A personal injury insurance claim can be settle without an
attorney. Make no mistake. In fact, the great majority of personal injury claims
do not involve attorneys. The reason for this is the high legal fees and cost
that will be tackled to your settlement. So learning the process and handling
your claim can save you a bundle and increase your injury compensation.
The personal injury insurance claim process starts when you
go to the doctor. As soon as a medical professional treats you, you will be
considered “injured”. When people claim headaches or similar injuries, the
adjuster will not allow payments for pain and suffering unless they think they
can settle the day you filed the claim. Most of the time, however, there will
want to see some objective evidence of the injury.
Most insurance companies will try to settle the person
injury insurance claim (as oppose of your personal injury “legal” claim) as soon
as they think they can get a settlement and release form from you. This document
will be an agreement between you and the insurance company in which you agree
that you will not present a legal claim against the liable party in exchange of
a certain amount of money. This agreement will be honored (most of the time as
it can be disputed) in a court of law.
It is not unusual to find insurance adjusters trying to
settle in your first conversation. They can have a recorded agreement on the
phone that could have the effect of an agreement and release.
If you do not settle, then the personal injury insurance
claim will continue. You will follow a treatment schedule and your medical bills
will be paid by your insurance company by your
Personal Injury Protection Coverage.
Both insurance companies will send you a Medical
Authorization From. This form entitles them to ask for your medical bills and
records. You insurance company will not pay the medical bills until you give
them the form. This is perfectly legal. Courts have ruled that if the insurance
company is required to pay the medical bill, they are entitled to see the
reports. However, you do not have to give this Medical Authorization form to the
insurance company of the person that hit you. You can withhold the records until
you are ready to settle.
After you insurance company pays, they will be reimbursed
by the responsible party’s insurance company but only when you settle. This can
take up to three years, depending on your state’s bodily injury statute of
limitations. However, your insurance company will not pay for you pain and
suffering and general damages. You have to settle those by yourself.
The personal injury insurance claim process will focus in
your medical treatment. The insurance carrier will be sending you letter and
asking you to report your medical condition. If they believe that you are over
treating, they will send a letter to your own insurance company telling them
that if they pay for your medical bills, they will not reimburse them. This is a
technique to put pressure on your own insurance company to review the medical
records and decline payment in anything that does not appear to be accident
Once you feel better, you are back to “pre accident
condition”, or you are release from treatment, the other person’s insurance
company will be asking you for the medical authorization form again. You can
declined to turn it in, but you can collect the medical records yourself, review
them, exclude whichever ones you believe do not help your case, and submit the
rest (just like a lawyer would do). Most people will just sign the medical
authorization from, giving the insurance company the right to see every record
in your medical history.
The next step in a personal injury insurance claim is the
evaluation process. Once the insurance company receives all medical records and
reports, they will “compare” your injuries and treatment to similar cases in
your area and find the average jury award. Their first offer is the lowest
amount they believe a jury would award you. You can negotiate that amount to
what you believe a jury would award you.
Once there is an agreement, the insurance company will send
you a settlement of any and all claims form. Once you returned signed, they will
issue you payment and the claim will be settled. At that point, your insurance
company will be reimbursed for your medical bills.