Filing An Accident Insurance Claim

There are two types of insurance claims: first-party claims and third-party claims. A first-party claim is one that you file with your own insurance company, while a third-party claim is one that you submit with the insurance provider of another person or organization. Third parties who are harmed as a result of a holder’s conduct are usually covered by insurance.

You can choose to file a tort claim, but it’s often not necessary. If you hit someone on the street and they get injured, you would want to file a tort claim. Depending on who was at fault in the accident, the type of accident that occurred, and the level of insurance coverage available, you could submit a variety of claims.

If you were injured in any other way while on the road—for example, if a vehicle hit you or you were involved in an accident as a passenger in someone else’s car—you should file a third-party claim with the driver’s insurance company. If you were harmed while shopping at a store or dining out, you can file a third-party personal injury claim with the business’ or land/property owner’s insurance carrier. These claims cover both physical and property damage.

The Insurance Claims Process

Whether you were hurt in a vehicle, your house, a building, or a company, you should report the incident to your insurance provider as soon as feasible. Even if you weren’t at fault, reporting an automobile accident to your insurance company is a smart idea. Regardless of the site of the accident, you’ll almost certainly be asked to describe the circumstances and extent of your injuries.

After you settle your claim, the insurance company will begin an investigation. You may be required to submit photographs of the accident scene, witnesses’ names, or a more detailed description of what occurred. If the damage was caused by a condition on the premises, the claims adjuster may conduct an inspection.

The insurance carrier will send you a settlement check once it has calculated the value of your claim. You may be able to negotiate with the insurer if your claim is denied or if you believe the payment is insufficient. If negotiation isn’t an option, you can appeal the firm’s decision. An appeal may necessitate your submission to additional testing or the provision of further information and evidence regarding the accident.

Denial Of Insurance Claims And The Appeals Process

There are a number of reasons why your insurance claim may be rejected. For example, you may have delayed too long after an accident to file a claim or failed to get an independent medical examination. Alternatively, the sort of automobile accident in which you were involved might not be covered under your insurance plan.

Denial of your claim is not always the end of the road; in many situations, you’ll get notification from the insurance carrier if your claim is rejected. It’s then up to you to appeal the company’s decision. Appeal processes vary from company to company, so check with your policy for more information on how to proceed.

You may also be able to file an insurance company complaint with your state’s insurance department or a lawsuit against both the insurer and the person insured. If you want to appeal and your claim is rejected, you should definitely contact an insurance attorney.

Calculating The Value Of Insurance Claims

Medical bills and missed or lost income are usually straightforward to compute, but it’s difficult to quantify the suffering a person goes through as a result of their injury. Insurance firms have created damages algorithms in order to calculate how much money should be given to the injured for non-monetary losses like this.

The insurance claims analyst compiles a list of all of your medical expenditures first. This total is generally increased by 1.5 or 2 if the injuries aren’t too severe. This figure is used to calculate your special damages—damages with a known cost (as opposed to general damages, which do not have specified dollar amounts associated with them, e.g. emotional distress).

However, if the injuries are really serious, the whole figure may be multiplied by 5 or 10, depending on how severe they are. The value of your lost earnings is then added to the total special damages amount to arrive at your settlement. If you come up with a settlement that is less than the average fair market value of your claim, you’ll have to pay additional money towards it. You can frequently negotiate with the insurance company to get a higher payment.

Hire A Lawyer For Expert Legal Assistance

If you’re perplexed as to why your insurance claim was denied or feel that the amount of your settlement is insufficient, you should consider speaking with a lawyer. An experienced accident lawyer will be able to answer any questions you may have about your case and provide guidance on your next steps. Contact Texas Personal Injury Lawyers for a free case evaluation.

Call us at (888) 997-2148 now for you free consultation.

We take cases on a contingency fee basis and there are no costs unless we win, and the consultation is completely FREE. Contact us to learn what Texas Personal Injury Lawyers can accomplish for you.