How Do Insurance Companies Evaluate Injury Claims?

Motor vehicle accidents cause a wide range of injuries. These include broken bones, cuts, bruises, and head and spinal cord injuries. Whiplash, concussions, and herniated discs are also common. In some cases, these injuries can lead to long-term pain and disability.

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How Do Insurance Companies Evaluate Injury Claims?
2 Min Read February 20th, 2023

Getting injured in an accident is an upsetting experience. Not only does it cause physical pain, but it can also be expensive. You may have to go to physical therapy or doctor's appointments and have to miss important life and work events.

You can file an insurance claim if you are injured in an accident caused by someone else's negligence. When you file your claim, you will be asked to send in all the documentation you have of your accident and expenses. The case will be assigned to an insurance adjuster who will investigate the crash.

An insurance adjuster will review the evidence in the case and decide whether or not to honor your claim. If they honor it, they will offer you a settlement offer. You can expect an insurance adjuster to look at a few things when evaluating your claim. A lawyer from Brown & Gessell can help you throughout this process.

The Police Report

One of the first things an insurance adjuster will look at when they get your case is the police report of the accident, if one exists. They will want to know who was involved, the conditions at the time, and if any citations were issued. 

In a car accident, the adjuster will want to know how fast the cars were traveling. They will evaluate pictures and look at the skid marks that the cars left when they crashed. They will also want to interview any witnesses who were at the scene. 

Medical Expenses

After reviewing the police report, the insurance adjuster should have a good idea of who is at fault. If they have decided that your claim is valid, they will move on to deciding how much money they should offer you. They will need to see copies of your medical bills related to the accident. They will also want to see receipts for medications you have taken.

Part of an insurance adjuster's job is to keep the insurance company's money in-house. The main thing they will look for when they review medical reports is evidence that the injuries you were treated for were caused by the accident in question. They may try to establish that your injuries were caused by something other than the accident.

Other Expenses

If you have missed time away from work because of your injuries, you should get your employers to write you a letter documenting this. If you have missed an important event because of your accident, you should document that as well. An insurance adjuster will want to see proof of any money you have lost or any other expenses you have had due to your accident. For example, you may require maid service because your injuries prevented you from cleaning the house or transport if your injuries prevented you from driving.

At the end of the day, an insurance adjuster works for an insurance company. You should always get a personal injury attorney to review an insurance company's settlement offer before you accept it.

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