Last Updated on February 5, 2024 by John Robinson
Starting an insurance claim is typically the injured party’s first step toward getting reimbursed for their damages. The process of filing a claim can involve many things, including lots of paperwork which can be daunting. However, learning about the claim process after a car accident can help make it easier for you to make informed decisions.
First-Party vs. Third-Party Claims
There are two types of claims: First-party claims and third-party claims. A first-party claim is filed with the victim’s insurance company. In contrast, a third-party insurance claim is filed with the insurance of the driver who caused the accident.
The type of claim you file depends on several factors, including the type of insurance coverage and liability in the accident. For example, if the responsible driver does not carry enough insurance to cover your losses from the accident, you would have to file a first-party claim with your insurance company.
You also need to consider the state laws before starting an insurance claim because some states follow a no-fault rule that requires the injured party to file a first-party claim regardless of who is responsible for the accident. However, in at-fault states, you can file a third-party insurance claim.
How is Fault Determined?
Once you file a claim with the insurance company, they will investigate to determine the legitimacy of your claim. The insurance adjuster may want to inspect the vehicle or visit the accident site.
In addition, they may also need to question witnesses to get their statements on the accident. The available evidence, including photos from the scene and police reports, will be evaluated by the insurance company to determine fault in the accident.
Insurance companies also contact the injured and responsible parties to record their statement regarding the accident to determine fault. Once the investigation is complete, the insurance company will make its judgement of the liability of the accident.
Determining Value
The financial losses the victim suffers due to their injuries are more straightforward to calculate as they can be determined by verifying receipts and other documents. However, for noneconomic damages, such as pain and suffering, the insurance company uses two methods to calculate the value of the victim’s pain and suffering in an insurance claim.
One is the Multiplier Method, in which all economic damages suffered by the claimant are multiplied by a number between 1.5 and 5. The numbers from 1.5 to 5 are the multiplier and indicate the severity of the plaintiff’s injuries. The other method to calculate the settlement is the Per Diem Method. According to this method, a daily rate is assigned to the pain and suffering of the victim, which is then multiplied by the number of days it takes for them to reach maximum recovery.
Filing The Claim
Once you have started the claim, you will be required to provide the insurance company details and evidence related to the accident. The insurance company will investigate and propose a settlement offer. If you believe the settlement offer is low, your attorney can negotiate it with the insurance company. That is why you should get legal help from an attorney to communicate with the insurance company and other aspects of the personal injury claim.
After the investigation, if your claim is accepted, the insurance company will approach you with a settlement offer. You will also have the option to negotiate this settlement offer if it does not cover the extent of your damages. However, another possible outcome is that the insurance company denies your claim. If that happens, you can appeal the insurance company’s decision to deny your claim. You can take the matter to court if your appeal is not accepted. You should speak to an attorney to learn more about your options in a personal injury lawsuit.
