When you are injured in an accident, your first concern is to heal from your injuries.
But a second concern is often a financial one - how to pay outstanding medical bills, or manage without your paycheck when you are taken off work due to an injury.
It's important to wait until your injuries have healed or stabilized, before settling your injury claim. This is the only way to get a full and complete picture of what your injuries and costs are, related to the accident. Once you are healed, your attorney will gather the needed documentation and send a settlement demand letter to the insurance company.
This article will discuss the facts of the loss, liability (fault) of the respective parties, your injuries and treatment. It will also contain a specific, monetary demand to resolve the case. This demand amount is a "ceiling" - a high number that is not expected as a settlement amount. Rather, it is a starting point for negotiations.
Note: It can take a month or more to gather the records from your providers. You can help to speed this process by keeping your attorney informed of all medical providers and treatments. Let your attorney know immediately when you are done with your treatment so the records can be ordered. If you have lost time from work, let your attorney know so proof can be requested from your employer. If wage loss is significant, or you work on commission or are self-employed, you will be asked to provide your tax returns.
The adjuster will usually need at least 30 days to review the demand. She will review all of the documentation and attempt to gain an understanding of your injuries and how you have been affected. She will look at the facts of the accident and the fault of the parties, as well as records from any prior injuries or pre-existing conditions you may have. She will look at the vehicle damage, review the parties' statements and police report. After that, the adjuster will assign a settlement value to your claim. For more information on how this value is reached, see the article "How do Adjusters Value Claims?".
The settlement value will cover both your special and general damages. Special damages, or "specials" are out-of- pocket costs that can be proven, such as medical expenses, prescription costs, lost wages, loss of earning capacity and the cost of repairing or replacing property. These can be proven with copies of bills and receipts.
General damages are harder to put into numbers. Though commonly referred to as "pain and suffering"; they cover much more than that. Examples include pain, suffering, embarrassment, loss of enjoyment of life, disability, permanent injury, disfigurement and scars.
Once a value is determined, the adjuster will call your attorney to start negotiations, usually with a counteroffer. Each party will make arguments to support their case. Your attorney will point to the fault of the other party, the nature and extent of your injuries, and the reasonableness and necessity of your medical care. The adjuster will argue any comparative fault (fault they place on you) as well as any perceived weaknesses in your case, such as excessive treatment or pre-existing conditions. There is always something to discuss on both sides of the argument.
Sometimes the counteroffer is much lower than expected or fair. These are called "lowball" offers. If an adjuster is unreasonable and unwilling to pay what your attorney feels the case is worth, he may have to file a lawsuit on your behalf. But in many cases, the adjuster will make a workable starting offer. Your attorney will communicate these offers to you, and get authority from you on a settlement value as the negotiations proceed.
When you have reached a settlement amount that is acceptable to you, then the case will be resolved. The insurance company will send release forms that must be signed before the settlement check is issued. The release concludes the case and states that the insurance company and their insured have no further liability to you. A signed release will be exchanged for the settlement check, which will then be processed and distributed by your attorney.
Remember that adjusters are often expert negotiators, whose job is to pay as little as possible to settle claims for their company. They deal with hundreds of claims every year, while most of us only have one or two claims in our entire lives. It's important to have an expert on your side. Attorney James Sellers is an established professional with many years of experience battling insurance companies. Let him fight for you!