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What You Need To Know About Personal Injury Insurance Claims

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Learning how carriers process insurance claims for those seeking personal injury settlements may help you to maximize the amount of money you receive for being hurt. As you try to move forward, keep an eye on how these four steps are handled.

Sending a Demand Letter

In the early stages of the process, you'll send a demand letter to the insurance carrier outlining what your injuries are and how much compensation you're seeking. You should try to gather as much supporting documentation as possible, such as police and medical reports related to the incident that left you injured. Present as honest a timeline as possible. It may be wise at this stage to retain counsel in order to ensure that all the paperwork you're filing is in good order.

Automated Processing

Most major insurance carriers use advanced analytics systems to determine a settlement range that they consider tolerable. Their models include a variety of factors, such as the assessed total value of the claimant's life, adjustments for local economic conditions and comparisons to similar claims that were settled. All this data is then handed to the adjuster in charge of your case with a directive to try to keep the settlement at or below the low end of the projection the automated system spits out.


If you've presented the insurance company with a competently composed demand letter, the next step should be for the adjuster to move forward with negotiations. Many companies try to make the negotiating process as long as possible to encourage claimants to settle cheaply. It's understandable that you may be dealing with everything from medical expenses to unpaid utility bills, especially if you've been unable to work. Should the insurance provider decide the claim is without merit, you will be informed that no settlement offer is on the table at this point.

Having an experienced attorney look over the initial offer from the insurance carrier will give you a better sense of how close you are to getting a fair settlement. Most likely, your lawyer will send back a counteroffer, and negotiations will go back and forth for several weeks or months.

Accept or Sue

About 95% of personal injury claims never end up in a courtroom, so you should expect a negotiated solution. Your attorney, however, should maintain a clear threat of a lawsuit in order to hasten negotiations and to maximize compensation.