Legalese — Auto Accident Insurance Claims — Part Two

accidentLast week, I wrote about property damage claims in an auto accident. As promised, this week, I am going to talk about personal injury claims. Personal injury claims are all the claims that involve damage to you personally, as opposed to property damage claims, which are the claims that involve damage to your stuff. Personal injury claims include your medical bills associated with injuries, pain and suffering, lost wages, and any other expenses associated with your injury.

Lost wages are fairly easy to calculate, if you are employed by someone else and have a regular hourly wage or salary. If you spent three days in the hospital, and then your doctor doesn’t clear you to go back to work for two weeks after that, you just add up the number of work hours you missed. Unfortunately, you don’t usually get paid for lost wages associated with the afternoon you spent on the phone with the insurance company or the whole day that got lost sitting in the back of a courtroom to testify against the joker that rear ended you. If you work on commission or if you are self employed, the calculation can be trickier.

Medical expenses are generally fairly easy to calculate. Whatever the medical bill is, that is what your medical expenses are. Generally you get to claim what your health insurance company paid out, since your health insurance company has the right to ask you to be reimbursed if you are fully compensated for your loss.

Pain and suffering is a whole lot more difficult to calculate. Large verdicts and settlements like the infamous “burned on hot coffee at McDonald’s” millions are extremely rare. (Plus, if you have ever seen the nasty third degree burns on that poor woman’s inner thighs you might change your mind about the appropriateness of that verdict.) If your injuries were not so severe that you did not go to the doctor or the hospital right after the accident, odds are good the insurance company isn’t going to want to pay you much (if anything) to compensate you for your pain and suffering. Likewise, if you went once, and didn’t go to any follow up visits, you are also not likely to be compensated much, if anything, for pain and suffering. The insurance company’s attitude tends to be, “You didn’t go to the doctor for a week, and then you only went one time. How injured can you be?”

Some injuries do not present symptoms immediately. How many times have you smacked your shin into the open dishwasher and the bruise doesn’t show up until a day or so later? (Or is this just me?) Internal bleeding or organ damage may not show symptoms at the time of impact, either. So not going do the ER or hospital immediately afterwards is not necessarily fatal to a personal injury claim. It just makes it more difficult to prove, and is something you might need the assistance of a lawyer for.

Which brings me to causation. It isn’t enough that you had an accident and you had an injury. You need to be able to show that the accident caused the injury. Sometimes the timing is coincidental. Sometimes the accident might highlight the symptoms of an injury you had in the past. This is where it gets complicated.

Because of the difficult to prove nature of personal injury beyond medical bills and lost wages, if you are in a situation where you want compensation for ‘pain and suffering’ you will likely need help with that. However, don’t just jump directly to the lawyer’s office. Most lawyers take personal injury cases on a contingency basis. This means that the lawyer gets nothing if the case loses, but a percentage of whatever the settlement is if you win, including what you get for medical expenses and lost wages. So make sure it will be worth it to you to get a lawyer involved. Additionally, as soon as the lawyer got involved, the insurance company’s legal department had to get involved, which necessarily made the whole thing take a whole lot longer. On the other hand, you don’t want to rush and accept a low ball offer just so you can get money quickly and then regret it down the road.

There are many personal injury cases out there needing the assistance of a lawyer, especially if the insurance company is not being cooperative. Accidents with catastrophic injuries, or injuries with long term consequences, or with unusual circumstances need special attention. Even if you decide not to hire a lawyer for the negotiations, it is probably a good idea to run the insurance company’s offer by a lawyer for the price of a consultation fee to see if it is in the ball park of what is reasonable.

This article was written by a lawyer, but should not be considered legal advice in any way, shape, or form. It is written for general (and generally vague) informational purposes only. In order to properly evaluate your case, a lawyer must examine all the facts and circumstances that are particular and personal to your situation. I have not done that here.

About Lori Duff 352 Articles
Lori is the author of the bestselling collection of humor essays, "Mismatched Shoes and Upside Down Pizza" currently available exclusively on Amazon. In order to finance her writing habit, she is a practicing lawyer with Jones & Duff, LLC. She is married to Mike Duff, who is a retired DeKalb County Public Safety Officer, and has two amazing children who make cameo embarrassing appearances in her blog posts and who attend Walton County Public Schools. Her legal column, "Legalese", is meant to de-mystify and humanize the Court system. When asked about her writing, Lori says, "Life is too short not to laugh at every available opportunity. My goal is to make myself laugh -- and hopefully you will laugh along with me."

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