Starting a Claim with the Insurance Company
After an accident, you return home from the scene or the hospital and ask yourself "What do I do now?" You have a couple of options. You can call an attorney to help you (see How to Choose an Injury Attorney), or you can try and figure out how to get started on the claim yourself. Assuming you chose to get moving yourself, you must first contact the at-fault party's insurance company and report the claim. You first must have the name of the responsible driver and the name of his or her insurance company. Hopefully, you also have the policy number, which makes things go much easier. All of this information is usually obtained at the accident scene, assuming all the parties are not in need of medical transport to a hospital. If you don't get the basic information at the scene (also, some people refuse to give it or they give the wrong information), then the best place to obtain it is from the police report if one was done by the local police. Police reports can usually be obtained a few days after the accident, and sometimes you can call and get the information from the police department even if the report is not final (see Obtaining a Police Report). But what if a report was not done and for whatever reason you didn't get the other driver's insurance information? Then you must locate the other driver and request the information. At my law office, I have an in-house investigator who routinely pursues and locates insurance information. Most numbers for the insurance companies are easy to find on the internet, but I have compiled a listing of Insurance Company Phone Numbers. When you call the claim in, be ready for a long call as lots of questions are asked. At my law office, we make these calls ourselves and take this burden off of the client. During this initial call, you should receive a claim number and establish an expectation of when you should hear back from an adjuster. You must stay on top of this and continue to call if you don't hear back in the time frame quoted. Oftentimes it's the squeaky wheel that gets the attention. At the beginning of an insurance claim, there are a few main things that arise. Please read about the following issues before you proceed forward on your own: Getting medical treatment- not always so easy Giving a recorded statement to the insurance company- hold on, read this first Property Damage- getting your car repaired or replaced Rental Car Issues- can be very frustrating
Giving a Recorded Statement
After the initial claim is filed, a request often comes for a recorded statement, usually before the property damage is resolved. This recorded statement is used to help the insurance company adjuster determine if they are going to accept responsibility for the accident. Is your recorded statement important? You bet it is. Anything you say can either help or hurt your claim. I sincerely believe that you should not give a recorded statement without advice and guidance from a Board Certified Personal Injury attorney. Time and time again, I have seen accident victims hurt their case early on by giving recorded statements on their own. The adjuster who is asking the questions is a trained professional who knows how to ask questions and knows how to try to solicit information which will help his
employer (the big insurance company) save money. After all, the insurance company is in the business of making money and the less they pay you, the more money they make. Do you really think the insurance adjuster is watching out for your best interest? These statements sometimes take only a few minutes, but sometimes they are very detailed and last much longer. The adjuster usually asks about the accident and your injuries, which sounds reasonable. But they oftentimes follow scripts written in a manner to ask the same question different ways. I personally think some of the questions are very tricky and an injured person should be very careful on how they answer it. If I am hired and my client has already given a recorded statement, the first thing I do when I give the insurance company notice that I have been retained is to request a copy of the recorded statement (You have a right to get a copy). I am always anxious to see what was said in the statement.
Damages Recoverable in an Accident Case
If you have been hurt in a wreck, you are initially focused on your injuries. Soon, however, the bills start arriving and reality sets in. Why should you be in pain and be out considerable money--all as a result of someone else's mistake? The answer is you shouldn't be out at all. In order to make things right, you must pursue a claim and attempt to recover what is due to you. In Texas, the law allows you to recover compensation for the following damages relating to your bodily injury: 1. Medical Bills--This includes everything related to the accident (hospital, surgery, physical therapy, medical equipment, doctors, chiropractic, pharmacy, etc.). 2. Future Medical Bills--it will be necessary for a doctor to support the need for any future medical treatment. 3. Pain and Suffering--all of the physical pain you experience as a result of your injuries is an important part of the recoverable damages. 4. Lost Wages--whether self-employed, hourly or salaried, they are recoverable. 5. Loss earning capacity--these are the wages or salary you are likely to lose in the future due to your injuries. 6. Disfigurement--this includes results like scaring or other physical changes. 7. Impairment--if your life or activities have been impaired due to your injuries. 8. Loss of consortium--this applies when the injuries have affected the private relations of a couple.
Your Own Insurance Policy
It is mandatory under Texas law that all car, truck and motorcycle owners carry at least the minimum amount of liability insurance coverage. The current state law requires that each owner have at least $25,000 in liability coverage per person and $50,000 in coverage per accident. This type of insurance is used to compensate others if you are at fault in the accident. But, let's say you are in an automobile accident where the other driver is at fault. What sort of insurance applies to compensate you for your injuries? If you are lucky enough that the at-fault driver has liability insurance coverage, then that is the first place you look for compensation. The Texas Department of
Public Safety has estimated that 20% of the drivers on our Texas roads do not carry insurance at all. (I personally think that the number of uninsured drivers is actually higher). So what happens if the at-fault driver has no insurance? As a board-certified injury lawyer, there are several questions I ask next. What was the driver doing at the time of the wreck? Was the driver in someone else's car? What's the driver on the job at the time of the accident? Sometime I find an insurance policy that applies, but lots of times I strike out. Then what? If there is no additional insurance, I then look at your own insurance policy to see if you carry "uninsured/underinsured motorists" coverage (called "UM/UIM"). This is a type of insurance that you pay for and it covers you in case you were in an accident where someone else is at fault and they don't have insurance. This type of insurance also applies when the other person does not have enough insurance to fairly compensate you. In such a case, you stack your underinsured motors policy on top of the at-fault driver's policy to come up the total amount of available insurance to compensate you for your injuries. You must sign a waiver when you first obtain your policy to deny this type of coverage, otherwise you have the coverage. Another type of coverage which may be applicable is PIP, which stands for Personal Injury Protection. This covers your own medical bills and lost wages and is paid to you regardless of who was at fault. It covers everyone in your car at the time of the wreck. In Texas, PIP is available in amounts from $2,500 to $100,000 depending on the insurance company. This type of insurance comes in very handy if you are in an accident, even if you have health insurance (and, believe it or not, some health carrier's do not cover bills if the treatment is related to a car accident). You can make a claim on your PIP regardless of whether the at-fault driver has insurance. I recommend that all of my clients purchase this insurance. Sometimes my clients don't want to make a PIP claim as they are afraid that their rates will go up. By law, Texas insurers cannot raise your rates solely because of a PIP claim. I have never heard that making a PIP claim has this effect, so I always encourage my clients to let me make the claim on their behalf. The way I see it, the big fat insurance companies take your money year after year--let them pay you when you have valid claim.
New State-Wide Policy on Verifying Uninsured Drivers
Starting in June 2008, Texas started implementing a computer database in all of its law enforcement cruisers, which will allow officers to verify drivers’ insurance on-scene. This will basically eliminate the chance for uninsured drivers to avoid a costly ticket simply by presenting the police officer with a fake or expired insurance card. This is good news for those of you who buy insurance, and bad news if you are (illegally) uninsured. The purpose of the new technology is to encourage those uninsured motorists to obtain the proper coverage. Being caught without insurance could result in a maximum fine of $350 and repeat-offenders could lose their license for up to two years. Approximately 20 percent of drivers are driving around uninsured. According to Texas law, $25,000 is required per injured person for liability insurance and that same number is required for property damage. Additionally, up to $50,000 is required by law for everyone injured in an accident. Although the program is new, more than 200 insurance companies have jumped on board, giving information to law enforcement about policyholders for the verification system. This number will no doubt increase as the new system starts to take effect.
Settlement or Litigation
Many auto accident claims can be resolved without the need of filing a lawsuit. These are generally where the accident facts are clear and the extent and nature of the injuries is not in question. The general process is for the client to finish treating and for the attorney to assemble all of the relevant evidence, including all of the bills and records from the treatment, and put the insurance company on demand to resolve the case. Usually about two weeks to a month later, the insurance company will respond with an offer and a decision will need to be made. Sometimes the answer is easy. However, other times a very detailed analysis needs to be conducted before a decision is made on whether to accept the settlement offer or file a lawsuit. Part of my job is to offer advice and guidance as to this decision. If the injured party decides to settle the case, the settlement check will soon arrive and a release will be signed. Once the release is signed, the claim is over for good and there can be no reopening of the claim if the injured person’s condition worsens in the future. If an injured party is handling the claim on his own, then he or she must be very careful not to settle the case too soon. A settlement is a final and permanent decision. If a lawsuit needs to be filed, then it clearly takes longer to resolve the claim. I try to set most cases for trial as soon as possible, and the trial date is what tends to get the insurance company ready to resolve the claim. If the other driver’s insurance company doesn’t offer enough compensation for my client, then it is a matter of waiting until the Judge calls the case for trial. Lots of factors come into play as far as how long will a case take to resolve, such as the need for expert witnesses and the complexity of the individual case.