process without obligation. The contingent fee billing method and the free consultation ensure that anyone who needs legal help after someone else’s negligence injures them has access to it.