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Negotiating a Settlement with an Insurance Company After an Injury

June 14, 2024 
by LA Injury Group

An individual who is injured through another individual’s negligence has the right to restitution. This is where insurance providers come in, allowing the injured to receive compensation. However, the entire settlement process can be overwhelming. It is therefore crucial to understand what is required before starting the negotiating process for a settlement with an insurance company. Engaging a personal injury lawyer to help in insurance settlements can provide valuable guidance and increase the chances of obtaining fair compensation.

Now, let us look at the steps necessary in negotiating with insurance companies after the involvement of an injury so as to arrive at the desired settlement.  

Understanding Insurance Settlement

The issue of opting for a settlement as opposed to going to court is a common preference. This is because court hearings are relatively slow and time consuming. It is important to understand that the outcome(s) of any negotiation results from the discussion between the victim and the insurer.

In addition, the process is budget-friendly because costs such as attorney fees as well as implied court charges do not exist.   

Another added advantage is that the aspect of privacy is withheld. Court hearings tend to publicize hearings as more people are involved. Negotiations usually keep negotiations private, between the involved parties. 

Lastly, involved parties can exercise flexibility because they can consider the relevant needs and interests. 

Negotiating with an Insurance Company After an Injury

There are important ideologies you need to adopt when dealing with an insurance company to ensure fair compensation. Below is an outline of what to do. 

• Collect all evidence 

The first step will be to collect all the evidence regarding the incident. This can be in the form of documents, photos, videos, as well as witness accounts. A medical report will also come in handy. To ensure fair compensation, you must also provide pay stubs that will indicate the loss or cut on your income. All evidence will come together to support your claim and avoid relying on mere hearsay. 

• Damage assessment 

After obtaining your evidence, you can assess the damages you suffered as a result of the accident. This step is critical because it helps to directly reflect on your dues. Therefore, ensure that you are thorough, not to leave out anything. To avoid mistakes, involve relevant experts such as doctors and financial experts. At this stage, consider economic (loss of income/monetary) as well as non-economic (mental distress, reduced quality of life, and stress) effects.   

• Understanding your insurance policy 

It is your insurer’s obligation to compensate you after an accident especially where you incurred injuries. Even at this, the insurance policy comes with terms and conditions that you adhered to. Therefore, your policy can only cover you as per the terms and conditions. Go through the policy and outline all cover limitations, any exclusion, as well as the possibility of deductibles. Also, consider the type of damages covered. For example, a cover may cover medical expenses but not property damages/loss. Others may cover lost income but not property loss. 

• Provide a demand letter 

With the help of an attorney, you will send a demand letter to your insurer. The demand letter indicates the desired amount as well as the reason(s) for the requested compensation amount. Under normal circumstances, the letter will conclude with a declaration about the consequences of failing to honor the demands, such as taking the matter to court.  

Once the insurer receives and reads the letter, they will reach out to your attorney seeking to discuss the matter at hand. 

• Initial Offer 

It is logical that the insurance company will not just pay out your requested amount from your demand letter. Instead they will also conduct a separate investigation that will determine the liability. The insurer will then “suggest” an initial offer, which indicates the amount they are initially willing to pay out. One thing you should keep in mind is that the initial offer is normally lower than what was stated in the demand letter. Your attorney will have a sit down with you to determine whether the initial offer will cover the outlined damages. 

• Open Negotiations

If the initial offer is insufficient, you should move to the negotiation stage so you can reach a reasonable amount. Present evidence and arguments to support your claim, highlighting the strength of your case and the extent of your damages.

When negotiating, be assertive yet reasonable. You should also be willing to make compromises if required.

• Settlement Agreement

Once you reach a mutual agreement, you have to sign a settlement agreement form. The document finalizes the settlement terms and often contains a release of liability. This means you agree not to seek additional legal action against the company for the damage.  It also states how the money will be paid. Some companies pay a lump sum while others offer structured payments over a certain period. 

Tips for Successful Negotiations 

1. Understand the Insurance Company 

If you decide to file a personal injury claim, always keep in mind that the provider is on the opposing side and they may want to give you the lowest amount possible. This is usually the case even if you are working with your insurer. Therefore, you should maintain your guard to get fair compensation. 

2. File the Claim As Soon As Possible

Successful personal injury claims require strong evidence. Unfortunately, many critical pieces of evidence usually start to disappear shortly after the accident. Therefore, it's essential to file the claim as soon as possible to safeguard your interests.

3. Be Patient 

Insurers rarely begin with the best offer. They normally start with an unrealistically low offer to 'anchor' the negotiations in their favor.  Sometimes you may be tempted to accept the offer since negotiating with insurance companies can be a lengthy process. 

Maintain your focus on fighting for fair compensation, and be willing to negotiate for as long as it takes to get better results. 

4. Get Everything in Writing

When negotiating with insurers, it’s important to keep everything in writing during the entire process. Ensure you take notes during in-person meetings or even phone calls and keep copies of all correspondence. This will act as evidence in case issues arise in the future. 

5. Be Professional and Courteous

Always maintain professional and pleasant behavior when dealing with insurers. Also, avoid making allegations or being combative, as they might disrupt the negotiation process.

6. Stick to Facts 

Insurance adjusters often want you to talk extensively about your accident. This way, they can pick some statements they can use against you and reduce the amount they ought to pay you. So, whenever the company’s adjuster reaches out to you, avoid giving opinions on your accident, recovery, or injuries. 

Related FAQs

Q: What will happen if I don’t agree with the insurer’s settlement offer?

A: If you're unable to achieve a mutual agreement on the compensation amount with the company, you can file a lawsuit. However, before making a decision, consider the potential expenses, time, and uncertainty associated with litigation.

Q: Can I negotiate directly with the insurance provider, or do I need an attorney?

A:You can negotiate with the provider directly or hire a personal injury attorney, depending on your preference. However, it’s advisable to seek the services of a professional to avoid issues in the future and ensure you get a fair amount.  

Q: Can I get compensated even if I was partially at fault for the accident or injury?

A: Yes. The California judicial system uses the pure comparative negligence system which allows you to get compensation even if you were partially at fault. However, the amount of compensation you receive majorly depends on your degree of involvement. 

Talk to Us

Negotiating with an insurer on your own can be stressful. A lawyer can relieve stress and increase your chances of getting a fair settlement since they have enough experience when it comes to dealing with such issues. Contact a personal injury attorney from LA Injury Group to help you navigate through the process.

References

Gabriel Sepulveda. (2020). The 5 Most Important Pieces of Evidence In a Personal Injury Case (and How to Preserve Them) Last seen 11/5/2024 @ https://www.linkedin.com/pulse/5-most-important-pieces-evidence-personal-injury-case-gabriel

Will Kenton, Chip Stapleton. (2021) Demand Letter: Definition, Purposes, Sample Contents, Legality as last seen 11/5/2024 @ https://www.investopedia.com/terms/d/demand-letter.aspDavid Goguen, Charles Crain. (2024) How Settlement Negotiation Works in an Injury Case as last seen 11/5/2024 @ https://www.nolo.com/legal-encyclopedia/how-the-negotiation-process-works-injury-case.html

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