Overview Of Filing A First-party Claim Under Your Own Insurance

If you acquired injuries in a vehicle accident, then you may need to file a claim against your own insurance provider, instead of against the other party. A personal injury claim against your insurance is called a “first-party claim,” while a claim against the party at fault is called a “third-party claim.” (List of Top Questions after an Auto Accident)

If you reside in Puerto Rico or a no-fault state, then you don’t have an option. You should file a claim against your own coverage.

3 Reasons for Filing a First-party Claim

1. The responsible party was either uninsured or under-insured. You have UIM insurance.

2. You have PIP (personal injury protection) coverage, and do not have the time to expect the responsible party’s insurance company to begin paying your expenses.

3. You reside in Puerto Rico or a no-fault auto insurance state, and are obligated by the law to do so.

If you acquired injuries in a vehicle accident, then you may need to file a claim against your own insurance, instead of against the other party.
If you acquired injuries in a vehicle accident, then you may need to file a claim against your own insurance, instead of against the other party.

Pros

• You do not have to be anxious about which party was to blame. Your insurance pays your claim irrespective of who caused the incident.

• Your present medical expenses are paid, without the need to settle the sum or argue liability with an adjuster.

• You are paid off for future medical expenses that only relate to the mishap.

• Your out-of-pocket bills are compensated (e.g. crutches, medications, etc.)

• You get your benefits quickly, unlike a third-party claim, taking months (or even years!) before negotiation and payment.

• Your stress is reduced, since a first-party claim isn’t an adversarial course.

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Cons

• You may need to pay your deductible first before your insurance will begin paying for your medical expenses and bills.

• Depending on the state you reside, the most expensive insurance settlement may not be high. A lot of states establish the highest medical coverage under PIP or no-fault at approximately 80% of the total. And the lost wages maximum at only 60%.

• You may need to waive your rights to subjugate.

• You may need to repay your insurance if you get any payment from the responsible party or his/her insurance company.

• You may also need to repay your insurance if you accepted reimbursements from your own medical health plan.

• In a first-party personal injury claim, you cannot get payment for the suffering and pain or emotional misery you underwent due to the accident. You are also forbidden to claim disciplinary damages for deliberate misconduct.

Should You Negotiate a Personal Injury Claim or File a Lawsuit?

Picture yourself being in a car accident and injured because of somebody else’s negligence. You have doctor and hospital bills, costs for bandages and medications, and other ongoing therapy bills. You are hurt and you cannot work. The pain you endure continues day by day. What do you do?

Should you file for a claim and opt for a settlement, or do you file a court case against the guilty driver? A personal injury lawsuit and a personal injury claim are two very different things. It is imperative that you understand which one applies best to your case.

(Car accidents are usual examples, but the info here refers to all kinds of personal injury cases such as slip and falls, defective products, dog bites, etc.)

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Difference Between a Lawsuit and Claim

Personal Injury Claim. The claim is between the responsible driver and your insurance company prior to any considered case. The process is a chain of negotiations and discussions between you and the insurance company adjuster. With any luck, the negotiations will lead to a mutual settlement payment, wherein both sides or parties are satisfied.

Personal Injury Lawsuit

The lawsuit is charged when the process of negotiation goes wrong, and cooperation cannot be attained. The breakdown could take place because the adjuster refuses to accept the fact that their insured was responsible for the accident, or does not acknowledge the graveness of your injury to compensate for the amount you are demanding. When claim discussions do not progress, the next thing to do is to file a lawsuit.

A claim starts after the injured party is harmed or is suffering property damage, or both, attributable to the negligence of another driver.
A claim starts after the injured party is harmed or is suffering property damage, or both, attributable to the negligence of another driver.

Beginning a Personal Injury Claim

A claim starts after the injured party is harmed or is suffering from property damage, or both, attributable to the negligence of another driver. To cover the ensuing costs, the injured party pursues the responsible driver, who takes the issue over to the insurance company.

As soon as the insurance company is informed, it produces a claim number then hands over the case to an adjuster. The adjuster establishes a claim and makes contact with the injured party to discuss a settlement. If both parties can decide on a settlement, a court case won’t be needed to be filed.

In order to resolve the case, the adjuster requires evidence that the mishap was caused by his/her insured (the responsible driver), that his/her insured was careless, and that the damage of the injured party are sufficiently severe to be eligible for a settlement. And to acquire this evidence, the adjuster will look into the facts and details of the case.

This investigation could include:

• Evaluating your medical bills and charts
• Conversing with you along with the other accident’s witnesses
• Assessing the police report
• Visiting the accident scene and taking photographs

We hope this article was helpful to you. You will find more information about personal injury law in out site.

What to Do Immediately After an Accident

If you are injured in a vehicular accident, the first thing that you should do is dial the emergency hotline and report the accident. If you’re seriously injured, somebody else must call for you.

Reports from police and EMS (Emergency Medical Services) will be important documents in the personal injury case you’re in. The report of the EMS will take in an account of your injury as well as the medical care they provided during the scene. In addition to that, EMS may relocate you to the closest hospital, where medical practitioners will document more medical records.

A police report includes in depth information regarding the errors of the responsible driver (including issued tickets), names as well as contact information of the witnesses, insurance information, accident diagrams, weather conditions, and more.

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Do not allow the other driver to talk you out of dialing the police.

Always call the police if anyone is injured or any property was damaged. Don’t agree to any arrangements that don’t involve making an official accident report. If you plan on filing a personal injury or property damage claim against the other driver, a police report will be very helpful.

EMS and the police can only document certain information in their reports. Try to gather any additional information you think may help during claim negotiations. The more information you have, the better your chance of a higher settlement.

Note down the following immediately after the accident:

• The negligent driver’s name, telephone number, address, e-mail address, as well as any other contact info you can acquire.

• The driver’s name of the insurance company, telephone number, as well as his or her policy number.

• The all witnesses’ names and contact info.

• Your immediate observations and opinion.

Also take pictures of the scene of the accident, your injuries, and the damages inflicted on the car. If you are badly injured, then request somebody at the scene to assist you in taking photographs.

If you are injured in a vehicular accident, the first thing that you should do is dial the emergency hotline and report the accident.
If you are injured in a vehicular accident, the first thing that you should do is dial the emergency hotline and report the accident.

In The Next Few Days

You will have to consult a doctor to acquire treatment for the injuries you’ve acquired. In order to have a strong case, you should have independent and credible medical documentation and records. Be certain to obtain recommendations from any specialists that have treated specific injuries.

Watch out for clinics and doctors that advertise directly to victims of personal injury. There are countless of these medical professionals that have needlessly extended the cost and length of the treatment. Insurance adjusters are acquainted with who these guys are, and instantly mark down their standing, and this requirement of standing can be particularly damaging if the case proceeds to court.

Consult your own physician first. If you do not have a doctor, ask for recommendations from friends and family. Look for doctors who’ll treat your injuries objectively and provide the medical records required to support you and your case. Accept therapy and medical treatment as your physician orders.
An adjuster (from the insurance company) will contact you soon after the incident. The sole job of the claims adjuster is to look into and settle accident claims.

The best means of making a good impression to an adjuster is to be always ready, show complete evidence of the negligence of the insured, and verify your property damage and injuries. That is what personal injury lawyers do. With the right information and preparation, you can also do the same.

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Why You Need the Services of a Personal Injury Attorney

Are you having second thoughts as to whether you need a personal injury attorney in a personal injury case or not? If you are, then we will help you make up your mind in this section.

You need a lawyer for any severe injury case, or whichever case that requires expert legal knowledge or advanced financial support. Lawyers have the sufficient experience to negotiate settlements, and, if necessary, can file a court case. They can dedicate the huge amounts of cash and time required to bring cases to trial.

A lawsuit’s advance costs can entail taking the private investigators and expert witnesses into service, paying for depositions and court reporters, and a lot more. The most difficult cases, particularly against big businesses, can cost you a lot of money.

You need a lawyer for any severe injury case, or whichever case that requires expert legal knowledge or advanced financial support.
You need a lawyer for any severe injury case, or whichever case that requires expert legal knowledge or advanced financial support.

Cases that usually do require a lawyer include:

• Extreme injury cases, like dismemberment, wrongful death, compound fractures, scarring or major disfigurement, paralysis, eternal loss of function of body organs, long-term disability, permanent illness, as well as toxic exposure.

• Medical malpractice with intricate evidence and medical testimony.

• Class action cases, counting drug lawsuits against pharmaceutical corporations.

• Complex assessments of suffering and pain.

• Police brutality.

• Cases that need huge amounts of cash to prepare.

• Law questioning, making and filing of lawful briefs and memo.

• Hiring professional witnesses.

• Other cases that involve very multifaceted and extended evidences.

Making a Decision

Each case is special. If the proof or evidence is clear, dealing with your own case could cause a higher form of settlement, although not always. Nothing can assure you with a successful result. The choice to resolve your own claim or employ a lawyer rests generally depends upon the graveness of your injuries.

You may believe that your case is extremely strong, however, the insurance company might disagree with you. Instead of acquiring a small amount of settlement (or worse, nothing at all), it is best to employ a personal injury lawyer.

Anyway, it is always a great idea to obtain a free consultation.

Know The Characteristics Of A Medical Malpractice Case

Are you trying to figure out whether or not you have a medical malpractice case? Well, if you are, then we will do our best to explain the different characteristics of a medical malpractice case in this section.

According to professional malpractice attorneys in the United States, a medical malpractice claim requires the following broad characteristics:

1. Failure to give the appropriate standard of care. The law declares that there are standard medical principles by which healthcare experts should stick to while providing care to individuals. The medical career distinguishes these standards.

Patients are expected to experience these medical standards while getting treatment. If the standard are ignored, then there could be medical negligence.

Failure to give an appropriate standard of care.
Failure to give an appropriate standard of care.

2. An injury is the effect of negligence. A claim can’t be set if the individual thinks that the hospital or doctor was careless but caused no injury or harm. The individual being treated has to show that the carelessness resulted in the harm or injury, and that it wouldn’t have happened if the healthcare professional or provider had not been careless.

If the patient isn’t happy with the result, then that in itself isn’t medical malpractice. It’s only malpractice when it’s established that the negligence resulted in the injury or harm. An injury without negligence isn’t considered malpractice, and neither is evident neglect if there’s no injury or harm.

3. The injury of the patient should be severe. Lawyers state that in order for a medical malpractice case to be credible, the victim has to confirm that the harm or injury caused by the negligence lead to substantial damages. Attorneys are very expensive to pursue for this purpose. Instances of significant damages include enduring hardship, suffering, having to endure constant pain, significant loss of income, and immobilization of the patient.

If the damages are minor, the victim will most likely pay out more on the claim compared to the final cash recovered.

An injury is the effect of negligence.
An injury is the effect of negligence.

Informed Consent. If the patient doesn’t provide an “informed permission” to a medical operation, the healthcare provider or doctor may be legally responsible if the procedure causes injury or harm, even though it was done perfectly. For instance, if a surgeon didn’t report to the individual that a medical/surgical operation has a 50% risk of brain damage, and that individual suffers one, the doctor will be legally responsible, even though the procedure was carried out perfectly, since the patient could have chosen not to proceed if they had been notified of the dangers.

Researchers in Harvard Medical School showed that a large minority of doctors and healthcare providers don’t think that patients should constantly be told of the entire truth.

Those are the characteristics of a medical malpractice case. Feel free to share or like this post if you think it has answered your question.

How to Build a Personal Injury Claim following a Car Accident

If you’ve ever been into a car accident, then you must be asking a lot of questions about how to build a personally injury claim. This section will give you a number of pointers on how you can build your case.

First of all, it is important to remember that the responsibility for a car accident claim rests on the driver who is at fault. If their carelessness resulted in the accident, they are legally responsible for your damages.

Damages can include property damage, personal injuries, or both. If the mishap was your liability you do not have a case. You can merely file a claim by means of your insurance company. Damages in a personal injury include your lost wages, out-of-pocket expenses, medical bills, as well as pain and distress. Damages in property include car damage as well as any personal stuff within it.

Negligence and Damages

To win the claim, you should confirm that the other party was careless, and that his carelessness resulted in property damage or your own personal injury. If you do not have damages, then you do not have a claim, regardless of how irritated you may be with the other party.

Inspector. Graphic logo is my artwork. Thanks. Red leather Personal Injury Law book and gavel with gold embossed type and stylised icon of figure with arm in a sling embossed on the book cover and a Personal Injury writ.
Inspector. Graphic logo is my artwork. Thanks. Red leather Personal Injury Law book and gavel with gold embossed type and stylized icon of figure with arm in a sling embossed on the book cover and a Personal Injury writ.

You are either injured or you are not. Your vehicle is either damaged or it is not. Your moral decision has no stand on your case. Regardless of how speedy the other party was going, the number tickets the officer issued, or the level of his intoxication, without property damage or injuries, you do not have a case.

Example: Minor rear-end accident

At a red traffic light, a guy named Jim is stopped. A vehicle comes up high-speed behind him, and do not stop in time to avoid smacking into him. Jim as well as the other driver pulls off to the road side. When they get out of their individual vehicles to talk, the alcohol smell is apparent on the breath of the other driver. Jim immediately dials 911.

When the police turn up, they issue tickets to the other driver for ‘Failure to Obey a Traffic Signal’ as well as ‘Driving with an Expired License.’ Following the failure of a field sobriety test for the other driver, they arrest him for DUI.
The car of the other driver suffers some damages to the fore bumper. Jim’s vehicle has impact resistant bumpers, and is not damaged by any means. Neither driver is injured.

Does Jim have a legal claim against the drunk driver?

No. Though the other driver was evidently careless, and police issued him tickets then arrested him, Jim did not experience any damages. He had no property damage or personal injuries to root a claim in.

The damages requirement is not limited to vehicular accidents. When somebody has their property damaged or is injured caused by the negligence of someone else, they probably have a good claim. This can include defective products, dog attacks, slip and falls, etc.

This section will give you a number of pointers on how you can build your case.
This section will give you a number of pointers on how you can build your case.

Example: Foreign object in food

Mark together with his friends is dining at an eating place and finds a piece of shattered glass in his food. He’s upset since he may have consumed a piece of that object and been injured internally. He calls the manager over, and shows him the tiny object.

The manager makes an apology, stating a saucer broke inside the kitchen, and a piece of that dishware perhaps fell into Mark’s food. The manager creates an incident statement, and provides a free meal to everybody at the table.
Does Mark have a case?

No. He was not injured. It does not matter how traumatized or upset he was over discovering a piece broken of dishware in his food. What really matters is that he did not swallow the object and become injured. If he had consumed the object and endured internal injuries, the negligence of the restaurant, together with his injuries, could be a strong claim.

We hope that the information and examples we have presented in this section was helpful to you in some ways. If you want more information about how personal injury claims can be built, go to this website –