The Role Of Insurance In Catastrophic Injury Cases
A catastrophic injury is an injury that causes severe, permanent damage. These injuries have a profound physical and emotional effect on victims, and they can also take a considerable financial toll. You may be able to recover compensation from your insurance company, but doing so is often more complex than you’d expect.
Here’s a closer look at how insurance may impact your compensation and legal options in a catastrophic injury case.
What Types Of Insurance Are Involved In Catastrophic Injury Cases?
The role of insurance companies in catastrophic injury cases is highly complex, and that’s partly because so many types of insurance companies can be involved. Depending on your circumstances, you may need to file a claim with one or more of these insurance companies:
Car Insurance
Car accidents are a major cause of catastrophic injuries. If you were injured in a car accident, you may need to file a claim against the other driver’s insurance, your insurance, or both.
Health Insurance
Your health insurance should pay for your medical care immediately after the accident, and it should also cover ongoing care.
If it’s determined that your injury was caused by someone else, a health insurance company may subrogate the claim. This means that they will pay for your healthcare and then attempt to recover what they spent from the responsible party.
Disability Insurance
If you have disability insurance, you may be able to receive replacement income while you heal.
Workers’ Compensation Insurance
If your injury happened at work, you would likely file a claim with your employer’s workers’ compensation insurance provider.
Homeowners’ Insurance
If the accident happened on private property, you might pursue compensation from the property owner.
How Does Insurance Coverage Affect Compensation For Catastrophic Injuries?
If you’re involved in an accident and suffer a minor injury, you might be able to file a personal injury claim and receive compensation quickly. However, catastrophic injuries are often expensive to treat, and even initial treatment costs could exceed an at-fault party’s insurance coverage.
For instance, many catastrophic injuries are caused by car accidents, and many Colorado drivers only have the mandatory state minimum insurance:
- Bodily injury per person: $25,000
- Bodily injury per accident: $50,000
- Property damage per accident: $15,000
If the at-fault party’s insurance can’t cover all of your expenses, you may be able to file a claim with your own uninsured/underinsured motorist insurance or sue the at-fault party directly. However, even if you are able to recover some compensation this way, you may not be able to recover all of your losses.
Many people hear about multimillion-dollar settlements for catastrophic injuries and assume that they will receive similar compensation. Often, the defendants in these cases are trucking companies, hospital systems, or other large entities.
What Limits Or Exclusions In Insurance Policies Should Victims Be Aware Of?
Policy limits can have a major impact on any settlement you receive. However, many insurance policies have specific exclusions that may also affect your case.
Using Personal Vehicles For Commercial Purposes
Almost all car insurance policies will decline coverage if someone gets into an accident while using a personal vehicle for business purposes. For example, if an Uber driver doesn’t have a rideshare insurance endorsement and gets into an accident while logged into the app, their personal auto policy would likely not pay for damages.
Intentionally Misusing A Vehicle
The purpose of car insurance is to cover unforeseen events. If a driver is behaving recklessly and causes a crash as a result, their insurance might refuse to pay any related claims.
For example, imagine that you suffer catastrophic injuries after being hit by a street-racing driver. Even though you need help paying for medical care, the insurance company might refuse to pay because the policyholder was deliberately misusing the car.
Pre-Existing Conditions
If you have a pre-existing condition that was made worse by your accident, the insurance company may try to deny the claim altogether. They might try to do this even if you just had a related condition in the past.
If you have a legitimate claim that the insurer is trying to deny, our team can help gather evidence to show that the other party’s negligence significantly worsened an existing injury, caused a new injury, or both.
How Do Insurance Companies Handle Catastrophic Injury Claims?
Once you file a claim for a catastrophic injury, the insurance company begins its investigation. In general, cases involving very serious or very complex injuries take longer to evaluate, so the insurance investigation could take months.
The process starts when the insurer assigns an adjuster to your case. The adjuster is responsible for gathering evidence, determining fault, and calculating the value of your case.
In theory, insurance adjusters are assessing your case independently. However, because they work for the insurance company, your adjuster will likely make decisions that lean in the insurer’s favor.
What Challenges Arise When Dealing With Insurance In These Cases?
With most types of claims (especially those involving catastrophic injury), insurance companies will do whatever they can to avoid having to pay. Some will resort to bad faith tactics, like these:
- Lowball settlement offers
- Unnecessary delays
- Requests for redundant information
- Denying your claim for unclear reasons or no reason
- Refusing to promptly and thoroughly investigate
These challenges can be frustrating and discouraging, especially when you’re trying to adjust to a life-altering injury. The best way to deal with these tactics is to work with a lawyer. The Elite Litigation Group team knows how to push back against these tactics and increase your chances of fair compensation.
Can Insurance Settlements Fully Cover Long-Term Medical Care And Damages?
Many types of catastrophic injuries require lifelong medical care and have a lasting impact on your quality of life. When filing a claim against your insurance coverage for catastrophic injuries, you may be able to receive compensation that covers your past, present, and future expenses.
Calculating the value of your current medical bills and other damages may not be especially complicated. However, estimating the monetary value of future medical care can be difficult. We often consult with economists, medical professionals, labor market experts, and other expert witnesses who can come up with an evidence-backed figure.
How Can An Attorney Help To Navigate Insurance Issues In Catastrophic Injury Lawsuits?
Any personal injury lawyer can tell you that insurance issues are common. When your case involves a catastrophic injury, there’s more money on the line, and that means the insurance company may use aggressive tactics to avoid paying.
Insurance companies that resort to unethical tactics often do so because they think they can get away with it. When you work with our personal injury attorneys, we can quickly identify bad-faith tactics and push back accordingly.
We can also help you navigate the complex web of insurance policies that may apply to your case. For the average person, it can be very difficult to decide where to file a claim first. We handle the logistics of your case, so you can focus your energy on healing.
What Steps Should Victims Take When Filing Insurance Claims After A Catastrophic Injury?
You might not be able to control the outcome of your insurance claim. However, taking these steps can increase your chances of receiving fair compensation:
- Keeping detailed documentation of your medical treatments and progress.
- Keeping your medical bills and medical records.
- Keeping proof of all other injury-related expenses.
- Following all of your doctor’s advice.
- Attending all follow-up appointments.
- Not discussing your case with anyone but your lawyer.
- Keeping a written log of any communications you have with the insurance company.
You’ll probably have questions for your injury lawyer as you go through this process. Don’t hesitate to ask. The legal process can be disorienting and overwhelming, but when you have a general sense of how it works, it becomes easier to proceed with confidence.
Why Choose Elite Litigation Group For Catastrophic Injury Insurance Claims?
If you’ve suffered a catastrophic injury, you need a catastrophic injury lawyer who grasps the unique challenges of cases like yours.
Elite Litigation Group is a team of investigators, paralegals, and senior attorneys who focus exclusively on catastrophic injury and wrongful death cases. If you’ve suffered a catastrophic injury and don’t know where to turn, we’re here to help.
Contact Us Today To Set Up A Free Consultation.