How to Negotiate an Injury Claim

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When injured in an accident, it’s common for an insurance policyholder to file a claim with their insurer to seek compensation for their injuries.

In an ideal world, policyholders would always recover a fair settlement amount from their provider. However, while your insurance company may claim that customer service is its highest priority, the fact remains that insurance is a business. Fortunately, policyholders may hire an experienced attorney to seek compensation from their insurance company.  

If you or a loved one has been injured in an accident and needs help negotiating a claim with their insurance company, call Zinda Law Group at (800) 863-5312 for a free case evaluation with our El Paso personal injury attorneys.

TYPES OF INSURANCE LIABILITY CLAIMS

In the event the insurance company denies coverage for your injuries, keep in mind that this doesn’t mean you don’t deserve coverage.  If your insurance company denies your claim, you may file a lawsuit for breach of contract or bring an action for bad faith.  Specifically, a breach of contract claim is brought when an insurance company fails to make payouts it is obligated to make under a binding contract signed by both the insurance company and the policyholder.  A bad faith claim is made when an insurance company wrongfully denies coverage by claiming that an event is not qualified for coverage under the insurance policy.  Bad faith cases often involve debates over legal semantics in the policy, so it’s important to have an experienced personal injury lawyer on your side.

REASONS INSURANCE COMPANIES DENY OR DELAY CLAIMS

Insurance companies deny claims for a variety of reasons; some reasons are valid, while others are not. Some of the more common reasons insurance companies deny claims include:

Lack of Coverage

Your insurance company may argue that your claim isn’t covered by your policy.  Examine your policy’s exclusions section to better understand what’s not covered.  Keep in mind that ambiguities in the policy are judged in favor of the policyholder, not the insurer.

Late Medical Attention

Your insurance company may deny your claim if you are unable to prove that your injuries were a result of the accident.  An immediate doctor’s visit often serves as proof that your injuries occurred at the same time as the accident.

Pre-existing Conditions

Your insurance company may also try to deny your claim if you suffer from a pre-existing condition.  It may argue that your condition caused your injury rather than the accident.  For example, if you have a pre-existing neck injury but you suffered additional or new injuries to your neck because of the accident, the company may deny your claim and argue that your new injuries did not result from the accident.

Timeliness Errors

Your insurance company may set time limits for notifying the company of your claim.  Check your policy to see what the requirements are for notifying the insurance company of a claim.  Some timelines may be as short as 24 hours.

Bad Faith Denial

Remember that an insurer might offer many justifications, often with confusing insurance policy jargon, to disguise the fact that they just don’t want to pay for the claim.

HOW TO NEGOTIATE A CLAIM AND OR SETTLEMENT WITH YOUR INSURANCE COMPANY

Insurance companies are businesses and operate as such.  While insurance companies may claim to have your best interest in mind, your insurance company may still try and award you with as little compensation as possible.

Insurance adjustors are aware that the more of a financial bind you’re in, the more likely it’ll be for you to accept a low, but immediate payment on your claim, as opposed to waiting for a higher settlement.  Even if you tell the insurance adjustor the minimum amount you’re willing to settle for, you may still be offered less.

Below are some tips that may help you negotiate with an insurance adjustor:

1. Document as Much as Possible

Take as many photographs as possible of the accident scene, including any visible injuries you may have. In some instances, an insurance adjustor may not visit you until days after the accident, which could provide time for your wounds to heal and any property damage to be repaired. Photographing and documenting evidence immediately after an accident may assist you in proving the severity of the accident and help you negotiate a more appropriate settlement amount.

2. Determine a Minimum Settlement Amount

Once you have understood the scope of your losses, you should use this information to determine a settlement amount that could adequately cover your damages. Be sure to make an added effort to describe and calculate all the damages you suffered due to the accident. This may include medical bills, treatment costs, pain and suffering, and loss of wages.

3. Keep Your Story Straight and Emphasize Emotional Points

It may be helpful to write down the details of the accident to keep your story straight when negotiating with an insurance adjuster.  The insurance company may attempt to have you change your story of how the accident occurred or claim that you were responsible for your injuries as a way to justify paying you a lower settlement amount.  It may also help to emphasize any emotional points that support your claim.  For example, if your injury has interfered with caring for your family, mention how your family has suffered as a result of the accident.  While there is no definite way to place a dollar value on pain and suffering, describing these types of damages to an adjuster may help the insurance company make a fair settlement offer.

4. Expect the “Back and Forth”

While you may expect your initial settlement offer to be turned down, you should not feel obligated to accept the insurance company’s counteroffer if it’s too low.  This tactic is common amongst insurance adjusters to determine how much you may fight against their offer and whether the claim may be settled quickly.  It is highly recommended that you ask your insurance adjuster to justify their offered settlement amount.

5. Remain Calm and Patient

Remember that insurance adjusters are people too, which means that they probably won’t respond well to aggression or threats.  Even if you have to work with a difficult insurance adjuster, stay calm and don’t let your emotions get the best of you.  Your job is to show the insurance adjustor that your claim is a valid one and that you believe in the facts you have presented.  If you can show the adjuster that you are making a good faith claim, you may be offered a fair settlement offer in return.

Although these tips may help you seek a fair settlement amount for your damages, the assistance from an experienced El Paso attorney who knows how to negotiate an injury claim is crucial to helping you seek a favorable outcome for your case.

HOW AN ATTORNEY MAY HELP

Insurance companies know that many accident victims are unaware of how much their claim may be worth. Because of this, insurance companies typically offer unrepresented victims a settlement that is lower than the actual value of their claim in the hopes that a victim may take the offer and forfeit their right to a legal claim.

It’s important to contact an attorney before accepting a settlement amount from the insurance company. An experienced personal injury attorney may calculate the value of your case, which an attorney may use in negotiating with the insurance company.

In addition to your financial costs, a settlement may cover pain and suffering resulting from the accident. Generally, there are two methods commonly used to calculate damages for pain and suffering: the per diem method and the multiple method. The per diem method calculates the dollar amount the victim makes in a day multiplied by the number of days the victim continues to suffer after the car accident. The multiple method is more commonly used and is made by totaling the victim’s economic damages and applying a multiple from 1 to 5.

Learn More: Why Hiring a Lawyer Will Help Your Case

BE AWARE OF THE STATUTE OF LIMITATIONS

If you are unable to reach an agreement with the insurance company, you may want to file a lawsuit to seek compensation for your injuries.  The statute of limitations provides a deadline by which an accident victim must file a lawsuit.

Once this deadline passes, the victim is barred from bringing their legal claim in court, so a victim shouldn’t wait too long while negotiating with the insurance company.  Negotiating with the insurance company is not enough to beat or extend the time limit.  Filing your summons and complaint in the right Texas court of law is how you’ll meet the statute of limitations.  In Texas, the statute of limitations for most personal injury claims is two years.

GET HELP FROM ZINDA LAW GROUP’S EL PASO PERSONAL INJURY ATTORNEYS

At Zinda Law Group, our personal injury lawyers have the experience and knowledge that has helped injured victims seek compensation from their insurance companies after suffering an injury from an accident.

If you or a loved one is unsure how to negotiate their injury claim with the insurance company after suffering injuries from an accident, call Zinda Law Group at (800) 863-5312 for a 100% free case evaluation with our El Paso personal injury attorneys.

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