Personal Injury FAQs

Dealing with Insurance Companies FAQs

 


Q: Should we provide statements to an insurance company without a lawyer’s help?

A: The more significant the injuries, the more consideration should be given to consulting with a lawyer before providing any information to an insurance company. Without legal representation, any information given regarding the facts and circumstances surrounding the case or suit may come back to haunt the injured party at a later date. Identifying information, such as names, addresses and so on would be okay to provide. We strongly suggest you consult with CANAS & FLORES personal injury attorneys in Fort Worth, Texas before making such an important decision.

Q: Is an insurance company responsible for more than property damage?

A: The responsible party’s insurance company owes you for more than just the damage to your property. An insurance company usually must pay for:

  • All related medical bills
  • Out-of-pocket costs associated with an accident, such as time off of work
  • Pain and suffering, general damages or non-economic damages

The challenge is putting a dollar figure on these items. Personal injury lawyers at Canas & Flores recommend that it would be wise to postpone a settlement until you’ve completed therapy and have recovered as completely as your physician feels you will.

Q: Can the insurance company refuse to pay my medical bills if my car wasn’t damaged?

A: No. Insurance companies usually try to draw a direct connection between the amount of property damage sustained by a motor vehicle in a collision and the severity and degree of personal injury to be expected. As you know, the human body doesn’t work that way. People sometimes suffer very significant injuries with minimal impact. On the other hand, there are times when people suffer only minor cuts and bruises from a major impact. Consult with your personal injury lawyer at CANAS & FLORES to get personalized attention on your particular facts and circumstances.

Q: Can an insurance company refuse to pay due to a pre-existing injury?

A: No. An insurance company is responsible for the additional injury or flare-up to a pre-existing injury. Insurance companies are not willing to openly accept responsibility for such injuries, but the proper medical documentation may aid your personal injury lawyers at CANAS & FLORES in helping you get the injury claim accepted.

Q: What is considered bad faith on the part of an insurance company?

A: In Texas, your own insurance company likely has an obligation to act in good faith with regards to you. If not, you can bring a claim for bad faith. Bad faith claims are difficult to prove and very difficult to recover on. Hinting at such a claim without a good lawyer is not going to get you anywhere. Normally, allegations of bad faith can be used as additional leverage to get the insurance company to pay fair and adequate compensation. Your personal injury lawyer at CANAS & FLORES can help you raise such a claim if necessary and if the situation calls for such measures.

Q: Do most cases go to trial to recover damages?

A: Most cases don’t end up in trial. And about 95 percent of personal injury cases that are filed settle prior to trial.

Q: When should I settle my case?

A: Personal injury attorneys at CANAS & FLORES recommend not to begin settlement negotiations until you’re sure of the nature and extent of your injuries and whether you’ll need continuing medical attention. You should know whether you’ll be able to work in the future and how the injury will affect your ability to do normal household tasks, sports and hobbies before you and your attorney discuss money with the insurance company or others.

Q: What is considered “pain and suffering?

A: Pain and suffering means not only the fact that you are physically hurting, but also the mental anguish of going through potential surgery and avoiding activities that you used to do before the accident. Personal injury attorneys at CANAS & FLORES typically ask insurance companies to consider “pain and suffering” as a major reason for the demand made.

Q: What is subrogation?

A: Generally, a health insurance plan or policy has a subrogation provision, which says that the health insurance company of the injured party is entitled to be paid back from the third-party wrongdoer’s insurance company. Lawyers at CANAS & FLORES usually handle this matter in one of two ways:
1. The opposing insurance company settles when the health insurance company has agreed to release whatever claim they have against them; or

2. The health insurance company accepts as full and final payment the amount agreed upon for the services received. Health insurance companies routinely take less than the full amount owed to them because of the costs incurred in going out and getting fair and adequate compensation.

Q : How does a prior injury affect the value of my claim?

A. Generally, a person who is negligent or careless is responsible only for the harm he or she caused. That means that you have to prove there was negligence and that the negligence caused your injury. If you had a prior injury, their negligence did not cause your initial injury. However, if you can prove that the negligence made the injury worse, you can collect for the degree to which the condition has been aggravated.

Q: What are the issues affecting the damages that can be recovered?

A: Every case addresses three issues:

  • Liability — was someone negligent?
  • Damages — the amount that will fairly and adequately compensate you for your injuries
  • Source of collection – is there insurance or are there other assets from which damages can be recovered?

Q. What is a normal settlement amount?

A: Insurance companies will pay not because they like you or they think it is fair, or because they settled a similar case for a certain amount. They pay because they have no other alternative. The proper value of a claim is established when an experienced trial lawyer reviews and interprets the case information, such as:

  • The amount of the medical bills
  • Loss of past income
  • Future medical bills
  • How old you are
  • Permanent limitations you now have
  • Impact on your future earning capacity
  • Activities you no longer do
  • Activities you do but do not enjoy as much
  • Prognosis for further problems
  • Strength of lay witness testimony, and so forth

Personal iInjury lawyers at CANAS & FLORES begin with one end in mind — what a reasonable jury would award as fair and adequate compensation. CANAS & FLORES always negotiates from a position of strength with the other side. That means that the other side sees that you and your personal injury lawyer at CANAS & FLORES have put together the necessary lay and expert witnesses to go to trial.

Q: Is there a minimum or maximum amount that can be recovered in a personal injury settlement?

A: No, there is no minimum or maximum settlement amount when the case is taken to trial and submitted to the jury. However, any settlement reached between you and the insurance company would be limited to the amount of coverage available on the faulty party’s individual insurance policy covering his/her actions at the time of the accident.

Q: What is included in a bodily injury claim settlement?

A: The term “bodily injury claim” usually refers to a “personal injury claim.” “Economic damages” would include, but aren’t limited to, lost wages, medical bills, rental car charges and so forth. Pain, suffering, humiliation and distress all fall within the term “general damages.” If you settle your bodily injury claim, it must include all economic and general damages available to you, or you’ll likely lose your right to recover for those losses.

Q: Do I have to go through an operation for the insurance company to compensate me for suffering?

A: It’s not likely you’re going to have to go through the operation to recover for the cost of it. In civil claims, you have the burden of proof to prove your damages, but only by preponderance of the evidence. If your doctor says it’s more likely than not that surgery is going to be required but you want to wait to do the operation, there is no reason that you cannot be compensated for the cost of that operation and the pain and suffering associated with the operation.

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