A GUIDE TO PERSONAL INJURY INSURANCE CLAIMS

A personal injury claim is an action against someone who caused you harm or injury through their negligence or other wrongful conduct.  Most common claims result from car or motorcycle accidents but a claim for injuries can be made based upon any wrongful conduct.  If you have been injured, you might file an insurance claim against the at-fault party or you may end up pursuing your legal claim by filing a lawsuit in court. 

This blog post focuses on the insurance claims process for cases that do not need to go to court.

PRESENTING A CLAIM FOR PERSONAL INJURIES

Generally, the process begins with notifying the insurance company for the at-fault party and providing basic information about the nature of your claim.  Typically, this will be done by your attorney.  At the early stages it is not necessary to make a demand for a specific amount of money nor is it necessary to provide details on your injuries, medical treatment, wage loss, or other damages.  It is sufficient to let the insurance company know that you are making a claim and have them open a file.

If you hire a Santa Rosa personal injury lawyer, your attorney can present the claim on your behalf. Your attorney also handles the next step in the claims process, the investigation. 

CASE INVESTIGATION

An insurance adjuster conducts the investigation for the insurance company. However, the adjuster is not acting on your behalf and it is important that you or your personal injury lawyer conduct an independent investigation.

A Santa Rosa personal injury attorney works for you. Your lawyers collect evidence that can prove your claim. Evidence in a personal injury case includes, but is not limited to:

  • The traffic collision report of other police and fire department reports report
  • Photographs and videos of the involved vehicles and accident scene
  • Interview and obtain statements from helpful witnesses
  • Physical evidence from the accident scene
  • Medical records linking your injuries to the accident 

A professional investigation by your Santa Rosa personal injury lawyer produces a stronger and more valuable claim.  Working with an experienced personal injury lawyer with the resources and expertise to conduct a thorough claims investigation is always good for your claim. 

SETTLEMENT NEGOTIATIONS AND CASE EVALUATION

In every case, we hope that you make a complete recovery and put the pain, suffering, anxiety, and other losses behind as soon as possible.  We realized that it is not quite that simple and sometimes the ill effects of an injury accident are long term, even lifelong.

Ideally, we will wait until you are fully recovered, or until you have reached you maximum medical improvement, before evaluating your case for settlement and actually beginning settlement negotiations with a specific dollar demand. 

Typically, we will present a narrative settlement demand letter that chronicles the suffering brought into your life by the accident and includes copies of documents and evidence we have developed in our investigation.

Your recoverable damages following an injury accident may include:

  • Medical bills including future medical expenses
  • Wage or earnings loss including future losses
  • Physical pain and suffering from you injuries past and future
  • Mental anguish and loss of enjoyment of life
  • A decrease in earning capacity
  • Property damage if not already settled

The value of your injury claim is a function of multiple variables including the above listed damages and an evaluation by your Santa Rosa personal injury attorney of what prior similar cases have been worth either from a jury verdict after trial or in prior negotiated settlements with the insurance companies.

It is no secret that our initial settlement demand is usually higher than what we believe to be the true value of the case; this leaves some room to negotiate.  Likewise, the insurance company is likely to make a settlement offer lower than they are willing to pay and then negotiate against that figure.

The insurance company and your lawyer might negotiate back and forth for several weeks or months. The parties discuss the merits of the case, the evidence, and the value of damages. Most personal injury cases are resolved through negotiations with the insurance company. 

CASE SETTLEMENT 

Once we settle with the insurance company, the client and attorney sign a settlement agreement, or “release”, memorializing the terms of the settlement.  The insurance company sends your attorney a check for the full amount of the settlement.  That check is deposited into the attorney/client trust account. 

Typically, your lawyer will deduct from the settlement the following:

  • Attorney’s contingency fee (usually 1/3 of the settlement amount if the case settles before filing a lawsuit, less if the injured party is a minor)
  • Costs of the case (investigative costs, copies of medical records and bills, etc.)
  • Medical bills and liens — the client may be obliged to pay out of the settlement unpaid medical bills not covered by insurance and usually must repay some portion of the bills paid by health insurance)

The remaining proceeds are the net recovery which is paid to you.  This often takes ten to thirty days from the time the case is settled and the release is signed.

We always do our best to negotiate any medical reimbursement claims or other amounts you owe to minimize the amount paid our and maximize the net recovery to our client.

WHAT IF THE CASE DOES NOT SETTLE WITH THE INSURANCE COMPANY?

Some personal injury cases just cannot be resolved through negotiations with the insurance company or at-fault party. The parties might disagree about who caused the accident or the value of injuries or damages.  If the case cannot be resolve to your satisfaction, you always have the right to pursue the matter further by filing a personal injury lawsuit against the responsible party.  Your experienced Santa Rosa personal injury lawyer has the tools and experience to fight for you in court.  This process will be examined in a separate blog posting to this site.

CONTACT OUR SANTA ROSA PERSONAL INJURY LAW FIRM

If you were injured in an accident in the North Bay Area, or you have suffered the loss of a family member or loved on, please contact our office for a free, no obligation, personal injury consultation with an experience Santa Rosa personal injury lawyer:

Law Offices of Kevin McConnell, PC

700 College Avenue

Santa Rosa, CA  95404

(707) 696-8800

team@kevinmcconnelllaw.com