What's the Difference Between a Claim and a Lawsuit?

Your first priority after an accident or injury is your health. Seeking medical attention for injuries can prevent your condition from worsening or becoming life-threatening.

At some time after your condition is stable, you need to consider your legal rights for holding the party who caused your injury responsible for what happened.

Most people are familiar with the terms “claim” and “lawsuit.”

They understand that the terms relate to seeking compensation for damages caused by an accident or injury. However, they may not realize that the terms refer to two different processes.

What Does it Mean to Have a Personal Injury Claim?

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A personal injury refers to an accident or situation that results in an injury to another person. The person who is injured sustains damages because of the accident or injury.

Under Florida personal injury laws, the victim has a “claim” for damages against the party who caused the injury.

A claim for damages can arise from a variety of situations. A personal injury case might arise because of a car accident, medical malpractice, slip and fall accident, boating accident, defective product, or countless acts of negligence or wrongdoing that results in an injury.

The types of damages caused by an accident or negligent act could include:

  • Medical expenses and costs to treat the injuries
  • Physical injuries, including brain injuries, broken bones, spinal cord injuries, internal organ damage, back injuries, etc.
  • Emotional, mental, and physical pain and suffering
  • Loss of income and benefits, including decreased earning capacity 
  • Disabilities and permanent impairments
  • Scarring and disfigurement
  • Long-term care and assistance with daily activities
  • Loss of enjoyment of life or a decrease in quality of life
  • Other financial losses and out-of-pocket expenses

The “claim” is for financial compensation of damages. It is against the party who caused the accident. 

However, the person who caused the injury may have insurance coverage that applies to the claim, such as general liability insurance, car insurance, or homeowners insurance. If so, the insurance company may be liable for payment of damages.

Filing an Insurance Claim After an Accident or Injury

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If the at-fault party has insurance covering the claim, you need to file a claim with the insurance provider. For example, if you are injured in a motorcycle crash or truck accident, you file a claim with the other driver’s car insurance provider.

It’s important to understand the claims process.

The insurance company assigns an adjuster to investigate your claim. The adjuster might interview witnesses, gather evidence and investigate the accident scene, and request a written or recorded statement from you.

It is important to understand that the insurance adjuster is not working to protect your best interest. The adjuster works to limit the insurance company’s liability for your claim. Limiting liability means paying as little as possible to resolve your claim.

Therefore, it is generally not in a victim’s best interest to talk with an adjuster without consulting a personal injury lawyer. Most telephone conversations with insurance companies are recorded. An innocent statement made by the victim could make it more difficult for the victim to recover full compensation for their injury claim.

In addition to providing legal advice, a personal injury attorney can best negotiate with the insurance company.

Settling a Personal Injury Claim 

The insurance company may make you an offer to settle your claim.

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“Settling a claim” means that you release the parties from all liability for the claim in exchange for a specific amount of money.

Even if you discover additional damages or injuries, the settlement agreement you sign when you accept the offer prohibits you from demanding more money for your claim.

You are not required to accept a settlement offer for your claim. You can negotiate with the insurance provider or the at-fault party for more money. If you hired a personal injury lawyer to represent you, your lawyer handles the negotiations with the insurance provider.

Your attorney prepares a settlement demand letter to forward to the insurance provider. The demand letter outlines the facts of the case, your damages, and how much you agree to accept to settle the claim.

The insurance company may accept the settlement demand and pay that amount to resolve your injury claim. The company may issue a counteroffer. At that point, your attorney and the insurance provider negotiate to arrive at a figure that all parties can accept.

However, there are a few important facts about negotiating an insurance settlement that you need to know before agreeing to a settlement:

  • It is never in your best interest to settle an injury claim before you complete medical treatment 
  • The settlement agreement is legally binding
  • You are giving up your legal right to pursue additional claims or damages
  • Insurance companies typically make offers that are below the value of the personal injury claim
  • If the insurance company acts in bad faith regarding your claim, you could have an additional claim against the insurance company for bad faith insurance practices

Most personal injury claims are settled directly with the at-fault party or its insurance provider. However, if you cannot agree to a settlement amount or liability for the claim is disputed, you may need to file a personal injury lawsuit.

What is a Personal Injury Lawsuit?

Physical Therapy

A lawsuit is different from a claim. A personal injury lawsuit is a legal proceeding in civil court. When you file a lawsuit, you must prove the legal elements of negligence to win the case. Negligence is the basis of most personal injury claims. 

You must provide evidence that convinces a jury that:

  • The other party owed you a duty of care
  • The party breached the duty of care
  • The breach was the direct cause of the incident or accident that resulted in your injury
  • You sustained damages because of the accident caused by the breach of duty

When your attorney files a lawsuit, there is no guarantee that you will recover compensation for your injury claim. A jury decides the question of liability and damages. You might believe you have a clear case of negligence, but a jury might not agree.

Also, filing a personal injury lawsuit is a lengthy process. Specific steps must be completed before the case can go to trial.

Steps in a personal injury lawsuit include:

  • Filing the complaint and serving it on the other party
  • Receiving a response to the complaint from the other party
  • Engaging in discovery (gathering additional information and evidence from the other party, witnesses, experts, and other parties associated with the case)
  • Participating in ADR (alternative dispute resolution) such as mediation and ongoing settlement negotiations 
  • Filing and hearing pre-trial motions
  • Trial and jury verdict

If either party does not agree with the case’s outcome, they may appeal the jury’s verdict. Appeals could take years to resolve. 

Before filing a personal injury lawsuit, it is wise to consider the pros and cons of filing a lawsuit. If you do not have enough evidence to prove negligence, you might want to accept a settlement offer. Likewise, suppose the other party alleges that you could be partially at fault for the cause of the accident. In that case, your compensation for damages could be reduced under Florida’s comparative fault laws.

Your lawyer carefully analyzes the case and provides an honest assessment to help you decide what is in your best interest.

Call Our Florida Personal Injury Lawyer for a Free Consultation

The Florida Statute of Limitations restricts the time you have to sue a party for damages caused by an accident or injury. It is best to talk with a lawyer about your case as soon as possible to avoid losing your right to file a personal injury lawsuit. Call our office to schedule your free case review with an experienced Florida personal injury lawyer.