Injury Settlement Negotiations with Insurance Companies

Wednesday, January 29, 2025

Injury Settlement Negotiations with Insurance Companies

Written by Malman Law, reviewed by Steve J. Malman.

Insurance companies are often daunting to navigate in the aftermath of an accident. These profit-driven entities use all manner of techniques to minimize payouts to protect their bottom line. Often, injured parties take meager settlements because they are uninformed about the process, exacerbating their financial and emotional stresses. It is in this regard that the acumen and negotiation skills of an experienced Chicago personal injury lawyer become quite invaluable to counter those tactics by insurance adjusters.

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Insurance adjusters are trained to use different tactics during their work, from delayed processing to cost underestimation for repairs or medical treatment. While these techniques will help minimize payouts, they can effectively be offset by a seasoned personal injury attorney. These attorneys understand not just the subtleties of state laws and insurance regulations but also build strong cases that underline the validity and worthiness of your claim. They equalize the balance of power against insurance companies and, when possible, accelerate the process of receiving fair compensation.

It would be great if one could retain the services of a personal injury lawyer who would allow one to recover while taking up the instrumental role of claim negotiations. In this respect, they relieve the burden that comes from dealing with insurance companies in that one need not struggle with them alone. By so doing, it eases your stress not only in this respect but also ensures recovery occurs without one struggling for their money to recover their finances quickly.

Hence, support from an efficient personal injury lawyer may prove quite significant, though the road to recovery is invariably long and painful. They protect your rights, strongly negotiate on your behalf, and provide counsel in order for you to make an informed decision and obtain compensation for your injuries and losses that you rightfully deserve.

How Insurance Negotiations Work

Suppose you hire a Chicago personal injury attorney to represent your claim. In that case, they will first carefully evaluate all the details of your case. They need to determine how your injuries happened, who caused them, and their severity. All of this information will help them find out what your case should be worth.

Then they will draft a demand letter to the insurance company. This letter will detail your injuries and damages and make a formal request for the amount of money expected for your claim. Shortly after receiving it, the insurance adjuster will usually call your attorney to begin the negotiations.

Sometimes these negotiations occur over just a few days and are relatively simple. In other injury cases, negotiations can take months or even years. Rest assured that your attorney is obligated to tell you about the offers you receive and let you decide how you want to proceed. You can tell them to keep negotiating for you, to accept an offer, or that you want to litigate your claim.

Types of Insurance Disputes

Insurance disputes are so different in their type of insurance. Each category presents unique challenges, which deeply require an understanding of policies and legal precedents that border on these disputes.

Auto Insurance Disputes: These usually arise in the aftermath of an auto accident, wherein the extent of the vehicle damage or personal injuries is in dispute by the insurer. Specific issues may include, but are not limited to, disputes over fault determination, coverage limits, or sufficiency of compensation for repairs and medical treatments. Given the complexities, therefore, specific legislative requirements must be referred to, such as those laid out in Section 7-211 of the Illinois Vehicle Code, which requires proper claim handling procedures by insurers.

Health Insurance Disputes: These are typically centered around the denial of coverage for certain medical procedures or treatments, with insurers possibly claiming that the treatments are experimental or not medically necessary. Patients may also face high out-of-pocket costs for treatments that were assumed to be covered. 

Insurance disputes for homeowners: Most of these usually arise from claims over property damage attributed to a natural disaster, theft, or fire. Major points of dispute may be in respect to damage valuation, policy exclusions, and the speediness of the insurer’s action. To effectively resolve these disputes, one has to understand the specific terms of the policy and any relevant state laws.

Life Insurance Disputes: Life insurance claims can be made fraudulent if one contests the policyholder’s death benefits claim on the grounds of false information provided in the application form or when a policy is cancelled due to non-payment of premiums. These cases are usually determined on the basis of the policy provisions and the facts that surround the policy acquisition and the claim.

Malman Law’s founder Attorney Steven Malman has over 30 years of experience handling personal injury, nursing home, medical malpractice, premises liability, construction and workers’ compensation cases.

STEVE J. MALMAN

Founding Attorney

Steps to Take to Dispute an Insurance Claim Denial

The process of opposing an insurance claim denial is not a very simple one, as outlined below:

• Document Review: Read the denial letter and your policy documents to determine why the claim was denied.
• Evidence Collection: Ensure that you collect all the evidence documents such as the medical records, repair bills and expert opinion that you have.
• Formal Appeal: Write a letter under the formal letter heading to the insurance company, state why the denial should be reversed, and put forward documents in support of the claim.
• Legal Consultation: It is advisable to seek the advice of an insurance lawyer in order to ensure that one is well informed on the process and to increase his/her chances of success.  The experienced attorney will be of help in giving insight with the legal framework of Section 2-2301 from the Illinois Compiled Statutes, ensuring readiness for the proceedings.

What to Expect in an Insurance Dispute?

An insurance dispute goes through a series of stages, starting with the initial assessment made by the insurer to check the validity of the claim. Where conflicts occur, or the claim is rejected, the process progresses to the communication and negotiation stage with the aim of finding common ground and not going to legal proceedings. These negotiations are very important because both sides of the conflict get a chance to state their cases in an effort to come up with a middle ground.

If the negotiations reach a stand-still, then the mediator or the arbitrator can be brought in to solve the problem but on a lesser contact and without going to court. In such a situation, if all these methods prove uneffective in resolving the issue then the case is taken to the court. In court, a judge or a jury goes through the evidence and issues a final judgment. Therefore, it becomes important to reconsider insurance policies after the conflict has been solved in order to avoid the recurrence of such conflicts in the future. In all these stages, it is imperative to have counsel who is knowledgeable in insurance matters as this offers strategic advice and makes arguments that will lead to a favorable decision.

 ADR (Alternative Dispute Resolution)

Alternative Dispute Resolution (ADR) is an effective method for resolving disputes outside of traditional court settings, offering options like mediation, arbitration, and conciliation. These methods facilitate a more collaborative resolution process:

• Mediation utilizes a neutral third party to help disputants reach a voluntary agreement.
• Arbitration involves a neutral arbitrator who listens to both sides and makes a binding decision, akin to a private judge.
• Conciliation focuses on rebuilding and improving relationships between the parties through a facilitator who helps them resolve their conflict.

These approaches are designed to provide a quicker, more cost-effective, and less adversarial resolution to disputes, particularly valuable in complex cases where maintaining relationships may be beneficial.

Benefits of ADR

The benefits of using Alternative Dispute Resolution are significant, particularly in complex insurance disputes where relationships and ongoing interactions can be preserved.

• Cost-Effectiveness: ADR is generally less expensive than court litigation due to the reduced legal fees and expedited process.
• Time Efficiency: Resolutions are typically achieved much faster with ADR compared to the often lengthy court procedures.
• Confidentiality: Unlike court cases, which are public, ADR proceedings are private, which can be crucial for maintaining business relationships and protecting reputations.
• Control Over the Process: Parties have more control over the selection of the individual who will adjudicate their dispute and more flexibility in scheduling when and how the process will take place.
• Preservation of Relationships: Because ADR is less adversarial, it is less likely to severely damage relationships between parties, which is particularly valuable in business contexts where parties must continue to interact post-dispute.
• Finality and Enforceability: Decisions made through arbitration are binding and enforceable in the same manner as court judgments, which can provide certainty to the parties.

These benefits make ADR an appealing option for many, especially in disputes where the underlying relationship between parties is worth preserving or when confidential matters are involved.

Should You Accept a Settlement Offer?

After you file an insurance claim for your injuries, the adjuster assigned to your case might attempt to call you as soon as possible. They want to catch you before you have the opportunity to discuss your case with a well-versed Chicago personal injury attorney. By doing this, you likely won’t know what your case is really worth or even that you don’t have to just accept what they offer you.

However, you do have the right to reject their offer and ask for a higher amount, kicking off a negotiation. The problem is that you likely don’t know the strengths and weaknesses of your case. An experienced Chicago personal injury lawyer would and can leverage each to get you a higher settlement.

Let an Experienced Chicago Personal Injury Lawyer Negotiate for You

The team of skilled personal injury attorneys at Malman Law is ready to negotiate for you today. Call (312) 629-0099 or use our online contact form to schedule your complimentary case review.