Insurance Claims and Procedures

Many people who have been in an auto accident involving injuries or property damage just want to resolve the matter as quickly as possible. For those with low-cost and uncontroversial claims, that’s easy. But if you have a complicated situation to resolve, disagree with the insurance company about who was at fault or feel its settlement offer is too low, don’t accept their offer just to “get it over with.” Too many consumers don’t realize that they can -- and often must -- negotiate with their insurance companies in order to get fair compensation. And once you take a settlement offer, you’re usually legally barred from filing a lawsuit or from pursuing more money through the insurance company. If the other person’s insurance policy doesn’t cover the amount of damages you have, or an insurance company stonewalls you, you may want to consider filing a personal injury lawsuit to recover all of your damages.

When you have an accident, the first thing you should do is call your insurance company and give them information about the accident and the other person’s insurance policy. When you do that, you’re entering a claim with the company to get the coverage -- the money -- you were paying for by paying your monthly insurance bill. You’re also entering a claim for damages from the other driver’s insurance, if the other driver was at fault. California and Nevada are both “fault-based” states, which means that it’s not legally possible to have a no-fault accident. Instead, insurance companies must look at the facts, determine how much fault each party involved bears and base their payments on that fault.

Once you’ve entered the claim, the company responsible for it assigns an adjustor to gather the facts of the matter and determine how much the company should pay. The adjustor will arrive at that figure by looking at the facts as the drivers, law enforcement and other authorities report them, and at how much coverage the client has. When he or she is done investigating, the company will make you a settlement offer -- that is, offer you some amount of money to resolve the claim. If you don’t like it, you don’t have to take it. You can and should negotiate, politely. The adjustor’s job is to save the company money; often, they will have a range of offers they think is acceptable, but start with the lowest one. If you’re armed with documentation about the accident, your medical bills and other costs, and the worth of your vehicle, you can often negotiate a higher settlement amount.

If you feel you know exactly how much your claim is worth, you don’t have to wait for the adjustor to get back to you. Instead, you can write the insurer a demand letter saying how much your injuries and other damages are worth. This letter should include the bare facts about your accident and what bills you incurred as a result of it. You should include any papers you have that prove your case, such as hospital bills, repair bills and photos and police reports from the accident. Don’t forget to include secondary costs that the accident created, such as bills for a rental car, childcare you needed while incapacitated and lost earnings from missed work.

If an insurer lets the case go on longer than you think is necessary, you don’t have to wait for them to call. Call them yourself and let them know you’re still following the case. If an adjustor is unhelpful, you can ask to speak to a supervisor; if the supervisor is unhelpful, you can complain to the state Department of Insurance, or find a qualified auto accident attorney to discuss whether you have a viable lawsuit.

Sometimes, an unscrupulous auto insurer will try to illegally increase your auto insurance bills because you’ve been in an accident, even though it was not your fault. Insurance companies may also deny claims that you know your policy should cover, and that you’ve already paid for with your premiums. This is called insurance bad faith, and it’s illegal. If your insurer is determined to save money by breaking the law, you may file an insurance bad faith lawsuit in order to recover the money you need to cover your accident. Under this scenario, the insurance company is liable not only for your damages if it is found guilty, but also for your attorney’s fees.

The following common mistakes can make it harder to pursue your insurance claim or a personal injury lawsuit:

• Don’t admit to anyone that the accident was partly or totally your fault. Even if you think it’s polite or the right thing to do, your judgment may be impaired.
• Don’t wait any longer than necessary to tell the insurance companies about the accident. -Don’t throw away any documents that might be helpful in proving your claim, including police reports and medical bills. Keep them all and write down any witnesses’ statements, names and phone numbers.
• Don’t sign anything the insurance company gives you if you don’t understand or agree with it. You may be signing a waiver of your right to pursue the claim further.
• Don’t accept money from an insurance company if you don’t think it’s enough. Accepting money may be seen as agreeing that the claim is closed.

If you have been seriously injured or lost a loved one as the result of a defective product accident, you need the advice of an experienced California car accident lawyer. Call BISNAR | CHASE Today for your FREE CONSULTATION or click here to fill out our online form.

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