We often receive calls from potential clients who, prior to calling us, have been handling their injury claim on their own. Most of the callers were under the impression that their claim was an open and shut case, and the at-fault party’s insurance company would treat them fairly. This illusion is shattered almost immediately when the injured party asks the insurance company to pay their hospital bills or put them in a rental car since their car was rendered not drivable by the accident.
The insurance company tells you, the injured party, that they must conduct their investigation before agreeing to pay for any medical expenses or property damages. They will say they need to talk to their driver, who invariably they never can get in touch with. They also need to see the police report, which the police officer has two weeks to turn in.
You ask, “What am I supposed to do in the meantime about getting to work without a car, paying for future medical treatment, and keeping the creditors from ruining my credit over the unpaid hospital bill?”
The insurance company informs you that you will have to pay those items yourself, and maybe sometime in the future they will reimburse you if they decide that they owe your insurance claim. By the way, the insurance company would like to take your statement about what happened in the traffic accident.
You, like many unsuspecting injured parties before you, may not realize that this is merely an attempt by the insurance company to get you to make some sort of admission of fault or partial fault for the accident. Perhaps you feel that if you work with them, they will treat you fairly.
Normally, after you have given your statement, the insurance company promises to get back to you but never do in a timely manner.
Insurance companies will try to limit payments in any way possible.
Injured parties often try to stand on their own against insurance companies with all their unlimited resources and knowledge, accumulated over a period of many years, of how to limit payments. It is surprising that anyone would attempt such a feat without legal representation on their personal injury claim, but it happens.
Let us suppose you have the resources to pay for your own rental and medical bills. Let’s also suppose that the facts of the case are so clearly in your favor that even the insurance company is admitting they owe 100% of the claim for property damages and medical bills.
The first problem will be collecting for the rental. If your car is totaled (it would cost more to repair than what it is worth) the insurance company owes no rental to the aggrieved party. You ride in a rental for the time it takes to get paid on your car, usually two to four weeks, thinking the insurance company will pay for the rental only to find out when you turn in the bill that you will receive no reimbursement.
If your car is deemed repairable, the insurance company is likely to not want to pay all for the rental bill, using several excuses.
- The shop took too long to do the repairs.
- The daily rental rate was too high.
- You got into the rental too quickly being that your car was drivable.
If the car is totaled, the insurance company will hunt for ways to reduce the value of the car.
- An independent service is hired that always manages to value the car at less than the NADA or blue book value.
- Deductions on the payment of the car will be made for supposed prior damage on the car for minor things such as dings or a dirty interior.
- Arguments on repairable cars are normally over items the insurance company does not want to pay that they say are not accident related.
As you can see, even something as seemingly simple as getting your car taken care of can get complicated quickly when you’re dealing with insurance companies.
If you have been injured, the complications only increase. Insurance companies will not pay any medical expenses until a claim is settled. If you don’t have health insurance, you’re left handling your own claims with no way to obtain medical care.
Medical records to prove up injury claims are exceedingly difficult to obtain.
Let’s suppose that you have managed to get through the aforementioned hurdles, have finished your medical treatment, and you’re ready to settle your case. The insurance company will require copies of all medical bills and records related to the case. A trip to the hospital by ambulance will create 5 separate items alone that will have to be obtained:
- Ambulance bill
- Itemized statement of charges from the hospital
- Emergency room records
- Emergency room physician bill
- Radiology bill
If you’re lucky, you may receive either the ambulance bill, emergency room physician bill, or radiology bill in the mail. Chances are you may receive one of those. The other items will have to be requested and paid for.
Most hospitals use a records service to distribute their bills and records and often there are different record companies that handle the requests. The process typically plays out as follows:
- Figure out to whom to send your requests.
- Send a request to the record companies for all items needed.
- If you’re fortunate enough to get a response to this first request, you will then send in the money required to get the records.
- Hope that after sending your money in, you receive the records for which you paid.
The time and effort required just to get the charges related to the hospital visit will be a tedious and time-consuming project that most people do not have the time or patience to obtain. Remember that the insurance company will not settle the claim without all the bills and records.
Insurance company offers usually aren’t fair.
You have jumped through the hoops, and an offer is finally made by the insurance company.
How will you know if the offer is fair? Why would the insurance company make a fair offer? You as the injured party have no idea what a case is worth because that is not what you do for a living. How will you know what the case is worth for pain and suffering? What yardstick will you use as to the value of a claim? What would a jury do with the case? When the insurance company tells you that they had your medical bills audited and are only paying half of them, will you know how to respond?
These are just some of the things of which an injured party does not know that are necessary knowledge to obtain a fair settlement from the at fault party’s insurance company.
You’ll have to negotiate with medical providers.
If representing yourself, the next hurdle you will have to overcome is that on almost every injury claim, medical bills with any medical providers must be negotiated down if the injured party hopes to end up with anything out of their settlement.
Any time you go to a hospital from the scene of an accident the hospital has a lien on your injury claim, and they are not bashful about billing much more than a reasonable price for their services.
If Medicaid, Medicare, or regular health insurance paid any of the medical bills, they will have a lien on the settlement.
Obtaining these liens and negotiating them down is a time consuming and tricky process for someone who does it all the time let alone someone starting from scratch.
Self-representation can have disastrous results.
Problems with getting paid on property damages, creditors pursuing pending medical expenses, payment for needed current medical expenses, obtaining the necessary proof for an insurance company to pay a claim, and trying to negotiate as a novice with an insurance company that has been settling claims for many decades are some of the reasons not to handle your own injury claim.
Don’t give the insurance company the upper hand by trying to represent yourself. There are pitfalls inherent in self-representation that open the door for insurance companies to leave you with less than you are owed.
An experienced car accident attorney knows insurance company tactics inside and out and will ensure that they can’t manufacture reasons not to pay you what you are owed. An attorney knows the processes of obtaining proof and vital documents for your claim, as well as how to successfully negotiate with medical providers. They will represent your interests while you focus on healing and rebuilding your life.
