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The Insurance Claims Process

After a serious collision, injured people must face the insurance claims process

After an injury accident, an insurance claim needs to be filed to ensure that the injured person receives compensation for medical expenses, lost work and wages, damaged property, and pain and suffering caused by the accident. Here is valuable information about the insurance claim process.

When an accident happens, regardless of who is at fault, all parties should contact their insurance companies immediately. The insurance adjusters will acquire information about the cause of the accident and the extent of injuries and property damage.

The insurance companies will then open an investigation. Those involved in the accident will be interviewed and asked to provide any accident-scene photos, names of witnesses, and any other information that has been collected.

Anyone injured in the crash will likely be asked to undergo an independent medical examination by a physician of the insurer’s choice to document the cause and extent of any injuries.

The insurance adjuster will calculate the value of the claim, and will issue a settlement check. If the insurance claim is denied, or if the insured feels that the settlement amount is too low, the insured can appeal to the insurance company.

Calculating Insurance Claim Value

While it is relatively easy to determine the cost of medical expenses and lost income, it's much more challenging to place a realistic dollar amount on the pain and suffering a person deals with after being injured. Insurance companies have developed damages formulas to calculate how much to pay the injured for these types of non-monetary damages.

Denial of Claims and the Appeals Process

There are many reasons why a claim may be denied:

  • The statute of limitations may have run;
  • The injured person failed to submit to an independent medical examination;
  • the type of accident may not be covered under the insurance plan.

If the claim is denied, the insured will receive notification from the insurance company. The insured then has the option to appeal the denial of claim. Appeals procedures vary from company to company, so it is important to review the policy in learn about the appropriate next steps.

When to have a personal injury lawyer step in to help

After having a claim denied or receiving a settlement offer that is too low, many people seek the help of a personal injury attorney who has experience in interpreting insurance policies and dealing with insurance adjusters to obtain the highest settlement possible. Many other people choose to find an experienced injury lawyer soon after an accident, so that the attorney can handle the insurance claim from the start and allow an injured person to focus on healing.

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Everett-Bellingham WA

When do you call a lawyer?

It’s one of the hardest times in life – after a debilitating accident. No one wants to be in this situation, but what if you are? You don’t have to go it alone. Because negotiating with the insurance company to try to get your bills covered just as your policy should be designed to do, can feel like David phoning up Goliath to try to make a deal. There are personal injury attorneys who spend years specializing in these kinds of situations. Sometimes all it takes is having one represent you to start a process in motion that would lead to a very different outcome than if you were to try to work with insurers yourself. For a list of questions to help you decide if an attorney can help you, click here.

Laredo, TX

Falls Becoming Leading Cause of Spinal Cord Injuries

Motor vehicle accidents that whipped people’s necks abruptly were long theleading cause of traumatic spinal cord injuries. However, the new study puts falls in the No. 1 position and suggests that new solutions are needed to prevent falls and spinal injuries.

Laredo, TX

Why Are Young Drivers Having So Many Accidents?

One of the most-studied factors has been the issue of age to see whether certain age groups have more accidents than others. The question is obvious: does age appear to play a role in crashes and, if so, which age group has the most car accidents?

Harlingen-Weslaco-Brownsville-McAllen, TX

My Neck, My Back: Epidural Steroid Injections

The violence of any motor vehicle collision can often cause serious neck and back injuries such as protrusions or herniations. When this occurs, injured parties will often visit an orthopedist or pain management doctor who will recommend a series of ESI’s which will provide pain relief and reduce swelling in and around the damaged discs and corresponding nerve roots. 

The True Cost of Severe Brain Injury

There are no winners in such injuries. The severity of brain injuries can take many forms and come with a tremendous number of complications. A Traumatic Brain Injury, or TBI, caused by an accident is a devastating diagnosis.

Laredo, TX

Can Social Media Ruin My Claim?

For anyone involved in a personal injury case, discussing your claim on social media can be a serious mistake. If you’re one of the 2.2 billion people using these social platforms, then you need to know how social media can ruin your personal injury case! Learn more about how to protect your claim here...

Corpus Christi, TX

How to Determine the Full Value of Your Car Accident Case

Determining the actual value of your car accident claim, and therefore how much you should ask for in return from the liable party’s insurance company, is a straightforward and simultaneously complicated process. It can be simple in terms of vehicular damage.  If you have been physically injured as a result of the car accident, you will need to know the cost of your own recovery, which is far easier said than done. Read more here about how professionals determine your claim value.

Harlingen-Weslaco-Brownsville-McAllen, TX

I’m Injured- Do I Have A Claim?

he best way to answer that question is that it depends on the specific facts and circumstance of the incident that led to the injury. While every injury and claim is different, there is certain information that can always be helpful when deciding what to do when you are injured, beginning with being familiar with different types of common injury claims.