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The Role of Insurance in Personal Injury Cases

  • On Behalf Of Rankingsio
  • Published: April 16, 2025

When you read descriptions of the personal injury claims process, you will see many references to the insurance company and what they may do in response to your claim. You may hear them spoken about as if they are an all-powerful entity who has control over you. The truth is that the insurance company has no power over you personally. While they can make your life more difficult when you are seeking money for your injuries, you also have the ability to turn the table on them and put them on the defensive.

Of course, you need to go through the insurance company in every forum when you are seeking compensation for your personal injuries. If you have filed a claim, you will be dealing directly with them. If you filed a personal injury lawsuit, the insurance company will be the one who defends the responsible party throughout the process. They will always be the one negotiating the settlement with you, since they are the entity representing the defendant and writing you the check.

The best way to deal with the insurance company is to hire a personal injury attorney to represent you. If you try to deal with the insurance company without the help of a personal injury lawyer, they have various ways that they can get the better of you in the process. You can end up with far less money than you otherwise would have received if you had a personal injury attorney fighting for you. There is even a chance that you may not be paid for your injuries at all. You will end up in a far better position by hiring a Sidney, MT personal injury attorney who will work for you on a contingency basis. Even after paying your personal injury lawyer a part of your settlement, you can still end up with more money in your pocket.

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The Insurance Company Does Not Have Power Over You

insurance, message on white card and hold by businessmanThe insurance company likes to present itself as the entity who has power over your claim. They want you to feel like you are coming to them for compensation and should be happy with anything that the insurance adjuster chooses to offer you. The insurance company attempts to create a picture where you are subservient to them, and they have control over you. Based on the reality of a personal injury case, that could not be further from the truth. If anything, you have the power to create a situation where the insurance company can face real consequences if they try to overplay their hand in your case.

The key is that you approach the insurance company in a way that makes them realize the potential consequences of pushing things too far when they are dealing with your claim. You may need to take an aggressive approach when dealing with the insurance company, and you can do that with the help of an experienced personal injury lawyer.

The Insurance Company Takes the Place of Their Policyholder

When one purchases an insurance policy, they enter into a contractual agreement with the carrier. The policyholder pays insurance premiums, and the carrier is supposed to provide coverage. The policy lays out the conditions under which the insurance company will cover the damages caused by their policyholder. The policy may also contain exclusions for circumstances where the insurance company will not cover the damages caused by their policyholder.

When the policyholder has caused damages that are covered by the terms of the policy, the insurance company will step into their shoes. It will be the insurance company who will then assume the responsibility to pay for the damages caused by their policyholder. The party who caused you the damage will hold the overall responsibility for your harm, but the insurance company will handle the claim. They will review the evidence you have submitted and determine whether they want to try to resolve your claim through a settlement agreement.

The Insurance Company Is Your Adversary in the Legal Process

The insurance company takes on an adversarial role to you in the claims process. Since it will be their policyholder who is responsible to pay you, and the insurance company is their representative, it follows that they sit across the table from you during the legal process. They are your opponent since their interests are the direct opposite of yours. As a personal injury victim, your interest is that you are paid every dollar that you deserve for your damages. As the one who pays the damages, the insurance company wants to get away with offering you as little money as they can.

Any dollar that the insurance company pays you is one that comes out of their own account. They allocate a certain amount of money to pay claims, and that money comes out of their profits. The more money that an insurance company pays out in claims, the less money they make. Thus, they often try to take as hard of a line as possible in reviewing and settling claims. Even though you may have a legal entitlement to all of this money, the last thing that the insurance company wants to do is pay all of it to you.

Your Personal Injury Lawyer Files a Claim with the Insurance Company

Stethoscope and colored paper with the words PERSONAL INJURY CLAIMSA personal injury attorney will compile a claim to file on your behalf. This claim will include evidence showing that the policyholder was negligent and caused your injuries, giving you the legal right to compensation in your case. Your insurance claim will also include proof and documentation of your injuries to back up the amount you are seeking in compensation.

At some point, after they have received the claim, the insurance company may choose to accept responsibility and make you a settlement offer. They can also deny your claim in its entirety. How long the insurance company takes to respond depends on the complexity of your claim and their own internal considerations. Insurance companies often have an incentive to delay things as much as they can because they think that time is on their side in your case.

You Can Push Back Legally When Your Personal Injury Claim Is Denied

If the insurance company denies your claim, it is not a final determination that you are not entitled to money for your injuries. It is just the position that they are taking as the representative of the person who caused your accident injuries. The insurance company does not play the same role as a judge or jury. They are not the ones who decide whether you have a legal right to compensation or even how much you may get. Their denial of your claim can be just the start of the legal process.

If you are not getting the results you want in the claims process, you can choose to take your case to court at any time. You can do this if the insurance company does the following:

  • Denies your claim in its entirety
  • Tries to blame you in whole or part for the accident
  • Takes too long to respond to your claim or communicate with you during the process
  • Makes you a very low settlement offer and refuses to raise it or takes too long to make a realistic attempt to resolve your case

You Can Always Sue The Responsible Party in Court

Lawyer talk to jury on courtroom on backgroundYou do not even need one of these excuses to file a personal injury lawsuit because you are the one who has control over your own legal rights. Working with your personal injury attorney, you can decide where and how you want to seek compensation for your injuries.

There is nothing that says that you have to go through the claims process altogether. You may see descriptions of the personal injury process framed in terms of filing an insurance claim, although that is entirely optional for you. The claims process is just one route that you can take to get your money, should you seek your legal entitlement to it. You can always begin the legal process in court by filing a lawsuit against the responsible party. Doing so will take the case out of the insurance company’s hands and put it in front of a jury should you choose to take your case all the way to trial. Some personal injury lawyers will advise their clients that it makes sense to start with the claims process because it can mean a quicker and less risky way to pursue the money you deserve.

You will be dealing with the insurance company throughout the entire legal process. When you opt to file a claim, you will send it to the insurance company, who is the representative of the responsible party. If you filed a lawsuit directly against the responsible party in court, it is the insurance company who has a duty to defend their policyholder. They will be the ones who pay the attorney who defends the responsible party since it is part of the policy coverage. Since the insurance company is the one who is paying the damages, they will be calling the shots in the litigation.

The Insurance Company Could Be Liable to Their Policyholder for Bad Faith

Even though the insurance company is the representative of the policyholder, their interests are not entirely aligned with those of their customer. The policyholder wants the claim to go away as easily as possible because they are not the ones paying the money. The problem for the policyholder is that they can be on the hook for damages if the amount of coverage that they have is not enough to pay for what happened to you.

The insurance company has to pay up to the amount of the policy limit, but the responsible party may be ordered to pay anything above that amount in a judgment if you take your case to court and win. The policyholder may not have a say in the decision the insurance company makes about settling the case, but they still have their own “skin in the game,” because they are potentially personally liable to you.

If the insurance company takes things too far, and they fail to settle a case when they should have, they may even owe their policyholder money. The insurance company’s own customer can sue them in a bad faith lawsuit for the failure to settle the case when it was apparent that the insurance company should have done so. Here, the insurance company failed to uphold the duty that they owed to their own policyholder, and their actions caused their own customer to owe money.

The prospect of bad faith litigation comes into play when you have a personal injury attorney who can stare down the insurance company and threaten potential litigation. Not only does the insurance company not want to pay the cost of a defense attorney, but they also do not want to take the risk that they can lose a lawsuit filed by their own policyholder. Insurance companies may even owe money in punitive damages when they lose a bad-faith lawsuit.

Always Hire a Personal Injury Lawyer to Deal with the Insurance Company

If you or a loved one has been injured by the negligence of another party, you should hire a personal injury lawyer to protect your rightss. If you insist on trying to deal with the insurance company on your own, you will get the short end of the stick. Whether your claim is denied altogether or you end up with less money, the insurance company will always get the better of you. They have far more respect for personal injury lawyers, because they know your lawyer can sue on your behalf.

If you need to do anything that involves an insurance company in a personal injury case, you should always have legal help. You are much more effective in the legal process when you hire a personal injury attorney to speak for you. Call a Personal Injury Lawyer today for best results.

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Colton Holm

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