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The Role of Insurance In Personal Injury Claims [Key Insights]

By  Dan McCrary | February 28, 2024

Insurance companies are important for personal injury claims. They provide the financial support outlined in an insurance policy to compensate victims. However, obtaining this compensation involves a detailed process.

The first step is a personal injury claim must be filed then the accused party notify their insurer agent and then the investigation process comes. The investigator also known as the claims adjuster will conduct a thorough investigation and proceed with the further steps.

If the claim is valid, the insurance company will pay for the compensation. In case of a fake claim, the case will be denied. Below we’ll explain what’s the role of insurance companies in personal injury claims in more detail. Make sure to read until the end!

Role of Insurance Companies In Personal Injury Claims 

In simple terms, an insurance policy is a legal agreement where one party, the insurance company, promises compensation in case of a specific loss. This compensation can be for the policyholder or someone harmed due to the policyholder’s negligence.

Various types of insurance policies provide support for personal injuries. If someone in California is injured in a car accident, they may receive compensation through liability insurance which is necessary as per California law.

If an accident occurs on someone else’s property, such as while working, compensation will be paid from the Business and Home owner’s insurance. Similarly, individuals who are injured at their workplace will receive compensation through worker’s compensation insurance.

No matter what type of insurance is, the process for receiving claim money is typically the same. The insurance company investigates the accident upon receiving the claim request and then decides whether to deny, accept, or offer a different compensation amount.

How Do Insurance Companies Handle Personal Injury Claims?

Below you can read the steps the insurance company takes after the policyholder notifies them about the personal injury claim. The process will be supervised by the claim adjuster of the insurance companies.

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Investigation Process

The job of the claim adjuster begins with the investigation of the accident case. The claim adjuster thoroughly checks all the evidence, your statement, and the CCTV footage videos of the accident scene.

After gathering the evidence the claim adjuster may also ask you for an interview to gather your perspective on the accident. You will be asked to provide the medical bills, proof of loss of wages, and your overall financial loss.

Assessment of Compensation 

The evidence you’ve provided to the claim adjuster will help understand the seriousness of the accident and how much you’ve suffered. Then they’ll assess a compensation amount according to their policy and the case details. 

It’s important to be aware that sometimes insurance companies try to shift blame onto the victim, undermining their confidence in the case. If you find yourself in this situation, it’s advisable to seek legal representation from a personal injury lawyer to negotiate on your behalf.

The Decision For The Claim

In the last step, the insurance company makes a decision regarding the validity of your personal injury claim. Upon confirming the legitimacy of your claim, they will compensate you for your losses or deny the claim.  

If you think the insurance company did an injustice by denying your claim you have the right to appeal. In case the appeal is unsuccessful, you can take the case to court. In court, a judge will determine responsibility for the accident and whether your claim is justified.

3 Proven Tips To EnSure You Receive Rightful Compensation

Here are a few tips that we suggest the injury victims follow to receive rightful compensation. By following the tips you can increase the likelihood of receiving the fair compensation you deserve for the personal injury claim.

  • Document Your Case: Timely documentation of the accident is a crucial point. It’s best to complete this task within 24 hours of the incident, as evidence from the accident scene can quickly vanish over time. 
  • Keep Records of Your Financial Loss: You should always keep records of your finances. The evidence that can be used to prove loss are hospital bills, proof of lost wages, damage to your vehicle or property, and other related expenses.
  • Don’t Accept Early Offers: It’s common for insurance companies to offer lower settlements after investigating the case. You should not accept these early offers without consulting the case with an experienced lawyer.

Insurance Company Role In Personal Injury Claim: Final Thoughts

The role of insurance companies in personal injury claims is crucial as they pay the compensation on behalf of the responsible party. The responsible party informs their respective insurance company about the claim upon receiving the legal notice.

Afterward, a claim adjuster of the insurance company investigates the accident case to find out who is at fault. If their insurance policyholder proves to be responsible they pay for the loss or offer another compensation amount.

However, there's a third scenario where the insurer may deny the personal injury claim due to insufficient evidence against the responsible party. In such cases, the personal injury case typically goes to court for a final decision

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    McCrary Accident Injury Law Firm specializes in personal injury litigation. Its founder, Dan McCrary, Esq., spent 14 years working for the insurance companies before switching sides to represent personal injury victims in Rocklin as an attorney.

    Dan McCrary’s years of experience on the defense side taught him exactly how to obtain maximum recovery for his injured clients. If you have been injured in an accident you should contact the Accident & Injury Lawyers, Personal injury Attorney, Car accident lawyers at McCrary Accident Injury Law Firm in Rocklin, folsom, Sacramento to get the money you deserve, and overcome the tactics routinely employed by the insurance companies.