CAR ACCIDENT CLAIMS. START TO FINISH. A BRIEF OVERVIEW

INTRO:

When you are injured in a car accident, you enter the maze of the insurance industry, which for many is complex and new.   This article outlines generally what happens in a car wreck case from start to finish.  The same general principles applies to motorcycle crashes, passenger car cases, boating accidents, ATV accidents and dog bite cases.

BEFORE THE CAR ACCIDENT:
Proper insurance levels to protect your personal assets in case you hurt someone, or in case you are hurt, and the other person has a low insurance policy is important.  A $25,000 liability policy does not go very far when you are seriously hurt.  Nor does a $50,000 underinsured policy.  If you have the financial resources, you should have high insurance policies.  It protects you, your family and your assets.  I recommend a non-captive insurance agent to purchase your insurance needs from because they are not bound by one company, but can draw different insurance products from different insurance carriers, tailoring the product to your insurance needs.  State Farm, Bear River, AllState are examples of insurance sales agents who are captive and can only sell that brand of insurance products.

THE CAR ACCIDENT:

When a car accident occurs, you are not expecting it and you probably just bought a new car.   The first thing to get is good medical care as the situation dictates.  Overreacting is better than underreacting when deciding which type of medical care you should receive.  When in doubt, seek care.  You only have one body in this life and there is no reason not to seek medical care, especially when Personal Injury Protection benefits are a part of every single Utah car insurance policy.

MEDICAL CARE:

As mentioned, after a wreck, seek medical care.  So many people do not have medical insurance in today’s world, but every Utah car policy of insurance does have at least $3,000 in PIP protection benefits.  You paid for the PIP, it is a part of your insurance policy, you should use it.  Don’t worry who is at fault, because PIP is no-fault insurance, where fault does not matter.  One a side note, you should call your insurance agent and up your PIP to $10,000.  It is cheap health insurance and well worth the small premium increase.

MAXIMUM MEDICAL IMPROVEMENT (“MMI”):

After the car collision, you will enter the treatment phase of your personal injury insurance claim.  This is where the health care professionals take over the medical treatment portion of your case.  These providers could be ER physicians, chiropractic physicians, physical therapists, and psychologists to name a few.   This course of treatment could last four months, or one year.  And in some cases, the medical treatment could be for the rest of the injured party’s life. In these circumstances good, experienced personal injury attorneys will bring in a life care planner to map out an injured party’s future medical needs for the rest of their lives.  This could tally into the millions for amputees, and brain injured individuals.

Once an individual reaches MMI, an insurance claim can be pursued for compensation.  Experienced personal injury attorneys always wait to settle a client’s claim to ensure the attorney has an understanding of what the client’s injuries are.

Reaching MMI can take time, but it is well worth the time because the doctors and your personal injury attorney will fully understand what injuries they are dealing with.  This is one reason why car accident cases not involving special circumstances have a four year statute of limitations.   Because injuries take time to heal.

EXPERTS:

Using the right expert witness matters.  Not using an expert witness can be fatal.  There are times when you do not have to use an expert witness and you can still get your case to the jury.  But those cases are the exceptions.  An example of the exception is where your arm was cut off in an accident.  It is pretty clear you had an arm before the collision and now you do not.  No expert will be needed to show that the car accident caused your injuries.   This clear cut case is contrasted against a back injury where you were hurt from the car wreck, but you had a pre-existing back injury that was present prior to the collision.  Here, without a medical doctor pulling apart your pre-existing injuries from your new injuries, the case will be thrown out for failure to provide competent expert witness testimony as to what caused the injuries.

There are many different types of experts.  Some are treating doctors, some are chiropractic physicians, and others are physical therapists. Outside the medical realm, there are accident reconstructionists, life care planners and economists that all project and measure your future damages over your expected life span.  These experts that measure future damages and injuries are very powerful in personal injury cases that have future medical costs.

Sometimes expert witnesses are used before the lawsuit is filed to demonstrate to the insurance adjuster the extent of a person’s injuries.  Other times, they are retained during the lawsuit process.  Experts can be your treating doctors, or specifically retained to give an independent medical opinion on what caused your injuries.

Whatever experts you are using, let it be clear they are expensive.  Not every attorney has the financial ability to hire, retain and front these expert witness costs.  In small cases, experts cost $5,000 to go to trial.  In larger cases, they can cost $100,000.  It is vital to know that your attorney has the financial ability to hire good experts.   Your claim will be compromised otherwise.  This ability to carry expert and cases costs is a major distinguisher when choosing a personal injury attorney.  Attorney Jacob S. Gunter and his law firm of Howard Lewis & Petersen, PC have a war chest, and use when needed to obtain the best compensation for their clients.

THE CLAIM PROCESS:

The claims process is the formal adjudication and negotiation of insurance disputes.  Example, Pedestrian Pete is hit by a car.  It is pretty clear that Pete the pedestrian was hurt by no fault of his own.  The real question is what the extent of his physical injuries are.  To Pedestrian Pete this injury can be very traumatic, but to the insurance company who insures the car that hit Pedestrian Pete, it may feel the case is much smaller.  These types of disputes as to value arise all the time. American insurance companies are constantly adjudicating claims.  These claims can be wage loss, coverage, or property damage claims to name a few.

Here are the players in the insurance claims world.

(1)  The injured party’s attorney.  The plaintiff’s lawyer, or personal injury attorney represents the injured party and ensures that the injured party gets a fair shake.  The insurance companies know when an injured party has hired a good, experienced personal injury attorney, or an attorney who really does not practice in personal injury, just dabbles.  Each of these attorneys is treated differently.

(2)  The injured party.   The plaintiff, or injured party, is often not able to work, and is in the dark about the insurance world.  They are initially contacted by the insurance company after a car accident and they often times do not understand who is on their side and who is not. They also do not often see the big picture on how to handle the case.

(3).  The bodily injury adjuster.    These adjusters work for the other side.  For the insurance carrier they work for, they value the bodily injury and attempt to negotiate the claim with the personal injury attorneys.

(4).  The medical pay adjuster.   These adjusters generally work for your insurance company and in Utah they are sometimes called PIP adjusters.  Some insurance company combine the bodily injury adjuster with the PIP and property claim adjuster.  Other carriers split out these functions.

(5).  The property claim adjuster.   These are the people that value the amount of property damage caused to your car, or the fence you hit while trying to avoid the collision.

(6).  The coverage adjuster.  These adjusters will analyze the insurance contract to determine if the insurance carrier must provide coverage for the loss asserted.    Coverage adjusters are not always used in car accident cases.

(7).  The insurance defense attorney.  When a lawsuit is filed, these lawyers will make an appearance on behalf of the insurance carrier and the insured.  Representing both the insurance carrier and the insured is called the TriParte relationship.  Sometimes these lawyers are consulted prior to a lawsuit being filed, but most of the time they only appear after a lawsuit has been filed and not during the insurance claims process.  Insurance defense attorneys can be in-house, where they are a separate department of State Farm, or AllState, as Utah currently does it, or can be privately retained counsel.

CONCLUSION:

If the personal injury claim is settled pre-litigation, or without the need to file a lawsuit, the case is over and the injured party receives compensation for their injuries.  You must settled the case or file a lawsuit before the applicable statute of limitations runs.  If the parties still dispute the value of the case, and negotiations fail, a lawsuit must be filed.

The process and timelines of a lawsuit will be covered in another blog post.

The takeaway here is that an insurance claim prelitgation takes time and a proper workup, or the injured party’s claims may be devalued.  Having an experienced attorney who has seen countless injury cases is important to steer the ship forward and reach fair compensation.

Call Attorney Jacob S. Gunter at (385) 269-9504 for a free personal injury case evaluation.  Jacob S. Gunter is a trial lawyer at Howard Lewis & Petersen, PC.  See www.gunterinjurylaw.com.   www.provolawyers.com.