Will Insurance Cover a Personal Injury?

If you’ve ever been hurt by the negligence of another, you know how it feels to wonder if your injury will be covered by an insurance policy. This is a complicated question, and it’s difficult to answer thoroughly in general terms. As a foreword, It’s always wise to set up a free consultation with a qualified and experienced personal injury lawyer whenever you have a question about your specific matter. Having said that, here are some of the general things that you need to know if you’re wondering if insurance will cover the injuries from your personal injury matter. 

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Negligence in the Law

Insurance policies cover accidents. It’s important to remember that they don’t cover things that are done on purpose or intentionally. Because of this it’s very important to take a look at the circumstances that gave rise to your injury. Some cases are easier than others when you’re considering this. For example a driver that is texting and driving and hit your vehicle is almost certainly going to be viewed as negligent. On the other hand, someone who purposefully hit you with a vehicle is likely to be viewed as causing intentional harm and thus, may limit recovery from an insurance policy. 

When our team of lawyers seeks to establish negligence, We look to the laws definition to make this determination. At its most basic, a negligent personal injury case contains the following elements:

  1. Duty
  2. Breach
  3. Causation
  4. Damages

Establishing Duty

A duty is established by either statutory law or common law. The easiest duty to proof is one that is found in the statute for the state in which the injury occurred. For example, in Ohio it is illegal to drive in excess of the speed limit. Thus, the law will impose a duty on drivers in Ohio to remain under or at the posted speed limit. Proving that a driver that hit you was going faster than the speed limit is just one way in which you might establish a duty that was owed to you. More generally, caselaw has determined that people in society have a duty to act as a reasonably prudent person under the same or similar circumstances. What is means in any individual case will vary significantly depending on the individual characteristics of that case. But in general, the law holds that citizens of America have a duty to act reasonably to prevent harm to others. There are many factors that are considered in determining whether somebody has acted as a reasonably prudent person. These factors could include mental capacity, cognitive abilities, age and experience. 

Breach of Duty

Once a duty is established, it’s vital to prove that that duty was breached. In some circumstances proven this can be very simple. For example if individual has a duty not to speed, and there is competent evidence that the vehicle was traveling faster than the posted speed limit, then that duty can be easily and simply established. On the other hand, if you are arguing that that individual was acting unreasonably, the fact specific nature of that argument may make proving breach a bit more difficult. In general the more fact specific the argument gets, the more likely it is to require a lawsuit. Experience personal injury attorneys should be able to quickly determine whether breach or duty is going to be an issue in your particular case, and provide you with strategies to navigate around this problem. 


Causation is a legal term that refers to the natural and probable consequences of an injury accident. It exists in the law to ensure that injured victims recover for the damages caused by a breach of the duty, but nothing more. Imagine that you are in a serious car accident, and injured severely. Six months later you slipped on some ice and break your arm. Unless your lawyer is able to successfully argue that the two things are sufficiently related, causation would prevent you from recovering for the unrelated injury that occurs after the initial injury. The same thing happens when you have a pre-existing condition, such as an old back injury. In many car accidents we see exaggerations of pre-existing conditions, meaning that old injuries get worse. These can be some of the hardest cases to establish causation in, but experienced legal counsel knows how to use medical evidence to support your claim. 


Personal injury accidents caused all sorts of damage to people ranging from minimal to extremely severe. Sometimes there is a ripple effect to an injury that impacts all sorts of unexpected areas of your life. As a result the law of damages is incredibly flexible and can be used to tailor recovery to your specific set of circumstances.The law will provide for recovery of damages for things such as medical bills, pain and suffering, lost wages, loss of consortium and more. However it’s important that you work with your attorney to sufficiently document your damages and present them to the insurance company in a way that the insurance company will accept. Insurance companies tend to be very technical and formulaic, so knowing how they work isn’t valuable to ensuring that you succeed in receiving insurance coverage for your claim. 

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Dennis P. Sawan

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Christopher A. Sawan


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