How to Negotiate with Your Own Insurer After an Injury

It is sometimes necessary to file a claim for your injuries with your own insurance company. This would be the case in an underinsured or uninsured motorist accident claim or in a hit-and-run case, for example. Your own insurance company may also step in if someone your policy doesn’t cover crashed your vehicle. Regardless of the situation, if you file a claim with your own insurance company after a personal injury, prepare yourself for a slightly different negotiations process.

Find out What First-Party Claims Require

A claim one files under his or her own insurance policy is a “first-party” claim. First-party claims use different rules and processes than third-party claims or claims against the other party’s insurance company. Typically, first-party claims require more information, documentation, and evidence than a third-party claim, partly to screen out fraudulent claims. Here’s what to expect from filing a claim with your own insurer:

  • Shorter filing deadlines. Often there is a strict time limit by which you must inform your company of a claim for it to be valid. Failure to get your claim in by the deadline does not mean automatic denial, however – your insurer cannot deny your claim because of a missed deadline unless it can prove that the late notice has prejudiced your case.
  • Release of personal records. Your insurance company will ask for your authorization of the release of important personal documents regarding your injuries, such as medical records and loss of income records. An insurer needs this documentation to support your claim and a description of injuries/losses. Make sure the release you sign is specific to your injuries related to the accident.
  • Independent medical examination. In some case, an insurance company may ask a claimant to undergo an independent medical examination (IME). Read your policy carefully to ensure you follow its terms when getting an IME. Your insurance company needs to agree – in writing – to pay for your IME before you go. Your claims adjuster should give you a description of the limits of the examination in writing.

An insurance claims adjuster has to give you a copy of your policy upon request if you do not have one. Read your policy for details regarding an IME request – do not take your claims adjuster’s word for anything. Doctors who work for the insurance company conduct IMEs, leading to potential conflicts of interest. Ask for a copy of your IME report from the physician, and bring it to the attention of your claims adjuster if anything during your IME was unfair.

Master the Negotiation Process

Once your insurance company has reviewed all documents and evidence related to your claim, it will either accept or deny your application. If your insurer denies your claim, it will list the reason why. At this point, you can submit documentation for corrections or clear up miscommunications with your insurance claims adjuster. Your insurance company may be willing to renegotiate. If you receive an acceptance, it will come with a settlement amount. Here’s where negotiations may get tricky.

Too often insurance companies offer settlement amounts to its policyholders that are well below what the claimant believes his/her injuries are worth. If this happens to you, you have options. First, make sure the amount you expected to receive was within your policy’s limits. If your claim check doesn’t exceed your policy limit but is too small for your situation, you may have a bad faith claim on your hands.

Bad faith insurance companies may offer minimal compensation amounts or none at all, failing to fulfill its obligation to policyholders. If you believe you might have a bad faith insurance company claim, speak to an Austin personal injury attorney for professional help. An attorney can help you negotiate your insurance company claim and fight for the settlement your injuries merit.