How Does Car Insurance Work in a Personal Injury Case? 

How does car insurance work in a personal injury case? After a crash, you have the right to recover damages from the at-fault party. If the other party wasn’t at fault, you are liable for covering their damages. Regardless of what side of the equation you are on, car insurance steps in to cover the losses accident victims endure. 

Were you hurt in a crash? Call Strong Law Offices in Bloomington to recover your losses. Call 309-393-2928. 

Understanding the Role of Car Insurance in Personal Injury Claims

Car insurance plays a pivotal role in personal injury claims, especially in a state like Illinois, which operates under a fault-based system. This means the driver responsible for causing the accident is liable for covering the resulting damages, including medical expenses, property damage, and other costs incurred by the victim. Understanding how car insurance works in personal injury claims in Illinois can help injured parties navigate the process effectively and secure fair compensation.

Types of Car Insurance Coverage in Illinois

Illinois requires all drivers to carry minimum liability insurance, which includes:

• Bodily Injury Liability (BIL): Covers medical expenses, lost wages, and pain and suffering for the injured party if the policyholder is at fault.
• Property Damage Liability: Covers repairs or replacement costs for the victim’s vehicle or other property damaged in the accident.

• Uninsured/Underinsured Motorist Coverage (UM/UIM): Protects you if the at-fault driver doesn’t have sufficient insurance.
• Medical Payments Coverage (MedPay): Covers medical expenses regardless of fault.
• Comprehensive and Collision Coverage: These cover damages to your own vehicle, though they are not directly relevant to personal injury claims.

Filing a Personal Injury Claim Against the At-Fault Driver

If you’ve been injured in a car accident caused by someone else’s negligence, your first step is to file a claim with the at-fault driver’s insurance company. This process involves notifying the insurer about the accident, providing evidence of the other driver’s fault, and documenting your injuries and financial losses. The insurance company will review this information to determine the extent of the at-fault driver’s liability and how much your settlement is worth.

How Insurance Companies Handle Personal Injury Claims

Insurance companies representing the at-fault driver will evaluate your claim to determine liability and the extent of damages. Insurance adjusters work to minimize payouts. They may downplay the severity of your injuries or argue that you were partially at fault. In Illinois, the modified comparative negligence rule applies, meaning you can recover damages as long as you are less than 50% responsible for the accident. However, your compensation will be reduced by your percentage of fault.

Handling a personal injury claim on your own can be challenging, especially if the insurance company disputes liability or offers a low settlement. An experienced car accident lawyer can negotiate with insurers, gather evidence, and ensure you receive fair compensation for your losses.

How Car Insurance Companies Evaluate Personal Injury Claims

When you file a personal injury claim after a car accident, insurance companies undertake a systematic evaluation to determine the legitimacy and value of your claim. Their primary goal is to assess liability, verify damages, and minimize the payout. Understanding how this process works can help you prepare for negotiations and increase your chances of securing fair compensation.

Determining Liability

The first step for car insurance companies is to establish who is at fault for the accident. Adjusters review evidence, including:

• Police Reports: These documents often provide an objective account of the accident and may indicate who the reporting officer believes is at fault.
• Eyewitness Statements: Testimonies from third parties can support your version of events.
• Accident Scene Evidence: Photos, videos, and diagrams of the crash site, including vehicle damage and skid marks, are crucial in determining fault.

If liability is unclear or if multiple parties are involved, the insurance company may assign partial fault to each party based on the circumstances, which can reduce the amount you’re eligible to receive.

Evaluating Medical Records and Expenses

Medical evidence is critical in personal injury claims. The insurance company scrutinizes your medical records to confirm the nature, extent, and cause of your injuries. They may look for:

• Consistency: Do the injuries align with the accident's details?
• Treatment Timeline: Were medical treatments sought immediately after the accident? Delays can be used to argue that the injuries aren’t serious or accident-related.
• Pre-existing Conditions: Insurers might attempt to attribute some or all of your injuries to prior health issues.

Assessing Financial Damages

The insurer calculates the financial impact of your injuries, including current and future expenses related to treatment, income lost due to your inability to work, and repair or replacement costs for your vehicle.

Considering Non-Economic Damages

Non-economic damages, such as pain and suffering or emotional distress, are harder to quantify. Insurance companies often use formulas or software to estimate these damages, typically multiplying your economic losses by a factor, depending on the severity of your injuries.

Once liability and damages are assessed, the insurance company offers a car accident settlement. This initial offer is often lower than what the claim is worth, as insurers anticipate negotiations.

What to Do If the Insurance Company Denies Your Claim

Having your insurance claim denied after an accident can be overwhelming, especially when you’re dealing with injuries and financial stress. However, a claim denial doesn’t mean you have no options. Instead, it’s an opportunity to assess the situation, understand why the denial occurred, and take steps to challenge the decision.

The first step is to carefully review the denial letter provided by the insurance company. This document outlines the reasons for the denial, which could include insufficient evidence, a dispute over liability, missed deadlines, or a lapse in coverage. Understanding the basis of the denial is crucial for determining your next course of action. If the reasons seem unclear or unjustified, don’t hesitate to contact the insurance adjuster for further clarification. This can help you uncover whether the denial was due to missing documentation, miscommunication, or a misunderstanding of the facts.

Once you understand the reasons for the denial, gather all relevant evidence to support your claim. This may include photographs of the accident scene, medical records, police reports, witness statements, and repair estimates. Strong, clear documentation can address gaps in your original submission and counter the insurer’s arguments. For example, if the insurer claims there wasn’t enough evidence to prove liability, providing additional accident scene photos or eyewitness accounts can strengthen your case.

If the insurance company made an error in denying your claim, it’s important to file an appeal. Most insurance policies have an internal appeals process, which allows you to formally dispute the denial. When submitting your appeal, include all supporting evidence and a detailed explanation of why the claim should be reconsidered. Be sure to follow the insurer’s guidelines for appeals, including deadlines, to avoid further complications.

In some cases, insurers deny claims in bad faith, meaning they fail to uphold their legal obligation to act fairly and in good faith toward their policyholders. If you suspect bad faith practices—such as denying a valid claim without proper investigation—you may need to escalate the matter. Start by consulting with a lawyer for your car accident who can evaluate your case, negotiate with the insurer on your behalf, and, if necessary, pursue legal action to protect your rights.

You can also seek assistance from your state’s insurance regulatory agency. In Illinois, for example, the Department of Insurance oversees insurers and ensures compliance with state laws. Filing a complaint with the agency can prompt an investigation into whether the insurer acted improperly.

Throughout the process, it’s important to remain persistent and organized. Keep detailed records of all communications with the insurance company, including emails, letters, and phone calls. Document every step you take to address the denial, as this information may prove invaluable if the dispute escalates.
A denied insurance claim is not the end of the road. By understanding the reasons for the denial, gathering evidence, appealing the decision, and seeking legal advice if necessary, you can take meaningful steps to challenge the insurer’s decision and pursue the compensation you need. In Illinois, Strong Law Offices has what it takes to secure you fair compensation. Contact our Bloomington office at 309-393-2928 to schedule your FREE consultation.