Insurance often plays a significant role in personal injury litigation.

The insured pays a premium to the insurance company to protect them from the costs of liability in case of an accident. If there is an accident, the insurance company will pay at least a portion of the costs of the liability. Because most drivers, property owners and business owners buy insurance to protect themselves from the costs of liability, an insurance company will often be responsible for compensating the injured party.

Keep in mind that insurance companies are driven by the bottom line to make money, not to fairly compensate injured parties. They are experts at manipulating the law will create a situation which reduces the amount of money they must pay. Insurance companies will not hesitate to pressure an injured person to settle a case prematurely for less than the injured legally deserves. It is to the advantage of any claimant to be represented by a lawyer familiar with personal injury law and experienced in dealing with insurance companies.

What Is the Typical Process an Insurance Company Uses to Evaluate a Claim?

Procedures for evaluating a claim will differ from insurance company to insurance company. However, the simplest formula involves coverage, liability, and damages.

  1. The insurance company will determine whether the claim is covered. Most insurance companies will start by looking for a way out of covering the claim. The most common ways are determining whether the accident is a type which is covered by the insurance For example, an insurance company which provides automobile insurance may not cover a pedestrian accident.
  2. The insurance company will determine who is liable for the accident. This will often affect how much the insurance company feels it is obligated to pay and whether the insurance company should contact the other injured party about payment. It is at this stage that lawsuits are filed to determine the person responsible for the accident.
  3. The insurance company will determine a dollar amount for the damages. Medical expenses, liability, and property damage are among the factors that an insurance company will consider if it has to pay the insured. Usually this amount will be lower than what the insured expected because the insurance company will be putting the lowest price tag possible on each injury. For instance, an insurance company might pay only $1,000 for a medical bill. If the insured signs the agreement for $1,000, but the medical bill turns out to be $5,000, the insured is both expected and legally obligated to pay the remaining $4,000.

How Would an Insurance Company Behave If Faced with a Lawsuit?

At the point of litigation, an insurance company’s primary goal is to reduce the amount that they must pay to the injured party. To achieve this goal an insurance company will attempt to minimize the liability of the insured by attempting to shift the fault and liability back on to the injured party or onto a third party. Insurance companies may also attempt to settle a case for significantly less than it might be worth if the case had gone to trial.

Should I Use My Insurance Company’s Lawyers If the Other Party Is Suing Me?

This is a personal decision. However, be forewarned though that any lawyers from the insurance company will be working for the insurance company, not for you. Many states, like Texas, have laws which forbid a party from suing the other party’s insurance company, the other party has no choice but to sue the other person involved in the accident.

In these states, the insurance companies will protect their own clients as part of the policy agreement. However, the insurance lawyers usually leave the actual parties responsible for paying any fees which exceed the policy limit. If the accident was severe, the fees could easily be above the policy limit. Thus, it might be prudent to have your own lawyers working on the case rather than relying on attorneys provided by the insurance company.

What Should I Do If the Insurance Company Calls or Contacts Me?

If an insurance company contacts you, do not give them any specifics about the accident or your injuries, do not sign anything, and avoid the urge to settle quickly – you may not yet know what your claim is worth. You, or your lawyer, may need to give more specific information about the accident later on in the process. However, in the initial contact with an insurance company you should only give basic personal information such as your name and address.

Do I Need a Lawyer?

Despite the charming advertisements on television, insurance companies are working for themselves and not for the people they insure. Insurance companies have armies of attorneys dedicated to finding loopholes in contracts. A personal injury attorney will protect your rights and ensure that you get the maximum amount that your policy is worth.