Wednesday, June 22, 2016

Insurance Company's View on Causation of a Car Accident

Insurance Agent preparing car accident estimate
Car Insurance Adjuster Reviewing Damage to Car After an Accident

Car Accidents - Causation

Many people think that when you are involved in a car accident and the opposing insurance company concurs that their insured is responsible for the accident; they will automatically pay. However, they often do not want to pay all the damaged caused by the collision, they would much rather settle for a lesser price. They will use numerous tactics to get out of paying anything at all. One of their common strategies is to take the position that their insured was the one that caused the accident, but the injuries were pre-existing and did not occur during the accident. 


Low Impact Labeling

Take for instance the damage to your car was minor; the insurance company will come back with a label of "low impact" for the accident. Over the past decade, insurance companies are trying harder than ever to fight insurance claims in these minor accidents. To prove their point they will sometimes reference the price to fix the car. If the repairs are between the ranges of $500-$3,000; the accident would be considered to be a low impact collision. Also, the insurance company can also just say the collision is low impact based on the visual aspects of the automobile. If and when they deem an accident with this title, it becomes hard to fight for compensation.


Once this label has been placed on a collision, the insurance company will try to dispute anything that you say happened during the incident. While they may be included to side with a minor soft tissue or whiplash type injury, this is often as far as they will go. 


A Likely Scenario

Let us imagine that you were stopped at a red light and another car came up from behind and hit you. You have damage to your bumper area, and your neck is sore and stiff. You do not call the police, or a squad because you feel the damage is minor; after all, you are not in that much pain. You and the other driver exchange information and go your separate ways. As the afternoon goes on, your neck pain intensifies, and you have a blinding headache to go along with it. You try over-the-counter pain relievers, but the pain just keeps getting worse. You decide to go to your primary physician.

The doctor takes some x-rays and gives you an anti-inflammatory pill along with some muscle relaxers to calm the pain. They suggest you start physical therapy if the pain continues to be a problem. You spend the next 2-3 months going through the grueling task of physical therapy, but it does resolve about 90 percent of your pain. Your car repair costs were $1,700, but your metal expenses were about $1,800. The total cost of the accident was $3,500 out of your pocket.

If you look at the total value of this claim, it is probably around $7-$8,000. However, the insurance company will want to offer you a settlement amount, which is usually lower than your medical bills. Low impact claims do not have demand a high dollar amount when it comes to a settlement. The adjuster will try everything they can to discredit your claim. They will say that such a small collision could not have caused your injuries. Even if you have medical research that proves differently, without extensive damage to the car, they do not want to pay. 


The Insurance Companies Tactics

Over the years, the insurance companies have had to deal with their fair share of fraud. Due to dishonest people, they have learned to offer low settlements to all claimants in a minor accident and try to get them to settle. Settling means that the accident is off their active list and they can move on to another case. Also, when a case goes to court it will demand more money than their settlement offer. In many instances, the insurance adjuster tactics work. Many people would rather accept the low-ball offer rather than hire an attorney and get a fair amount. Every accident that is in this category will receive a settlement offer; it is just how they save money. 

Dispute to Causation

Another claim that the insurance company will make is to say that their insured did cause the accident, but they will dispute that the accident caused the injuries. If you were to suffer from a back or neck injury during the accident, they will try to say that you had prior history of injury to these areas and are trying to profit from the accident. They will file a dispute to causation to deny what you state is true.

Let us assume that you are involved in a three-car pileup. You are the middle car. This accident happened due to a rear end collision. You have had back pain for the past decade and have seen a physician a few times for physical therapy. Consequently, after the collision, the pain is unbearable and constant. A few days after the accident, you have pain shooting down your legs into your foot. The pain you are experiencing is new, so you head to your doctor.

The doctor sends you to physical therapy and wants an MRI to look at the lower back. It shows that you have a herniated disc at L5-S1. They also notate that there are other degenerative changes in the same area. You try therapy, medications, and steroid injections; however, the pain does not improve. The pain is so bad that it is causing problems with working, exercising and living a normal life. You are sent to an orthopedic surgeon that offers surgery to help the pain. There is a great deal of risks involved, but you decide you have no other choice. The leg pain did diminish a great bit, but the back pain is continuing. Before the surgery, the medical expenses were $5,000. The cost of your surgery and rehabilitation is over $75,000. 


Eggshell Plaintiff Rule

A case like this would fall under the eggshell plaintiff rule (or what is known on Wiki: Eggshell skull rule). If you have a pre-existing condition, which is aggravated by the wreck that is not your fault; the responsible party must pay for all of the damages. Insurance companies want to focus on the prior injury and do everything they can to prove these are degenerative changes have nothing to do with an accident.


Why You Need a Lawyer

The best trial lawyers know what evidence needs to be brought to the courts to prove your case. You need a car accident lawyer who is well versed in how to handle these matters correctly. Never make a settlement with an insurance company without talking to a an attorney first.