If you suffered an accidental injury and someone else was to blame, you may be entitled to significant financial compensation. One way to get a check for your injuries is to go through the responsible party’s insurance company. Here is how the insurance claims process works in California.
Contact and Retain an Experienced Lawyer
The first step of the personal injury claims process happens before you even begin to work on the actual claim. Everything starts when you make a call to an experienced personal injury lawyer. This is something that you must do right after your accident, so you can have some degree of control over the claims process. Otherwise, the responsible driver’s insurance company may try to pressure you and begin the process for you.
Your Orange County personal injury lawyer will speak with you and learn more about the facts of your case and advise you of your legal options. They will answer all of your questions and ask you quite a few of their own. Once you have your initial consultation, you will sign a representation agreement that allows an attorney to represent you.
Your Lawyer Investigates the Accident
Right after you hire a lawyer, they will begin to investigate your accident and gather the evidence that you would need as part of your claim. This could include reviewing evidence from the scene of the crash and speaking with people who witnessed the claim. Before you begin the process with the insurance company, you must have proof that backs up your side of the story and shows your entitlement to the money.
At the same time, you are getting medical treatment and following all of your doctor’s recommendations. Your doctors are diagnosing your injuries and documenting your condition. Hopefully, your condition is improving. Before you file a claim, you would need to reach the point where you have achieved the maximum possible physical recovery.
Your Attorney Values Your Claim
By this point, your lawyer will have a strong idea of what your claim is possibly worth. You will need this before you begin to talk dollars with the insurance company because they will very quickly learn the value of the case from their adjusters and sophisticated computer programs. An attorney will review your medical diagnosis and how the injury has impacted the rest of your life to come up with a starting point for your claim. They will then devise a negotiation strategy for you to get as close to that number as possible.
Notice to the Insurance Company and Reservation of Rights
The actual claims process begins when you submit a notification to the insurance company that you intend to submit a claim. This allows them to begin investigating your claim themselves. They will not admit liability at this point, but they will send you a reservation of rights. This will tell you that they have begun their investigation, and they reserve the right to deny your claim. This is more of a formality, and it does not mean anything for your claim other than exactly what it says on the paper.
Issuing a Demand Letter to the Insurance Company
You will present your claim to the insurance company in a demand letter. This is where you state how much you believe that you are owed and why. The demand letter will include the facts that entitle you to financial compensation, including what happened to cause your injury and why the insured party is at fault.
In addition, the demand letter will itemize and specify your damages. You would normally wait until your medical condition is more apparent, so you can give details about your condition. This letter will break down your damages into itemized parts.
After reviewing your claim, the insurance company will do one of two things:
- They may deny your claim (ending the process and forcing you to file a lawsuit if you want financial compensation)
- They may enter into negotiations
Negotiation of Your Claim
When an insurance company negotiates, they give you their own settlement offer. Chances are that it will be for an amount far below the amount that you have requested. This is all part of the process. Their opening offer is always low because they want to allow themselves considerable room, and the insurance company also wants to test what you would accept. Do not be shocked at the amount in the offer, and know that it is always just the beginning of the process.
You can expect that your lawyer and the insurance company will exchange multiple settlement proposals throughout the process. This is how insurance companies work. You can let the process play out, or you can always take the case to court if the insurance company will not budge from their position or be reasonable in negotiations.
Settling Your Claim
At some point, the insurance company’s offer may end up in the right ballpark. Your lawyer will give you advice on whether to accept the settlement offer. If you decide to accept, you will sign an agreement. This will release the insurance company from any further liability in connection with your case. The money will go into an escrow account, and you will be paid.
If Necessary, You Can File a Lawsuit
The claims process does not always go according to plan, or the insurance company can simply dig in their heels. You are not limited to just filing a claim after your injuries. Your legal rights allow you to file a lawsuit against the responsible party for your full damages. Most cases will settle at the claims process, but this is not the end of the line for you. If you go to court, you can still negotiate for a settlement agreement right up until the end of the case. In rare cases, your lawsuit will go all the way to a jury, who will then issue their decision.
The two keys in every claims process are to contact a lawyer as soon as possible and to be patient. It takes time, and some effort, to get the compensation that you legally deserve.
