Dealing With Insurance After a Car Accident

Insurance companies are in the business to make money. Over many years, they charge you, their insured, and thousands of other people, premiums for accident protection. These companies hope in a given year that nobody needs them and often, nobody does and they happily pocket the profits. Even when you do need them, they are not always there for you and dealing with insurance after a car accident can be a horrible experience. The bad side of the business is the insurance claims department. This is where your accident will be “adjusted.” These adjusters are very experienced and savvy. They know how to pay out as little as possible for settlement of your accident. You should always have a lawyer in your corner before speaking with an insurance company.

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Accidents are very stressful. They are a traumatic event, creating uncertainty in your daily life. Your routine is in shambles. You are on an emotional roller coaster ride and suffer from financial stress and physical limitations. The insurance company knows this. They also know that often you will try to settle the case yourself before you involve an attorney. Trying that approach at this vulnerable time, usually results in either a lowball offer or frustration in not being able to reach the insurance company.

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Once they learn of the accident, the company will usually contact you and offer you a very lowball offer hoping you don’t speak with a lawyer first and accept it. They will ask questions, take your statement, and record your every word which will be used against you later in a lawsuit as they search for any reason to deny or minimize your claim. This occurs while you have not yet even finished your medical care and treatment. During this time, you are often in extreme physical pain and emotional suffering. You face many issues when you attempt to tackle your case without an experienced personal injury attorney. The consultation with a personal injury attorney is free and once retained, will even the playing field. You have everything to gain by talking to a personal injury attorney, but everything to potentially lose by attempting to handle it on your own.

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If you don’t accept an early offer, you may not hear from the insurance company again. What should you do if the insurance company doesn’t contact you after the accident? Often, the insurance company will not contact you for several months. This can be frustrating, as you have immediate concerns on how to get your medical bills paid, your car repaired, or rent a car. The insurance company just does not immediately compensate you when you are in an accident and whether or not they compensate you at all can be seriously questioned by them if they have any reason to do so legally. Although you are the victim, you must prove your case. 

What To Do if the Insurance Company Won’t Respond After a Car Accident?

First of all, soon after an accident, an insurance company will usually contact you to try and make a quick settlement. They know that you are hurt, stressed, confused and overwhelmed. If the victim does not accept this early settlement, you will often not hear from them for a long time or they will ignore you. This is especially true with your vehicle damage.

To assist you, always take accident photos of your vehicle. Then go and get an estimate from at least two body shops. Include all receipts for updates to the vehicle.  Send all of this to the insurance adjuster. Follow up aggressively to get an offer. Usually, they will offer a number lower than the “ blue book.” Often the offer is below what you owe on the vehicle. In that case, make sure that you take out “gap insurance” to cover the difference between the offer and the bank loan balance. If you can’t settle or they don’t respond,  then you would need to sue the Defendant to recoup your full property loss. 

You need to gather all related documents of your damages from the accident. Medical records and bills, wage lost information, personal property losses, and a  determination of pain and suffering. You submit all this information to the insurance adjuster. They will review all of it and provide you with an offer. You must also contact them aggressively for a response as they often will not get back with you. In the end, if they don’t respond to your demand, then you must either let the case go or sue the Defendant in the appropriate  court of law. Remember you have time limits which must be strictly followed.

How Do You Argue With An Insurance Company

The short answer is you shouldn’t argue with an insurance company. You should hire a lawyer to represent you and negotiate with your best interest in mind. If you decide not to hire a lawyer, before you discuss your case with the insurance company, you must have proof of four key elements: duty, breach, causation, and damages. Car accident cases involve negligence. The burden of proof by a preponderance of the evidence is on you to persuade the insurance adjuster that you are entitled to compensation. If they are persuaded that their insured has liability, they should cover that liability and how that process gets resolved is a negotiation or resolved by litigation. Here’s how negligence works in general (most states have their own nuances so it depends on the State where the accident occurred). 

Duty is created by statutes, ordinances, or common law and defines how we are to conduct ourselves in society. You are driving down the street and another vehicle runs a red light and slams into you and your car. That person has breached her duty of care to you by running the red light. To show the adjuster, you will need to send her photographs of your damaged vehicle, an accident report, and any witness statements that support your position.These documents will confirm the duty and breach equation of the puzzle. Causation and damages proof, will create the last part. Here you will need to send the adjuster all your medical records and bills, wage loss letters, receipts for personal damages, and request an amount for pain and suffering.

Once all the evidence is sent, the adjuster will take time to review all the evidence you sent. At this point you can begin to discuss the case. Your attorney must be prepared to counter any issue the adjuster brings up. Professionalism with a firm approach will usually work with adjusters. Being argumentative is best used at trial while the “sugar”approach works best in pre-suit negotiations. An experienced lawyer is worth their weight in gold to negotiate on your behalf. The adjuster has to move her cases through the system and get them resolved.

What Are The Three Reasons A Claim Might Be Denied For Payment

Insurance companies deny claims all the time. Here’s a few common examples why. Especially in a fault based State like Ohio, fault may be in dispute. Either the accident was your fault or there is a dispute as to who caused the accident. In most fault based accidents,  you must either be fault free or up to no more than 50% liable. A few jurisdictions will allow you to be 99% liable for the accident allowing you to a 1% recovery. If you are totally responsible for the accident, then the insurance company will deny your claim. If partially, then they will reduce the payment by your fault percentage. If liability is disputed, then there will be no payment until the fact finder determines fault.

The person at fault may not have had insurance or a driver may have not been covered by another’s insurance. Although required, people often do not carry automobile insurance. They will give the insurance information to the police, but later realize that it has lapsed. In addition, sometimes the driver is driving the vehicle without the owner’s permission. If that happens, the insurance company will not pay on the claim. If you have uninsured coverage under your own policy, you can make a claim. If not, you have to file a complaint against the party who caused the accident. Often, however, they will not have assets to cover your damages.

There may be a dispute that the damages alleged were not caused by the accident. In an accident, you must also present evidence of your damages. Those damages must be “directly and proximately” caused by the accident. For example, prior to the accident, you were getting chiropractic treatment for a low back injury. After the accident, nothing changed as to the pain in the back nor in the scope of chiropractic treatment. In this situation, the insurance company  will not pay on the claim, as your injuries predated the accident. If, however, your back condition worsened requiring more treatment, then the insurance company  would look at your injury as an exacerbation of your prior back injury. The insurance company may also deny you payment, if the claimed injury is not related to the accident. Again as an example, the flu would not be related to an accident. Trying to make that connection, would violate the “direct and proximate” cause analysis  preventing payment.

About the Authors: Sawan & Sawan is a multi-generational, family owned law firm practicing law in the areas of car accidents, truck accidents, insurance claims, personal injury, and more. Our firm practices law in Ohio (Toledo, Columbus), Georgia, and Michigan.

DPS-1

Dennis P. Sawan

Partner

Licensed in Ohio and Georgia

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Christopher A. Sawan

Partner

Licensed in Ohio and Michigan

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