If you or a loved one is involved in a motor vehicle accident, or another type of injury claim, you want to focus on your injury and healing process. However, it is important for you to understand the general procedures involved in the claims process.
The Early Stages
First, claims are not resolved overnight, nor is it usually possible for a lawyer to determine what your case will settle for when your injury first happens. This occurs for a number of reasons. If your injury is recent or ongoing, then you are likely still receiving treatment from your healthcare providers. Because the value of many personal injury claims are loosely based off of your treatment, and the amount of your medical bills, the value of your case is difficult to determine when your treatment is ongoing, especially if it is unclear when you will finish treatment and what your total bills amount to.
For these reasons, you have to be patient. Many clients say they just want to “settle” or “get it over with.” However, if you contact a lawyer to assist with your injury claim, part of your lawyer’s job is to get you the best result possible given the specific circumstances surrounding your claim. Settling early generally does not yield positive results. Oftentimes, the claim is settled for less than it is worth. Importantly though, this is not always the case. Talk with your lawyer about your expectations so that you both can be on the same page about your claim’s value, and the length of time it will take to resolve your claim.
Insurance companies do not pay money willingly. This is even true of your own insurance company. The insurance adjuster will thoroughly investigate the facts of the accident, the medical treatment involved, and any past injuries or claims that you may have had, even if you believe they are unrelated to the current case. The insurance company may also want to obtain of your past medical records.
Importantly, always tell your lawyer about any prior injury or prior pain to any parts of your body. Many good cases are lost by the injured person concealing or forgetting a previous injury.
It is also extremely important to let your attorney know of each and every location you went to for treatment. Failure to do so can result in a delay in settling your case, or even settling the case for a lower value than your case is actually worth.
When you are injured and file a claim, one of the first things an insurance adjuster will do is look you up on the internet. DO NOT TALK ABOUT YOUR INJURY OR ACCIDENT ON THE INTERNET. To learn more about this, read my post here.
The Settlement Process
Normally, your attorney will wait until you are done treating with all medical providers before ordering your bills and records. The attorney will collect all of the medical bills and records, along with any wage loss information, and other documented damages. If liability is clear, the attorney will usually submit a “demand” to the insurance company. A demand initiates the negotiation process with the claims adjuster in an attempt to resolve your case. There is little to be done settlement-wise until this point. The insurance companies will only pay out once for your injuries and damages, and it is therefore important to have all information regarding your injuries so that the insurance companies have all the information regarding your claim.
After submitting a demand to the insurance companies outlining out position, it is normal to not hear back from them for several weeks. Oftentimes, based on the amount demanded, the insurance company will assign a new adjuster to the claim who has higher settlement authority. Unfortunately, this means that it oftentimes takes additional time than expected to receive a response from the insurance carrier.
In response to the demand, the insurance company will either reject your demand for settlement entirely, or submit an offer of settlement. If the insurance company rejects the demand, or makes an offer that, after discussion with you, you and your attorney find unacceptable, your attorney may file a lawsuit against the defendant.
Going to Court – A Lawsuit
Filing a lawsuit in court and entering into litigation is a very long process. Once the lawsuit is filed, a copy of the lawsuit is given to the attorney’s process server, who must personally serve the defendant (the party/ies that caused your injury) with the lawsuit. Once this happens, a phase of litigation called “discovery” occurs. This is essentially the question and answer portion of the lawsuit. It involves both sides asking written questions and obtaining written responses under oath.
Generally, discovery will also involve the defense attorney taking your deposition, which is your in person, sworn testimony about the accident, your treatment, and other questions. The deposition is generally located in the defense attorney’s office. Your attorney will be there as well, along with a court reporter who types everything that is said during the deposition. Importantly, your deposition is also under oath, meaning you must tell the truth. The deposition is also a chance for the defense to observe your character and credibility, and whether you will make a believable witness should your case proceed to trial.
After discovery is completed, there may be several more hearings where your attendance may be required in an attempt to settle your case. These could include an arbitration, mediation or other type of settlement conference.
Most cases are resolved prior to trial. In fact, 95% of cases are resolved before trial. Assuming your case is in fact resolved before trial, that is not necessarily the end of the process. After settling your case, there may be liens or outstanding medical bills to be paid. Some bills involve both the attorney and client being responsible for the lien, meaning there is a guarantee the lien is paid out of the settlement. Other times, there is a clause in your insurance policy requiring some reimbursement of medical payments coverage, or there is a law dictating that there is reimbursement owed to coverages such as Medi-Cal or Medicare. This means that a portion of your settlement must be reimbursed to these entities.
Some claims are resolved in a matter of months, some take years after the lawsuit is filed to get settled. This slow process can be understandably frustrating.
Jokes and Zootopia aside, if you develop needs that are time sensitive, be sure to communicate that with your lawyer. It’s perfectly understandable that you may have outstanding bills or can’t go to work. These delays can and do take their toll on your daily life.
It is vital that you and your attorney have an open line of communication about your expectations and needs. Being clear from the start about what is expected of you as a client, and what you expect of your attorney will assist in resolving your case down the road.
Feel free to reach out. You’ll hear back from me personally within 24 hours, if not less.
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Phone: (415) 523-0302. Extension 707.
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