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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.

Greensboro-High Point-Winston Salem, NC

Who is Responsible for my Foodborne Illness?

Despite the strict food safety and handling regulations put in place by the federal government, thousands of people are still hospitalized for foodborne illnesses every year. In fact, the Centers for Disease Control and Prevention (CDC)[1] reported that as many as 128,000 people are hospitalized for food poisoning on a yearly basis, of which around 3,000 tragically lose their lives. 

Seattle-Tacoma, WA

AUTO INSURANCE: A Necessary Evil

Insurance companies are hard to deal with when you need to make a claim.  They don’t make the process easy.  They don’t always pay the bills they should pay.  They don’t always make fair offers to resolve claims.  They often delay, deny, and defend legitimate claims to boost their corporate profits.  It is no surprise that insurance company are disliked by almost everyone.

Miami-Fort Lauderdale, FL

Florida State Laws on Car Accidents for Pembroke Pines Community

It is important to remember that Florida has a four-year statute of limitation for filing a law suit involving a car accident.

Florida is a no-fault insurance state requiring every driver to carry insurance to cover their own physical injuries regardless of who is at fault, and vehicle insurance coverage to cover damages to the other vehicle if you are at fault.

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?

Yuma, AZ-El Centro, CA

10 Ways Insurance Companies Try to Reduce Yuma Personal Injury Claims

Anytime you’re injured in an automobile accident, don’t expect the insurance company to treat you fairly. In 2015 alone, the Arizona Department of Transportation reported 116,609 total car crashes with 36,139 accidents including injuries. The insurance company’s primary goal is saving money by convincing you to settle for the lowest dollar amount. Learn more here about how insurance companies try to reduce their payout.

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.