How Do Car Insurance Claims Work?

What should you know about car insurance?

There are hundreds of options when it comes to car insurance, and what is most important is how they protect you after an accident. 

All insurance companies will pay claims for damages their insured drivers cause. The biggest differences are in what instances, how much, how fast, and how difficult it is to get a claim paid. 

Different states have different requirements for the amount of coverage drivers require, the type of coverage drivers require, and the types of coverage offered. 

Overall, the concept is the same everywhere in that a driver pays a relatively small amount each month to a company to either protect their own property if damaged or someone else’s property they may accidentally damage in an accident.

How do insurance companies work?

Vehicles are, statistically, the most dangerous thing that millions of people have. Car accidents are not an “if they happen” event but one that happens “when they happen.” It is important to keep in mind that insurance companies make billions of dollars off these premiums paid to cover the large costs of the small percentage of claims that happen. The less an insurance company pays on claims, the higher the profit percentage is for that insurance company.

What happens after a car accident?

After an accident, all the details are reported to an insurance company. There are generally two parts to an insurance claim, which are property damage and bodily injury. An adjuster will look at pictures of the damage along with quotes for fixing the car to determine whether to pay to have the vehicle repaired or if the costs of repair would exceed the cost and effort of just replacing the vehicle, which would be considered a total loss.

How do insurance companies calculate settlements and payouts?

After adjusters determine the amount for property damage, they consider the bodily injury portion of the claim. Injury settlement calculations are more complicated because they are not just about replacing material damages but compensating for injuries that are both physical and emotional. The calculations of injury claims really shouldn’t be done until it is known how much the total injury  is going to cost. It could take several months after an accident to know how much medical treatment is needed and if the accident causes anything long term, such as the inability to work, long term pain management, or any other permanent impairments that will result in a large amount of pain and suffering from a car accident settlement. 

 

woman hurt, seeking car accident injury help with a specialist

Factors Affecting Car accident settlements 

There are many factors affecting the total amount before an accident settlement is paid. Here are a few things to consider. 

Does the insurance cover bodily injury or just property damage? This determines if there is coverage that pays for injuries or just vehicles and property. Some insurance policies require you to name the driver on the policy in order for it to pay for your damages. Another factor is the policy amount, which is the maximum amount an insurance company will cover in damages. Policies will range from $0 to millions of dollars. That is why it is very important to exchange insurance policies after an accident. Sadly, many drivers are uninsured, which means if you are hit by one, you may not get any compensation unless you have uninsured motorist coverage, which is a product you can pay for to protect you in these situations. 

 

Insurance claims are most commonly paid by the at fault driver’s insurance. Just because someone admits fault to you at the scene of the accident does not mean they are taking blame. Their insurance company is the one that will be paying the claim and will try to deny or reduce the amount of fault their driver had in an accident. The amount of fault or negligence plays a large part in determining if a claim will be paid and how much. Some jurisdictions will not allow certain recoveries if you are even barely at fault for an accident, while others will pay as long as you are not 100% at fault. Most states across the country follow the rule that “the person more at fault” is the 

“at fault party” and will be responsible for paying damages.

 

You should always call the police after an accident for the sole purpose of documenting the incident. Because the details are fresh and our minds tend to forget and fill in gaps, the accident report is real-time and more accurately documents what happened. This will also prevent any “he said” or “she said“ scenarios, which is one of the biggest reasons for accident claims to be denied or dragged out with no results. 

 

Millions of car accidents result in injuries ranging from soreness to broken bones and even fatalities. The severity of the injuries determines the amount of a potential settlement. The amount of medical bills is more of a starting point for settlement negotiations. If your injuries caused you to miss work, your claim will include a component for lost wages. Also, depending on the injuries and how they impact daily life and even the enjoyment of life, they can lead to significant amounts in pain and suffering that may even be more than the medical bills incurred. 

 

It is a good idea to get checked out by a doctor after being involved in an accident. Most people don’t realize they are injured after an accident because the body releases large amounts of adrenaline to protect the body and block pain receptors. Most injuries are described as occurring while exercising and not causing pain until days later. Actual treatment depends in large part on not only whether you get a settlement but also the amount of the settlement. Pain is not a documented injury. However, visiting a doctor for the pain documents it and should also come with a diagnosis of the cause. The provider may even recommend physical therapy, chiropractic care, and/or massage therapy to help. Trying to tough out pain after an accident can hurt a claim because the length of time from an incident to the time you actually go to the doctor can make it seem like there was not an injury from the accident, and the injury may be new and is being blamed on the accident. 

 

Accident settlement offers made right after the accident tend to be low but may sound appealing. Before accepting a settlement offer, it is wise to know how much the accident is actually going to cost you in the long term. Also, there are deadlines to file accident claims, and these deadlines differ from state to state, and claim deadlines may differ based on the insurance company. Reporting of the accident should take place as soon as possible. You may be asked to provide a recorded statement to the insurance company, so be sure you know your rights before providing one.

 

common car accident injuries questions

How Does a Car Accident Settlement Work with an Attorney?

Using the same example above but instead of you talking with the insurance company, a legal professional communicates with them on your behalf. 

An accident claims attorney or injury attorney will argue the pain and suffering you have and will have experienced because of this not to mention all the future treatment you may need. The attorney can also write a letter of protection to allow you needed treatment without paying out of pocket. The providers are paid once a settlement is received and the amount of payment should be negotiated down by your attorney. 

The attorney will seek all compensation you are entitled to including lost wages and emotional distress. Even though it’s rare that a lawyer has to file a lawsuit, they have the ability to do so, which puts more pressure on an insurance company because they have to play by different rules and have to spend money to defend the lawsuit.  Also, it is helpful to know that just because a lawsuit has been filed does not mean you will have to go to court. The insurance company may settle before going to court to avoid an unknown jury awarded settlement which could be far more than what they want to pay.  

This is an illustration of what a potential settlement could look like with the help of an attorney 

 

DAMAGES:

  • Medical Bills and Treatment: $19,300
  • Lost Wages: $4,600
  • Pain & Suffering: $21,000
  • Total Gross Settlement: $44,900
    • Standard fee of ⅓ : $14,966.67
    • Payment of negotiated medical bills: $13,250
  • Total Net Settlement: $16,683.33

 

In this example, hiring an injury attorney resulted in an increase of more than $15,000 for the injured party. 

 

Benefits of Hiring an Attorney for a Car Insurance Claim

Streamlined Process – There will be far less frustration letting a personal injury attorney handle your claim.  An injury attorney and their staff are experienced and do this everyday. Most claims are paid faster and more fairly when a personal injury attorney helps with the process. 

Fights For You – A personal injury attorney knows the laws and has most likely handled thousands of cases very similar to yours. They know how to enforce your rights and will stand up to big insurance companies to make sure you get the full amount you are entitled to. 

Fees Contingent on Winning – Injury attorneys work on a contingency agreement, which means they are paid if they win your case and their payment comes from the settlement instead of your pocket. 

Larger Settlements – On average, people who hire a personal injury attorney get much larger settlement awards for their injuries and more in their pocket. 

Resources – A personal injury law firm may help with property damage claims or help you get the medical treatment you need without having to pay for the treatment out of pocket. Some personal injury attorneys will help with transportation needs as well.

 

The material on this page is provided for general informational purposes only and is not intended to serve as legal advice. For further information or to obtain legal advice, you should consult with a licensed attorney about your specific legal matter. If you need assistance in connecting with a local attorney in your area for your accident, we can help if you call or inquire.