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You Can Do It: Handling Your Own Claim
by Joseph Matthews
Copyright © 1992 Nolo Press
Despite what the insurance industry and lawyers would like you to think,
settling an injury claim with an insurance company is usually quite
simple. Most
claims involve no more than a few short letters and phone calls with an
insurance
adjuster who has no legal training. You don't need to know technical
language or
complex legal rules. Your right to be compensated usually depends on
nothing more
than common sense ideas of who was careful and who wasn't.
You can often best handle a claim yourself. You know better than anyone
else--insurance adjuster or attorney--how an accident happened. You were
there,
they weren't. And you know what injuries you suffered and what your
physical
condition and other circumstances have been since.
The amount of fair compensation in any given case does not come out of a
crystal
ball that only lawyers and insurance companies know how to read. Rather,
a number
of simple factors--type of accident, injuries, medical costs--go into
figuring
how much any claim is "worth." The amount an insurance company will be
willing to
pay usually falls into a fairly narrow range, whether or not a lawyer
handles
your claim for you.
Except in serious or complicated cases, a lawyer can usually gain for
you only an
extra 10% to 25%, if anything, above what you can obtain for yourself
once you
understand the process. But the lawyer will also take 33% to 40% of your
recovery
as a fee--and in addition charge you for "costs" that seem to appear out
of thin
air and can quickly run into hundreds of dollars. Subtract the lawyer's
fees and
costs from the extra amount of the settlement a lawyer might get, and
you'll see
how you can actually do better on your own.
When you might need a lawyer
Sometimes, the skills of an experienced personal injury lawyer--or at
least the
threat to an insurance company that such a lawyer may present--are worth
the
money you must pay that lawyer to represent you. You may need a lawyer
because of
complex legal rules involved in your claim, or because your injuries are
quite
serious and so the potential amount of your compensation might vary
greatly, or
simply because an insurance company refuses to settle the matter with
you in good
faith.
There are no hard and fast rules about whether or not you need to hire a
lawyer.
Much of the decision has to do with how you feel things are going as you
attempt
to settle your claim on your own. At some point, you may feel
overwhelmed--too
much work, some obscure legal rule the insurance company throws at you.
Or you
may be stonewalled by an insurance adjuster who blusters that the
company does
not have to honor your claim at all or who offers you only a piddling
amount to
settle it. In these situations, you may at least want to consult an
attorney for
advice, and perhaps have him or her take over handling the claim.
A few types of injuries and accidents almost certainly require that you
consult a
lawyer.
Long-Term or Permanently Disabling Injuries
Some accidents result in injuries that significantly affect your
physical
capabilities or appearance for a long time--over six months--or even
permanently.
Figuring out how much such a serious injury is worth sometimes can be a
difficult
business and may require some assistance from an experienced lawyer to
get the
most out of the claim.
Severe Injuries
The amount of your accident compensation is mostly determined by how
severe your
injuries were. And the severity of your injuries is measured by the
amount of
your medical bills, the type of your injury and the length of time it
takes for
you to recover. Once the amount of your potential compensation gets
high, it may
be worth the expense to have a lawyer handle your claim and make sure
you receive
compensation at the highest end of the range.
Medical Malpractice
If you have suffered an injury or illness due to careless,
unprofessional or
incompetent treatment at the hands of a doctor, nurse, hospital, clinic,
laboratory or other medical provider, both the medical questions and the
legal
rules involved are complex. They almost certainly require that you hire
a lawyer
experienced in medical malpractice cases.
Toxic Exposure
In the increasingly chemical world, we sometimes become ill because of
exposure
to chemicals in the air, soil or water, in products or in food. Claims
based on
such exposure are difficult to prove, however, and often require complex
scientific data. And because the chemical and other industries have
erected a
huge wall to protect themselves from legal exposure while they continue
to expose
us to potentially harmful chemicals, the required evidence is very hard
to come
by. Get expert help.
When an Insurance Company Refuses to Pay
In some instances, regardless of the nature of your injury or the amount
of your
medical bills and lost income, you will want to hire a lawyer because an
insurance company or government agency simply refuses to make any fair
settlement
offer at all. In these cases, something--what the lawyer can get minus
the fee
charged to get it--is better than nothing.
Side Bar--What Kinds of Claims Can You Handle
Yourself?
- Automobile, cycle or pedestrian accidents.
- Slip or trip and fall accidents.
- Home accidents.
- Accidents with defective products.
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The selected articles originally appeared in the Nolo News and are Copyright © Nolo Press 1996 and reproduced here with permission.
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