JoshThe aftermath of an accident can feel overwhelming. You may face painful injuries that need long-term treatment, vehicle repairs that cost more than a pretty penny, and a lengthy stint off work. In addition, you might need to navigate the tricky insurance claims process to ensure you can afford to cover your expenses.
Dr. Louis Patino, an experienced personal injury lawyer in McAllen and San Antonio, Texas, shares his insight into the insurance claims process so you can get a fair settlement.
How the Claims Process Works
The first step for recovering compensation after an accident is to contact the at-fault party’s insurance company — this is why drivers exchange insurance company details after a crash.
However, you should contact your insurer too. They can help you with the process and may be able to pay a settlement and recover it from the responsible party’s insurance provider.
Your insurance company can also pay out on other policies you might have — for example, collision coverage to pay for damage to your car.
The insurance company will assign an insurance adjuster to your case, who will investigate the accident, determine if your claim is valid, and calculate how much you deserve.
Gathering Evidence
To recover compensation from the other driver’s insurance, you must prove they were negligent and that their behavior caused your accident and injuries.
You can gather some of the best proof for your claim immediately after your accident. If your crash happened on a busy road, you have a short window to collect evidence. Debris gets cleared, vehicles towed, and skid marks washed away. It can also be challenging to locate witnesses if you don’t get their information.
To give yourself the best chance of a successful claim, take photographs or videos of the scene, including the vehicles involved and the damage sustained, your injuries, debris, skid marks, and weather conditions, and note the contact information of anyone who witnessed the accident.
You should also seek medical treatment to document the severity of your injuries and the treatment you’ll need.
Negotiating a Settlement
The next phase of an insurance claim is to negotiate your settlement. Insurers typically make an initial low offer and encourage you to settle quickly. They may even tell you horror stories about claims taking a long time to resolve and urge you to accept a settlement now so you can avoid the hassle and move on with your life.
The risk of accepting the first offer is that it’s unlikely to cover your expenses, especially if you don’t know how your injuries will affect you long-term. For example, your injuries may worsen, or a complication during recovery from surgery may require additional procedures. However, you cannot take further legal action once you accept a settlement.
Most attorneys recommend countering the offer. Negotiations will continue until either side accepts the terms or you reach a stalemate.
What to Do If You Can’t Reach a Settlement
You might not settle an insurance claim for several reasons. Negotiations can fail, or a claim might not even get off the ground, such as if the insurance company determines their client is not liable for the accident, the at-fault driver doesn’t have insurance, or your expenses exceed the other driver’s insurance coverage.
If this happens, you may be entitled to file a lawsuit against the at-fault party. This legal action is a lengthy process involving discovery (gathering evidence), further negotiations and mediation, and, eventually, a trial.
Dealing with Insurance Adjusters
An insurance adjuster’s primary objective is to minimize payouts — fewer claims paid means more profit for the company.
Insurers will resort to many tactics to dispute your claim, including monitoring your social media activity and following your progress — and they will use your words and actions against you.
You might post an update on social media after an accident to tell friends and loved ones you’re okay. You might even say, “I’m doing well,” especially if you don’t want anyone to worry.
An insurance adjuster might use that update to argue your injuries aren’t as bad as you make out. Likewise, you might state you’ve become depressed and withdrawn after a car accident, impacting your relationships and causing emotional distress. But if an insurance adjuster sees a photograph on Facebook showing you enjoying a drink with friends, they will likely use it to dispute your claim and offer a reduced settlement.
That does not mean you should stay off social media during your claim — but consider what you post and how an adjuster might perceive it. You can also change your privacy settings to limit what others can see about you online. These actions are not about being deceitful but protecting yourself and preventing your words and behavior from being taken out of context.
This advice also extends to what you say to an insurance adjuster. During their investigation to assess your claim, they will ask you about the accident, including what happened and the injuries you sustained.
For example, an adjuster might ask about your injuries, so you tell them you sustained a broken arm. However, you later experience delayed symptoms of whiplash from the crash. You request a more generous settlement to cover your additional medical expenses.
The insurance adjuster may counter that you’re not entitled to additional compensation because you did not mention your other injuries when you made a statement. They may even claim you sustained whiplash later in a separate event.
What should you say to an adjuster, then?
First, know that you never have to speak to an insurer. The benefit of hiring an attorney is that they understand insurance company tactics and can handle all communications with an adjuster for you.
If you speak to an adjuster and they ask about your injuries, be polite yet firm, explaining that you’re currently seeking medical advice and they should contact your attorney.
Dealing with insurance companies is crucial to recover compensation after an accident. An adjuster may express concern — and they may be genuinely sorry for your injuries — but their job is to downplay their client’s liability and minimize your settlement, regardless of their feelings.
An experienced personal injury lawyer will protect your rights, gather evidence for your claim, and negotiate a fair settlement so you avoid having unforeseen future expenses and no way to pay them long after resolving your claim.