Claims VS Lawsuits. How Are They Different And Which One Should I File?

Following any personal injury accident, if compensation of any sort is required there are a few ways to go about it. However, choosing which one is best in any given situation is sometimes difficult because of the details involved.

 Filing a personal injury claim through insurance companies or involving litigation and filing a lawsuit both have their pros and cons.

“A personal injury claim and a personal injury lawsuit are separate and distinct from one another. It’s important to understand which one best applies to your situation,” says retired Judge Anthony P. Calisi on his website Injury Claim Coach. 

In addition to the requirements necessary for either a personal injury claim or a personal injury lawsuit, there is an added concern. 

“And always remember, whether you are suing or just filing a claim with an insurance company, these matters are stressful and complicated,” advises the LawKick blog, a social network to find lawyers.

Ron Bell Injury Lawyers have nearly 30 years of experience representing personal injury victims.

What is a Personal Injury Claim?

After an accident, this is the first step to receiving compensation for medical costs, injuries, property damage, loss of work, etc.. It applies to any situation involving the injured and an insurance company.

 This can include car accidents and anything else that may be covered by an insurance policy – slip and fall, dog bites, negligence on a premises, etc.

 This step is prior to any litigation or lawsuit being considered. The process starts when a victim files a personal injury claim with the insurance company for compensation.

 “The claims process is a series of negotiations between you and the insurance company’s claims adjuster. The negotiations hopefully result in a compromised settlement payment, where both parties are satisfied,” says Calisi on his blog.

The Personal Injury Claim Process 

• Victim pursues compensation from the person believed to be at fault. (Property owner, business owner, or other driver in a car accident.)
• They, in turn, contact their insurance company.
• The insurance company generates a claim number and assigns a claims adjuster to investigate.
• The claims adjuster contacts the victim if grounds are found to cover the insurance claim and they attempt to reach a settlement for cost and damages.

“When her investigation is over, the claims adjuster will make a decision based on all the information she collected. The decision can range from paying the entire amount of your demand, to paying nothing,” says Calisi. “Generally, the adjuster’s response is somewhere in between.”

If the victim feels that their damages are not being met by the proposed settlement, after negotiations have broken down, they may choose to pursue a lawsuit.

What’s Needed to Prove a Case

Since the insurance claims adjuster will be looking deeply into the case, it’s important to be able to prove unequivocally that their policyholder is responsible for the damages and the accident. This requires evidence.

 The claims adjuster will want to see everything associated with the case. These can include:

• Medical charts and bills
• Witness statements
• Police Reports of the accident
• Property damage and repair costs
• Photographic and video evidence
• Lost wages from time missed at work
• Bills related to property damage

Source: Injury Claim Coach and LawKick

How is a Lawsuit Different?

A lawsuit is when the negotiations with an insurance claims adjuster have broken down, or the victim believes that they can get more money from a lawsuit.

A lawsuit can take longer than an insurance claim but can involve a higher pay out. A lawsuit will involve taking the insurance company and at-fault person to court for higher damages.  Similar evidence will need to be presented by a lawyer on the victim’s behalf. The court case may involve the presentation of evidence, witness statements in a public setting, and attending court hearings.

When to Involve a Lawyer

 It is in the best interest of the victim to get legal counsel before even filing an insurance claim.

 “Adjusters can be fierce negotiators, and they sometimes even break rules. You must be the one policing them and ensuring they don’t engage in any bad faith practices,” warns Calisi.

“The at-fault driver’s insurance will try to low-ball you and your insurance company in order to save as much money as possible. They will try to get away with whatever they can,” adds LawKick. “Although your insurance company will advocate for you, it has a conflict of interest because it also wants to keep costs down and limit its own overhead.  Insurance companies often settle early in order to save money, so keep that in mind before you make the decision.” This makes involving an experienced attorney valuable.

 “Because lawyers are so knowledgeable about their areas of expertise, they can provide valuable advice about whether to sue or follow through with the insurance claim,” says LawKick.