Despite your best efforts to settle your personal injury case or accident insurance claim yourself, at some point in the process you might wind up wanting or needing help from a lawyer because of the seriousness of your injuries, complications in your claim, or simply an insurance company refusing to make you a reasonable offer - or take you seriously at all.
This three part series explains when you will want to talk to a lawyer, how to find the right lawyer to help with your personal injury claim, and whether you need the lawyer to take over handling the claim or just need a couple of hours of advice. For more on how you can work with a lawyer without losing control of important decisions regarding your claim, see our two part article on “Working With Your Personal Injury Lawyer”.
You might consider consulting with an experienced personal injury lawyer at different points in the claims process, and for several reasons.
At the very beginning of the process, or at any point along the way, you might decide that your accident or injury claim is too big or too complicated to handle without a lawyer. This may be because there are technical or legal complexities that make it very difficult for a non-lawyer to manage.
Or it may be that your injuries are severe or permanently disabling, which makes the case more valuable and also means there’s a wide range in the amount of money you might recover. In such a case, it becomes worth the cost of a lawyer to make sure that you maximize your compensation. For more on this issue, see “Are Lawyers Optional in a Personal Injury Case?”
It’s also possible that even though your claim isn’t particularly big or complicated, you still just do not feel comfortable handling it yourself. You might realize this at the beginning of the claim process. Or, you might begin handling matters yourself but later decide that you would prefer to have a lawyer take over. This happens to many people if their claim is headed to arbitration. In any of these situations, you are hiring an injury lawyer to relieve your stress in addition to winning more compensation for you.
In some cases, you may handle your claim comfortably and competently but still wind up wanting to hire a lawyer because the insurance company refuses to make a fair settlement offer. If you’re not willing to settle for a token amount and you believe your claim is worth quite a bit more than the dollar limit of your state’s small claims court, you’ll need a lawyer to help you—and in these circumstances, the compensation a lawyer might be able to get for you, even considering the lawyer’s fee, would be better than settling. There are two main reasons an insurance company might give for refusing to make a reasonable offer.
It is not unusual for an insurance company initially to deny that their insured was in any way at fault for an accident. Often it does this in the hope that you will believe it, or that you will quickly become so frustrated that you give up and drop your claim. Usually, though, after you show that you will not immediately fold up your tent, an insurance company will come around and make a reasonable settlement offer.
However, if an insurance company does not budge from its initial denial of all responsibility, you may need help from a lawyer. You have nothing to lose at that point. If an experienced personal injury lawyer can coax some money out of the insurance company, you will at least have received some compensation. If the lawyer agrees to handle the case for a contingency fee but ultimately gets no compensation for you, you won’t have any lawyer’s fees to pay and you will at least know you have turned over every stone. To learn more about lawyer’s fees and expenses in personal injury cases, see “Managing Lawyer Costs & Expenses in a Personal Injury Case”.
Another claim the insurance company might make is that the particular accident is not covered by the insurance policy. In this case, your first step should be to demand a copy of the insurance policy and read it carefully to see whether what the insurance adjuster says is true.
Even if you locate in the policy exactly what the insurance adjuster says is there, that does not necessarily end the matter. Most insurance policy provisions can be interpreted several different ways, and courts usually try to interpret them so that injured people are covered. So if an insurance company continues to deny coverage, take your claim to an experienced personal injury lawyer. The lawyer may be able to force the insurance company to provide the coverage it has been paid to provide.
The right to sue a government entity—a town, city, county, or state, or a school, transportation, or other local district—for an accident caused by its employee is strictly controlled by specific laws in each state. These laws—known as “sovereign immunity” and the “tort claims act”—establish the rules about when you are allowed to sue the government because of an accident, and the special procedures you have to follow before you may do so. See Personal Injury Claims Against the Government.
Even after completing these procedures, however, the government’s response may be to deny you any compensation, arguing that it is immune to claims in your particular kind of accident.
Like an insurance company’s denial of coverage, a government’s claim of immunity is sometimes just a knee-jerk response that disappears after you negotiate for a while. But claims adjusters for public entities do not give up public money easily, and sometimes they cling to an immunity defense all the way to court. Because of the complexity of the rules involved, if a claims adjuster refuses to make any settlement offer to you because of a supposed government immunity, you will almost certainly have to consult a personal injury attorney about making a legal attack on that immunity claim.
Occasionally, the success or failure of a claim turns on a specific legal rule. For example, your right to collect insurance from a business might depend on whether its employee was acting within the course of employment when the employee injured you in an accident. The law has technical rules about what is and is not the “course and scope of employment.” Or, you might have been injured on a buckled sidewalk, and the question of who is responsible might involve legal rules about water damage, tree roots, or other property law questions.
In one of these situations, you might want to consult with a lawyer on an hourly basis just to get an experienced legal opinion about how the rules of legal responsibility apply in your case. And, if the fate of your entire claim seems to hinge on a legal question, you might want to hire an attorney to take over handling your entire claim.