In most personal injury cases, the defendant won’t pay you directly. Instead, an insurance company pays.
This could be a car insurance company, a business insurance company, a property insurance company, or any other type of policy with the relevant policy. For example, in a breach of security and data loss injury case, a cybersecurity insurance company would pay. In a malpractice case, the practitioner’s malpractice insurance pays.
When you file a claim against the defendant, the insurance company will first tally up the claim’s potential value. They’ll also start working to minimize their payout amount. Here’s what you need to know.
The Determination of Liability
In a car accident case, you may hear the determination of liability called the determination of fault.
Either way, the insurance company first evaluates whether their insured is potentially liable. Liable essentially means, “Could they be successfully sued for this?”
If the answer is “yes,” they begin trying to resolve the claim.
Insurance Company Tactics
The insurance company will usually have an adjuster reach out to you, and the adjuster will ask for some information. Sometimes, the information they ask for is designed to undermine your case.
If you need a lawyer (see below), you should refer them to your attorney rather than dealing with them directly. Communication with any insurance company offers many pitfalls.
If you decide you’re going to go it alone, you should still be careful. Don’t sign anything that indicates you might bear more responsibility for the accident than you do. Don’t sign over medical records. They may try to tell you they can’t process the claim without that information, but they’re really just trying to determine if they can use a pre-existing condition against you.
Don’t be surprised if they delay the claim, stonewall you, or deny a legitimate claim. They do not want to pay. You also shouldn’t be surprised if they try to downplay the injuries you sustained.
Eventually, the insurance company might cough up an offer. This is often a lowball offer that won’t cover a fraction of your expenses. Unless you know you’re about to get what you need; you should always give a lawyer a chance to review the offer before you accept. Once you accept a settlement offer, you cannot sue again and can’t press for a higher settlement offer later.
The Impact of Insurance Limits
While theoretically, a New York personal injury case could result in any amount of money, pragmatically, you’re usually not going to get much more than the limits of the policy the insured is using.
There are exceptions. For example, if you’re suing a major corporation, they can afford to pay the difference between what their insurance covers and the actual value of the lawsuit.
In a car accident case, however, insurance limits place a practical ceiling on the amount of money you can receive from your injury case. This is why it’s always such a good idea to have some extra insurance of your own. For example, anyone who drives should probably take out more than the minimum amount of uninsured/underinsured motorist policy to ensure their expenses get covered.
When is it okay to deal directly with an insurance company?
If your injuries are relatively minor and routine, or if your accident mostly involved property damage, it’s usually okay to take their offer. Insurance case offers tend to be fair and straightforward on a smaller scale.
If you had to go to the ER, broke so much as a bone, or anticipate major medical expenses, you need a lawyer. You also need a lawyer for any claim you couldn’t launch on your own. For example, filing a malpractice claim without getting a lawyer involved is difficult.
There’s no real reason to do guesswork, though. You can have a lawyer review your case for free and can get guidance on whether you should deal with the insurance company before you begin talking to them.
When should you get a personal injury lawyer involved?
Get a personal injury lawyer involved:
- Whenever your injuries are severe.
- Whenever you want to go up against the city or the state.
- Whenever you are going up against a major corporation.
- Whenever you’re not absolutely sure you can manage without a lawyer.
Yes, we do take a percentage of your settlement. But you are far more likely to get a settlement at all if you work with us, and your settlement is likely to be three to ten times higher than the settlement you would have gotten on your own.
Have you been injured by another party’s negligence?
We have extensive experience helping New Yorkers manage their personal injury claims. Insurance companies know who we are.
When you’re hiring us, you’re telling them you mean business.
Contact us to get started today.