The claims process usually proceeds in predictable steps. Before you file a claim, you must notify people who may be responsible for the accident that you've been hurt and intend to file a claim for your injuries. This increases your chances of getting a quick settlement and prevents others from later saying that your claim unfairly surprised them.
Next, after you've taken time to thoroughly investigate your claim by gathering evidence, establishing who's responsible for the accident, determining what you believe your claim is worth, and planning good arguments, you will write a formal demand letter and submit it to the insurance company of the person who you believe is responsible for your injuries. (This may include your own insurance company -- for example, if you are covered by a no-fault automobile policy or need to make a claim for uninsured or underinsured motorist coverage.) From there, you will engage in informal negotiations with the insurance company until you agree on a settlement you can live with.
Many insurance claims are that simple, though sometimes you may find yourself dealing with a stubborn or unreasonable claims adjuster. If that's the case, you must resort to more determined negotiation tactics -- or perhaps consult an experienced personal injury lawyer. If all else fails, you may even have to take your case to court.
After you notify others that you've been hurt in an accident and intend to file an injury claim, you may receive phone calls from one or more insurance companies that want to talk to you about what happened. In these first conversations -- which will most likely occur before you file your claim for compensation (called a "demand letter") -- you should abide by the following principles:
* Remain calm and polite
* Identify the person you're speaking with, the company he or she represents, and the person who is insured
* Give limited personal information (your name, address, and phone number is sufficient)
* Do not give details about the accident or your injuries
* Resist any push to settle your claim immediately
* Set limits on further phone contact, and
* Take notes about any important information you received during the phone call, as well as whatever information you gave to or requests you made of the insurance adjuster.
After you decide which insurance company (or companies) should pay for your injuries, and you gather all the evidence you need to establish your claim, you must send the insurance company a demand letter. This letter is a critical element of your claim negotiation process, so it is essential that you write it carefully and well. In your demand letter, you set out your strongest arguments concerning:
* Why the insured person is legally responsible for your injuries
* What your injuries were and are
* What kind of medical treatment you've had and how much it cost
* What your income loss was
* What other damages you suffered, and
* If you have no-fault automobile insurance, why you qualify to make a claim against the insured person.
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