Accepting an insurance carrier’s settlement offer is a choice made by the plaintiff in a personal injury case. In actuality, this is the final step in the recovery process once both parties ( the injured party and the insurance company) sign on the dotted line, the legal process for financial recovery stops.
The insurance industry is highly regulated, and claims adjusters must act in good faith in response to a claim. This does not mean they must pay what you asked for. An accident victim has options if an insurance company denies or undervalues a request for compensation.
However, receiving fair and just restitution for harm caused due to negligence is a complicated endeavor. Every small detail is important, and dealing with the legal requirements can be intimidating, time-consuming, and costly. An accident victim’s best chance to receive fair financial recovery is to consult with an experienced personal injury attorney.
Understanding How the Process Works
Unpredictable moments can change a life. In the short time it takes to become a victim of a slip and fall accident, a vicious animal attack, or the broken body in a crumbled T-boned car, a person finds themselves looking for a resolution to the physical and financial fallout from someone else’s negligence or bad choices.
Accepting an insurance settlement too early in the game may be a shorted sighted solution to what can be a long-term problem. From the plaintiff’s point of view, it doesn’t feel much like a game, but it most certainly is to the insurance claims adjuster. When the negligent party’s insurance company reaches out immediately following the incident, it is because they know the victim has a valid claim. A quick offer is an attempt to mitigate the company’s losses.
An experienced claims adjuster builds their career by recognizing the true value of an injury claim and successfully making a payout before the victim can determine what that may be. Once an accident victim initiates the financial recovery process, they become a plaintiff. An experienced personal injury attorney has a frame of reference that a first-time accident victim may not.
The Full Value of a Personal Injury
The full extent of physical injuries takes time to develop. Reaching maximum recovery often does not happen as quickly as a first settlement offer, especially when the injury is severe.
All medical expenses to date should include:
- Ambulance charges
- Emergency room services
- Bills from all treating physicians
- Costs of radiology and lab services
It is impossible to predict what medical care will cost in the coming months. Permanent disabilities can often require life-long professional care and expensive modifications to a victim’s home. Retrofitting personal living spaces is an expensive project.
For example, according to HomeAdvisor, the cost of:
- Installing a chair or stair lift can cost between $1,500-$5,000
- ADA-compliant bathrooms and kitchens may cost anywhere from $9,000-$40,000 each
- Widening a doorway for a wheelchair costs between $700-$2,500 for each door
In addition to the costs of healthcare and possible home modifications, some other things to consider are:
- Adaptive equipment
- Alternative transportation costs
- Vehicle repairs or replacement
- The value of any damaged personal property such as clothing, jewelry, leather goods, and electronics
- Lost wages and benefits present and future
- Purchased services for household maintenance, cooking, shopping, and childcare
A personal injury accident lawyer can help a catastrophic accident victim understand the potential monetary value of pain and suffering, anxiety, emotional distress, and a loss of the ability to enjoy former leisure activities. When it comes to the future of an entire family, everything counts.
Serious Personal Injury Can Happen Anywhere
The more severe the injury, the more compensation a victim needs for recovery.
Average is a word seldom heard about a personal injury. Every accident comes with its own unique set of circumstances. The injured party knows firsthand the toll the accident and injury take on daily life. A seasoned litigator knows firsthand how to present a compelling case to insurance claim representatives, juries, and judges.
Some accident-induced injuries are self-limiting. While they are painful, they usually heal over time with few complications.
- Soft tissue damage
- Sprains and strains
Broken bones and lacerations are known to cause damage to nerves and tendons, dangerous blood loss, and hard-to-treat infections.
Some injuries have life-long consequences such as:
- Second and third-degree burns
- Crush injuries resulting in amputation, deformity, or disfigurement
- Traumatic brain injury
- Permanent organ damage
It may not matter where or how an injury happens. Passengers in a car are vulnerable to negligent drivers, as are pedestrians and motorcycle riders. Those harmed because of another’s wrongdoing have a financial need for restitution and a legal right. Business and property owners and managers must ensure the safety of their customers and tenants.
Compensable accidents are possible:
- While boating or enjoying other water sports
- On a playground or sports field
- In a hotel or motel
- On a broken staircase
- On public transportation
- While walking through a poorly lit parking lot
- While visiting a friend’s home
- In a public or municipal building
- At an amusement park
- In a neighbor’s pool
- In a restaurant
- At the gym
- On a school campus
- At a sporting event
- When using an unsafe or defective product
Manage Your Expectations
Following a personal injury that is clearly ( or to your knowledge) not your fault, you can expect the liable party’s insurance company insurance carrier to contact you probably sooner than you expect. Now is the time to remember that nobody can misquote silence. An accident victim is under no obligation to give any information to the suspected defendant’s insurance company.
The insurance company may ask you to sign a medical authorization release that allows access, not just injury related to the incident, but your entire medical history, including treatment notes. They may ask you to sign a release of liability.
Sometimes, a claims representative may come with a check in hand. Insurance companies pour through your social media and take unauthorized photographs and videos of you and your family. They will investigate to look for reasons to deny your request entirely or, at the very least, limit the amount you will receive. If you were injured and you plan to ask for restitution, it is sufficient to let them know you have an injury and plan to file a compensation claim.
Accidents are emotionally charged stressful situations. A qualified personal injury attorney best serves a victim’s interests.
How to Do It Right?
Time matters. The negligent person’s insurance carrier will usually have the final say-so as to how long a plaintiff has to accept or reject a settlement offer. If the offer comes in writing (and it should), it should come with a deadline. If not, ask.
The whole process, from start to finish, has a time limit. Every state has a statute of limitations for filing a personal injury or wrongful death claim. Failing to file within the allowable time frame will prevent any recovery.
In California, with few exceptions, the limit is two years from the date of injury. Once an accident victim fully recovers, their lawyer will send an official demand letter to the liable person’s insurance company. This ideally will include the pertinent details of the incident, documentation to substantiate past and future medical care expenses, and the value of lost wages.
There is no set-in-stone formula for paying a fair dollar amount for non-economic damages such as pain, suffering, and emotional trauma. An experienced personal injury attorney can use details from a client’s medical records, photos, radiology films, and expert medical testimony to illustrate the intensity of the physical pain endured by the plaintiff during treatment.
Impact statements from friends may be able to give some perspective to the changes in family dynamics following the accident. After connecting all the dots, the injured party should have a dollar amount to present to the insurance company. For a settlement offer to make a victim whole, the compensation should cover the full value of all losses.
Anything less can leave a person paying dearly for someone else’s negligence. The simple truth is that attorneys train to deal with the intricacies of the legal system. Their years of formal education make them orators and negotiators. A personal injury lawyer knows how to advocate for the victims of negligence. Having a legal advocate will give an injured victim a distinct advantage over those attempting to deal with the consequences of an injury-causing accident on their own.
The negligent person’s insurance company will want to know specific details about the incident so they may begin an investigation. Protect your legal rights. Except for the accident’s time, date, and location, check with a legal expert before releasing any personal information or signing any documents. Evidence is an equal opportunity asset in a personal injury claim.
Negotiations and final settlements account for facts gleaned from:
- Police and ambulance reports
- Emergency room records
- Surveillance camera data
- Accident scene photographs
- Accident reconstruction reports
- Cell phone usage
- Tapes of 911 calls
- Witness statements
- Medical records
- Expert medical testimony
- Victim’s impact statement
- Payroll records
Questions That Can Help Decide
When to reject a settlement offer?
- The offer comes before you complete medical treatment
- When it is an obvious lowball offer
- When you don’t agree with the insurance company’s reasons for the devaluation
- The amount is not enough to cover documented accident-related costs
- The amount is far below the limits of any existing insurance policies
- When you cannot reach a fair settlement and must take the matter to trial
After you reject the initial offer, the back-and-forth negotiation process begins. This is when the plaintiff might respond with a counteroffer. Negotiations may continue for several rounds.
When to accept a settlement offer?
- When you feel it is a fair offer
- When financially you can wait no longer
Excerpts from The Law Dictionary:
“About 95 percent of pending lawsuits end in a pre-trial settlement. This means that just one in 20 personal injury cases is resolved by a judge or jury in a court of law.”
“Over 90 percent of cases that go to trial end in victory for the individual who brought the suit.”
The Pros and Cons of Going to Trial
A trial is both time-consuming and expensive.
You may need to pay the fees for:
- Copies of documents, reports, and medical records
- Filing documents with the court
- Costs connected with investigations
- Expert witness testimony
- Court reporters
- Document transcription
Settlements are private and confidential; everything is up for public review in a trial. Accepting a settlement gives an accident victim a guaranteed amount of money—a trial may give substantially more or nothing at all. As a rule, the settlement process, from accident to check-in hand, is probably faster than deciding to litigate and waiting for a trial.
If an accident victim needs retribution as much as they need restitution, a trial may be the way to go. On the other hand, if, for financial reasons, the victim and their family need a quick resolution, accepting a settlement offer may be in their immediate best interest.
The accident victim retains control over the settlement negotiations; they are free to accept or refuse any offer. The judge and/or jury have the final say in a trial. A settlement, once accepted, is a legally binding contract. Either side can appeal a jury verdict. It is a tough decision that you don’t have to make without a support system to guide you through the process.