How Can Insurance Affect Outcome For Personal Injury Claims

Usually, the disputing parties in a personal injury case try to reach an agreement by means of negotiations with the insurance adjuster. That is one way that insurance can affect a claim’s outcome.

Here are some other ways:

If the at-fault driver did not carry any type of insurance, the injured motorist would need to use either comprehensive coverage or uninsured motorist coverage. In that case, the adjuster would negotiate with the holder of the necessary coverage.

If the at-fault driver did have insurance, then the amount of liability coverage available to the injured party would depend on the limits in the policy that had been purchased by the same at-fault driver.

—When the policy has a high limit, the adjuster has lots of money to work with, while trying to negotiate for a small payout.
—If the policy had a low limit, the adjuster would not make a high offer, even if the victim had been severely injured.

If someone were injured on another person’s property, then that injured party could seek compensation, as long as the property owner had purchased liability coverage.

If a pet dog bit someone, the dog’s owner could be sued, if he/she had purchased an applicable homeowner’s insurance policy. That would a policy that promised coverage of the damages resulting from a biting incident.

If a customer in a store or restaurant were to slip on a wet floor and fall down, the business owner could be held liable for the resulting damages, if that same business owner had purchased liability coverage.

If an insurance company were to ask a claimant to appear at a scheduled independent medical exam (IME), the injured patient/claimant could receive an examination from a physician that had been chosen by the same insurance company.

A smart claimant hires a personal injury lawyer in Niagara Falls to file a personal injury lawsuit before the adjuster becomes aware of the ultimate risk to the insurance company, should the case go to court. Claimants that fail to do so, could wind up being deprived of their chance at receiving a fair deal.

Regulation of insurance companies

State laws regulate the size of the premiums for the state’s insurance companies. States also oversee each company’s response to a filed claim, No insurer has the right to deny a claim, in the absence of a valid reason.

Insurers do have the right to declare a vehicle as “totaled,” if the cost for repairs were to exceed the same vehicle actual retail value. A claimant could challenge that declaration, if he/she had taken photographs of some added accessories, during the span of time before the accident. Otherwise, a claimant would struggle to get an insurer to reverse the label of “totaled.”

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