The Process of a Personal Injury Claim in Gainesville, FL
Bill Allen | December 28, 2022 | Personal Injury
Florida is one of only a handful of states that use no-fault insurance. After a minor accident, no-fault insurance blocks you from filing an injury claim against the at-fault driver.
But if you suffer a serious injury in a car accident or suffer any injury in a non-vehicle accident, you can pursue an injury claim. This process almost always involves liability insurers and insurance defense lawyers.
Liability Insurance Policies
A liability insurance policy is a contract between an insurer and an insured. Liability insurance does not protect the insured from injuries. If the policyholder gets injured, they cannot file an injury claim under their liability policy.
Instead, liability insurance protects the insured from liability claims. If an accident victim asserts a claim within the scope of the policy against the insured, the insurer must pay the damages arising from the claim.
For example, suppose that a restaurant customer trips on some loose carpet and breaks an arm. The restaurant’s liability insurer will pay the losses incurred by the customer due to the injury.
Liability insurance policies have policy limits. The insurer will pay up to the policy limit. If the losses exceed the policy limits, the policyholder will pay the difference. Thus, if the restaurant bought a $25,000 liability policy and the customer’s broken arm costs $30,000 in treatment and therapy, the insurer pays $25,000, and the restaurant pays $5,000.
Liability Insurance Coverage
If you get injured in an accident, you will usually start your claim with the at-fault party’s liability insurer. One exception in Florida surrounds car accident injuries, as discussed later.
But for most non-vehicle accidents, you can find a liability insurer to pay the claim.
Some examples of liability insurance that covers bodily injuries include:
- Medical malpractice policies
- Homeowner’s policies
- General business liability policies
- Business premises policies
These insurance policies often cover some unexpected liabilities. The liability provisions of a homeowner’s policy always cover slip and fall accidents at the residence or other on-premises guest injuries.
Florida No-Fault Auto Coverage
Under Florida’s no-fault system, every automobile owner in Florida must buy personal injury protection (PIP) coverage with their car insurance. After an accident, each vehicle occupant pursues injury compensation from the policy covering their own vehicle.
This system eliminates liability claims against the at-fault driver except in the most serious accidents. Accident victims can only pursue injury compensation from the at-fault driver when their losses exceed their PIP policy limits, or they suffer significant permanent injuries.
The Process of a Personal Injury Claim
A personal injury claim begins with a liability insurance claim. The claim describes the accident and lists the parties involved.
The insurer assigns an adjuster to the claim. The adjuster investigates the claim to verify that the claim falls within the scope of the policy.
The adjuster serves the insurer, not the policyholder or the accident victim. As such, the adjuster will look for any way possible to deny the claim. Some grounds for denial include:
- The accident did not happen
- The policyholder did not cause the accident
- The accident did not cause your injuries
- Your medical treatment was unnecessary
If the adjuster denies the claim, you and your injury lawyer can respond to the denial. Often, you will have medical records, accident reports, or other evidence to overcome the claim denial. The insurer will offer a settlement if the adjuster accepts the claim.
Negotiating a Settlement
When you get a settlement offer from the adjuster, it will likely be too low. You and your lawyer will assess the value of your claim and negotiate with the adjuster to get a better offer.
It’s important to remember that you can seek compensation for your losses, both economic and non-economic. Your economic losses include all the financial costs of your injuries, such as lost wages and medical expenses. Your non-economic losses include all the human costs of your injuries, such as pain, mental anguish, and disability.
By adding up your losses, you can estimate what you could get from a jury. As you negotiate with the adjuster, you may need to compromise. But you can fight for the best possible offer that fairly compensates you for your losses.
Filing a Lawsuit
Sometimes, you cannot reach a compromise with the adjuster. You may need to file a lawsuit to put additional pressure on the insurance company to settle the claim.
Also, you have impending deadlines to meet. A statute of limitations tells you how long after your injury you have to file a lawsuit. If you miss your deadline, a court must dismiss your lawsuit. If your case drags along, you may need to file a lawsuit to preserve your claim.
If you and your injury lawyer decide to file a lawsuit, the lawyer will prepare the pleadings and file them at the courthouse. You will sue the at-fault party, but the liability insurer will defend them.
Your lawyer will exchange discovery with the insurance defense lawyers. Your lawyer will also prepare for trial with motions filed with the court to determine what will be presented to a jury.
All the while, your lawyer will continue to negotiate with the insurance lawyers to try to settle the case. Only 3% of injury cases reach trial. Your lawyer will probably resolve the case before it ever reaches a jury. But if you do reach trial, your lawyer will present evidence to a jury. The jury will weigh the evidence and render a verdict.
Resolving a Personal Injury Claim
Whether you win or settle your case, the insurer and at-fault party will pay your compensation to your lawyer. The lawyer will deduct their contingency fee and send the remaining compensation to you. Since contingency fees usually range between 33% and 40%, you will receive the bulk of your settlement or damage award.
This money will go toward paying your medical bills and living expenses. While the compensation might not heal you, it might take some pressure off you and allow you to focus on your health. So if you plan to file a personal injury claim, consider teaming up with an experienced attorney.
Contact Our Gainesville Personal Injury Law Firm in North Central Florida
If you need legal assistance, contact the Gainesville personal injury lawyers at Allen Law Firm at your nearest location to schedule a free consultation today.
We have three convenient locations in North Central Florida: