How Personal Injury Settlements Work in Fairfield, Connecticut
When someone’s negligent actions cause you harm, their liability insurer pays for your injuries. Yes, that sounds right but it isn’t necessarily true. Despite what you hear from late night TV ads, or from friends and family in Fairfield, injury claims don’t always go the way you think they should. As each injury claim is unique, you usually learn how Fairfield personal injury settlements work only after a firsthand claim experience.
A liability insurer has a duty to protect their policyholder, not you. That’s one of the important lessons you learn when someone causes you harm. When you have a Fairfield personal injury lawyer working on your behalf, you have a seasoned professional protecting you. As your representative, they intervene with insurance adjusters and protect your rights, while you rest and heal.
What is a personal injury?
A personal injury is a physical, mental, or emotional harm caused by someone else’s negligence. A harmful event can occur at any time and under a wide range of circumstances:
- Car accident injuries: Accidents involving private passenger cars and trucks, motorcycles, bicycles, and pedestrians
- Truck Accident injuries: Crashes involving large commercial vehicles
- Product injuries: Harm due to defective manufacturing, defective labeling, or inadequate instructions
- Dog bite injuries: Fairfield dog owners are strictly liable for their dog’s actions
- Medical Malpractice and birth-related injuries: Due to a medical professional’s failure to meet the standard of care
- Sexual abuse-related injuries
- Workplace injuries: Caused by a negligent third party’s actions
How personal injury settlements work
When someone injures you, resolving your claim should involve an honest, efficient process. The responsible party’s insurer should investigate the occurrence quickly, confirm liability, and pay your medical bills. At some point, they should offer you a settlement. Sadly, injury-claim reality is usually more convoluted than that.
The adjuster must confirm coverage
When a policyholder reports a claim, their insurance company begins the claim process by confirming coverage for the responsible party. If there is no coverage, there is no claim. This is often more complicated than you might imagine.
When a novice claims adjuster is handling your claim, they usually need help determining coverage. They don’t always understand the issues and have no experience identifying potential coverage complications:
- As insurance follows the car, a policy may insure a specific vehicle but exclude certain drivers.
- Sometimes separate entities own and/or insure commercial tractors, trailers, and the loads they carry.
- When a product causes injury, an insured’s liability policy might not cover the involved manufacturing or retail operation.
- If a dog bites you, the responsible party’s property policy might have a dog bite exclusion.
- Personal and commercial liability policies usually exclude intentional acts and liability exposures they deem too costly to cover.
Liability coverage can be tricky, even for experienced claims adjusters. All policies describe what they cover. If a certain type of event doesn’t fit within the coverage parameters, it’s not covered. Even if a policy provides coverage, some policies specifically exclude certain circumstances or conditions.
They must investigate the incident
Once the adjuster confirms coverage, they investigate the incident that caused your injury. This usually involves reviewing existing evidence, inspecting the site, obtaining emergency reports, talking to witnesses, and taking your recorded statement.
- An adjuster may ask to record your statement while you’re still in pain or dealing with the effects of prescription medication. They will likely ask if you drank alcohol or took medication before the incident occurred. They probably won’t ask if you’re currently taking medication before they begin recording your statement. If you are, it could discredit their liability investigation.
- When an adjuster completes their investigation, they decide liability based on how the incident happened and the legal standards that apply. The evidence must prove (to the adjuster’s satisfaction) that their insured was negligent and caused your injuries. It shouldn’t surprise you that many adjusters don’t always recognize or understand relevant legal issues.
- You must meet their standards for injury documentation. It must confirm your diagnoses and for your injuries and prove the incident caused them.
- The liability claims adjuster must determine that their insured is liable for the incident and also that it caused your injuries. Even if they decide to pay you, they will never acknowledge that their insured was negligent.
Only after an insurer completes its liability investigation will an insurer consider paying your claim. They may agree to pay your injury-related expenses and consider offering you a settlement. You should know that this doesn’t always happen.
They must set a claim reserve
Insurance companies pressure adjusters to investigate claims quickly. They give them a tight deadline to report their investigative findings and recommend a loss reserve. That’s an educated guess as to the dollar amount an insurer might ultimately pay for a liability claim. Insurers have a legal responsibility to set aside funds based on their chances of paying a claim.
If an insurer decides to pay an injury claim, they try to negotiate a settlement at or below the reserve amount. If they believe an injured person was even minimally negligent, their reserve and settlement offers usually reflect a reduced value.
The insurance company doesn’t have to offer you a settlement
If the adjuster decides their insured’s liability is questionable, they may deny your claim without further action. If you sustained serious or catastrophic injuries, claim department management and higher-ups usually participate in the decision-making process.
A timely claim denial allows insurers to avoid noncompliance with Connecticut’s Unfair Practices standards. It also helps them meet their duty to protect their insured’s legal interests. When an insurer denies your claim, it’s up to you to move forward with the process. Insurers realize that some injured victims will file a lawsuit while others will simply walk away.
Claims adjusters don’t tell you everything
When a liability adjuster contacts you, they rarely reveal their goals or intentions.
- They don’t tell you if their policyholder reported that they did nothing to cause your injuries.
- They don’t tell you that they want your recorded statement, even if they’ll probably deny your claim.
- They don’t tell you that if you say something in a recorded statement that sabotages your liability position, you can’t take it back.
- They don’t tell you if claim technology is making all the decisions about your claim.
Even if they don’t tell you everything, you should understand a few simple facts.
- When they contact you about your injuries, they’re taking steps to protect their insured’s legal rights.
- They have no duty to protect you.
You need an attorney working for you as soon as possible after you become injured. When you establish a working relationship, they step in and handle your claim. They deal with insurance adjusters and their employers before they produce a negative outcome you didn’t anticipate.
Sometimes a liability insurance company offers a settlement
Some liability insurance companies prefer to settle claims so they can avoid litigation. Once they have your name on a release, you give up your right to sue, and they can close their file forever.
This could be a positive outcome if all insurers evaluated injuries consistently and negotiated fairly. Sadly, some negotiation strategies take advantage of the issues injured people often face.
- Weeks and months of limited or no income
- Costly medical care, physical therapy, and medication
- A backlog of household bills
- Adjustments in lifestyle and living standards
- A pending statute of limitations
Some insurers realize that a quick and easy settlement might tempt many injured people, especially those with a limited financial cushion. They also understand that if they’re dealing directly with an injured victim, they probably have no idea what their personal injury claim is really worth.
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A Fairfield personal injury lawyer works to resolve your claim fairly
When you consult a personal injury attorney as soon as possible after an accident, they can take immediate steps on your behalf. A legal team conducts a thorough investigation. Your lawyer assesses any liability issues, evaluates your injuries, and determines the best strategy for resolving your personal injury claim.
- Negotiation with the insurer or their legal representatives
- Filing a lawsuit when necessary and appropriate
- Participation in a court-sanctioned Alternative Dispute Resolution process
- Settling your case in a way that best benefits you
When a law firm represents you, you don’t have to deal with insurance adjusters, and that can change everything.
Contact a Fairfield personal injury lawyer
If a negligent person, business, or organization injures you, contact a personal injury attorney to schedule a free consultation. You can discuss your case and an attorney can determine if they can help you. After your consultation, you can decide what’s right for you.
