Settling an Injury Claim with an Insurance Company

If a defendant’s negligence caused injuries, you may be able to pursue compensation from the defendant’s insurance company. Insurance companies generally make payments for personal injury and wrongful death claims if there is a negotiated settlement or a jury verdict in the victim’s favor. However, insurance companies may work to deny your claim or minimize your damages. Our job as personal injury lawyers is to show how accidents happen, why the defendants are liable, and to seek full and fair compensation for your damages.

What does it mean to settle a personal injury claim?

Personal injury claims include vehicle accidents, product defects, medical malpractice, oil field accidents, and other types of negligence claims.

If someone owes you a duty of care, breaches that duty of care, and the breach causes an injury, you have the right to file a personal injury claim against that person. A common example is your right to hold a driver liable if they cause a car accident due to distracted driving, speeding, or other negligent acts. Drivers in Texas owe a duty to other drivers, pedestrians, and bicycle riders to drive safely. If a driver breaches that duty (for example, by speeding), you can file a personal injury complaint if the breach causes a car accident that resulted in an injury.

Your damage claim

When you file a personal injury claim, you have the right to seek compensation for all your reasonable and necessary medical bills, lost income, pain and suffering, car damage, loss of life’s pleasures, and other damages. We can work with your doctors, employers, financial experts, car mechanics, and others to show just how serious and traumatic your injuries are.

If a loved one dies, certain surviving family members—such as a spouse, children, or parents—have the right to seek compensation for the funeral and burial expenses, outstanding medical bills, loss of financial support, and loss of love, comfort, companionship, and guidance.

Why you should never settle a claim without legal representation

A personal injury settlement occurs when the defendant’s insurance company agrees to pay you a set amount of money to resolve your claim. Once you sign a settlement release and accept payment, you generally cannot seek additional compensation. This is why you should not try to settle an accident claim on your own.

When victims handle claims on their own, they may not recover the full compensation they’re entitled to. They can be more easily persuaded to accept a lower offer, including by insurance company arguments that may lack merit. Put simply, they’re more likely to settle for less than they could with the help of an experienced lawyer.

Once your claim is settled, the process typically works as follows:

• The insurance company will send us a check for the settlement amount.
• We will disburse your settlement funds after deducting agreed-upon fees and costs.
• You’ll sign a release form that confirms that you will not seek any more compensation from the insurance carrier for the defendant.

What factors affect the amount of a settlement for a personal injury claim?

Many different factors affect the amount of money you can receive from the defendant’s insurance company. These factors include the following:

• The amount of insurance coverage. For example, if you are in a car accident, and the driver’s insurance coverage is $100,000, that is typically the maximum amount payable under the policy, though additional recovery may be possible in limited circumstances, such as bad faith claims. If your damages exceed that amount, you may be able to pursue the at-fault driver personally or make a claim under your uninsured/underinsured motorist (UM/UIM) coverage if available.
• The strength of your liability claim. Our lawyers work to show that you have a strong likelihood of winning if your case goes to trial. In car accident cases, for example, we work with investigators, the police, traffic reconstruction experts, car product experts, and others to show why another driver is primarily responsible for your accident and to minimize any arguments that you share fault.

In medical malpractice cases, we can work with physicians to explain why one or more of your healthcare providers failed to provide competent medical care (such as failing to make a proper diagnosis or making surgical errors).

We also conduct discovery (written questions, oral questions, and requests for documents and other information) to support your claim.

• The amount of your damages. We can work with you, your witnesses, your doctors and other experts to verify all of your damages to date and the future damages you are likely to have for the rest of your life.

Other factors that may affect the amount of a settlement include:

• Whether there are other defendants and other insurance companies.
• Whether there may be any comparative negligence on your part.
• The extent and medical certainty of your injuries.

How does the settlement process work?

Generally, once we complete the discovery phase of your case and determine your damages, we can prepare a formal demand to submit to the insurance company.

The demand explains why we think your case is strong and what we believe it is worth.

The insurance company will then analyze our demand. Some of the factors that may affect their initial offer include:

• What are the policy limits?
• How much do they think your claim is worth? Many insurance companies use sophisticated software and databases of comparable settlements and verdicts for similar cases when making their offer.
• What liability defenses do they think they may have?
• What arguments can they make to reduce the value of your claim? For example, a physician retained by the insurance company as an expert or independent medical examiner may argue that your injuries are not as serious as claimed.

In clear-cut cases, an insurance company may meet our initial demand. In many cases, there are back-and-forth offers and counteroffers until a settlement agreement is reached or one or both sides agree that a jury trial is necessary.

When is it not advisable to enter into an injury claim settlement?

The decision whether to settle a case is the victim’s. We can tell you what we think your personal injury or wrongful death case is worth, but the final say is yours.

The main reason to refuse a settlement is the belief that you may recover more through a jury verdict.

Some of the concerns that clients have about jury trials are that there’s no certainty with a jury. Additionally, it may take several months or longer before a jury hears your case.

What happens if there is more than one insurance company?

In some personal injury cases, there may be multiple defendants. For example, in a truck accident case, the driver, the driver’s employer, and the owner of the truck may all be liable.

Our personal injury lawyers will explain how the settlement process works when there are multiple defendants. The downside of multiple defendants is that each may blame the others. We can work through these complexities to pursue a proper settlement with each insurance company.

Speak with our San Antonio personal injury lawyers now

At Pat Maloney: Accident & Injury Attorney, we have 40 years of experience settling accident cases and trying accident cases before juries. We can help you seek compensation available under Texas law. Please contact us online to schedule a free consultation. We handle personal injury cases on a contingency fee basis.