Claim

A “claim” is the act of putting forth a request for compensation as a remedy for damages. The term commonly refers to insurance claims or legal claims.

Everyone is familiar with the phrase “file an insurance claim.” Bringing forth a claim is the standard course of action whenever someone suffers an accident, property damage, or other losses.

Unfortunately, many insurance companies employ dishonest tactics to deny valid claims or underpay claimants. A bad-faith insurance lawyer can help resolve these situations. 

What Is a Legal Claim?

A legal claim is a formal request for reparations after suffering damage or loss. In the context of personal injury law, this usually means seeking compensation after an accident.

Depending on the accident’s circumstances and state laws, the injured person may file a claim against their own insurer or against the insurance company of whoever is at fault for the accident.

Claim vs. Lawsuit

While some people use the terms “claim” and “lawsuit” interchangeably, there’s a major difference between the two. A claim is a demand for an insurer to issue a settlement. A lawsuit is a legal action that passes through court, in which the injured party (the plaintiff) sues the allegedly responsible party (the defendant). 

An injured person may sue an insurance company that acts in bad faith and refuses to offer fair compensation. However, claims are usually settled through negotiations with the insurer. A lawsuit may also be an option if the at-fault party’s policy isn’t enough to cover the victim’s losses.

Available Compensation for Accident Victims

The compensation an injured person can claim depends on various elements, including the amount of losses, the at-fault party’s coverage limit, and any share of blame the victim had in the accident. In general, settlements may cover the following:

• Medical costs, such as hospitalization, surgery, rehabilitation, prescription meds, and prospective long-term care
• Lost wages, including missed days at work and an estimate of the wages the victim could have earned if not for the accident
• Property damage, like vehicle repair costs
• Non-economic damages, like physical pain, emotional trauma, and loss of enjoyment of life

The Steps of a Personal Injury Claim

An injured person may choose to handle their claim themself or hire a lawyer. The latter is highly advisable when dealing with a large claim after a serious accident. Insurance companies have many tricks up their sleeve to dispute a claim or reduce a settlement. Personal injury lawyers know how insurance claims work and how to protect clients’ interests when dealing with them.

The typical process of an insurance claim is as follows:

Determining Liability

The first step personal injury lawyers take is determining who is responsible for compensating the victim. In many cases, liability isn’t obvious or may be split between two or more sides. For example, several drivers may be responsible for a chain car accident involving multiple vehicles.

Personal injury claims are usually negligence-based. Proving negligence involves showing that:

• The at-fault party owed the victim a duty of care. For instance, a driver should exercise reasonable caution on the road, and a property owner must keep their premises safe.
• The at-fault party breached this duty, either by acting or failing to act.
• The breach of duty led to the victim’s accident and caused tangible damage.

Gathering Evidence

The accident victim and their lawyer must present solid evidence to prove negligence. This may include a police report, photos from the accident scene, dash cam or security camera footage, witness statements, and more.

A lawyer will review the client’s evidence and assess whether it’s enough to establish a viable claim. Professional testimony by a forensic consultant or an accident reconstructionist can tip the scales in complex cases.

Calculating Damages

Once it’s clear who’s responsible for compensating the victim, the next step involves calculating all eligible losses. This may take a while after a severe injury, as it may not be immediately clear how much the victim can expect to recover and what medical care they’ll likely need in the future.

The calculation of damages should include everything from medical bills to the household help the claimant had to hire to help with routine chores. Pain and suffering will also factor into the settlement.

Demand Letter and Negotiations

The injured person’s lawyer will send an official demand letter to the insurance company, listing their client’s losses and presenting a request for compensation. The insurer may comply with the demand, deny it outright, or offer a lower settlement. The last option is more common.

What usually follows is a negotiation process between the injured party’s lawyer and the insurance company. The insurer may try to downplay the extent of the victim’s damages, like the loss of their earning capacity or the prospective medical care they’ll likely need in the future.

Deciding Whether To Proceed With a Lawsuit

At some point, the claimant must decide whether to accept the insurance company’s offer or file a lawsuit. The accident victim’s lawyer will inform the client whether litigation will likely produce a favorable outcome. It’s also possible to file a lawsuit against a third party in addition to the insurance claim.

If the injured person decides to move forward with a lawsuit, their lawyer will handle the legal filing and the court process. The two sides may still settle their dispute at any point before trial.

If a trial occurs, the lawyer will represent the victim in court, present the evidence, and dispute claims from the opposing party. The victim may not need to do much other than be present at the trial.

About the Company

Accident Hotline is a nationwide service that helps people who have suffered accidents connect with vetted local lawyers. With Accident Hotline, finding an attorney who can handle your insurance claim and protect your rights is quick and easy. The platform offers 24/7 assistance, no-cost case evaluations, and a seamless live chat feature.

Call (844) 343-9609 or fill out a brief online form for a free consultation.