Negotiating A Bodily Injury Claim

How to negotiate an injury claim without outside intervention.

Negotiating is more than just an art: it is a skill that can be learned and perfected. There are some people that are natural negotiators, while others find it difficult. Often times one feels intimidated by parameters that have been preset by the other party involved or assumed predetermined guidelines. Negotiating is essential in many areas of life, from salary to purchasing an automobile. However, understanding the negotiation process is crucial when dealing with other parties in regards to a claim for bodily injury.

Lawyers and claims adjusters are trained to handle and negotiate a position that best suits their interests, sometimes, leaving the injured party to fend for themselves. The frontline for the insurance company is their adjusters followed by their legal counsel. Their bottom line is saving the company money and averting detrimental errors that may end up raising a reserve. To better understand the process one must familiarize themselves with some key terms that would help them in dealing with a bodily injury negotiation.

· Claim - in relation to insurance is a declared loss against another party and the insurance company that represents them

· Claimant - the person making a claim against another party's insurance; also known by the insurance company as the third party

· Bodily Injury - physical damage, incapacitation or trauma suffered by the third-party in an incident that another party is responsible for

· Liability - in relationship to a bodily injury claim, it is the damages that an individual is held legally responsible for either due to accident or design.

· Damages - includes out-of-pocket expenses, pain and suffering, and lost wages. The insurance contract does not allow for punitive damages to be paid out, those damages must be sorted out outside the insurance contract if gross negligence has occurred.

· Loss Reserve - amount of money set aside by an insurance company to cover a specified loss.

When employing an attorney to represent a bodily injury claim, one must be aware of the implications of this action. The lawyer is selling his services to the person that he is representing but his interests still invariably lies with his practice. He or she will represent the injured party but the motivation is still the fee, which, on average, is generally about a third of the settlement. However, learning how to negotiate can be beneficial if the injury was not significant or complex. There are times when attorneys or representatives need to be called in because of severe injury or complexities.

In this discussion the focus will be on learning how to negotiate with a claims adjuster and/or insurance company for injuries sustained in an accident. However, these methods can be practiced and used in a variety of areas and not limited to only the insurance industry.

A Lesson in Negotiation

Negotiating for a salary or position can be a frightening experience, but learning how to negotiate for a bodily injury claim can be daunting. Many find the methods of a company in handling a bodily injury claim to be a cold and calculating process. Looking at the process can shed some light on the motivation.

An insurance company's bottom line is not to just provide a service for individuals or groups but, also, to make money. In order for them to accomplish this they must take a more analytical role when handling a claim. When they are notified of a claim, the insurance representative, also called a claims adjuster, assesses liability before accepting responsibility for an accident. The representative gathers all the information, including police reports, witness statements and statements from parties involved. If liability is clear this can be done quickly without a police report. Usually, statements made by the parties involved and third-party eyewitnesses give the representative a general idea of the sequence of events leading up to the incident and he/she can determine or have a good idea of whom is responsible.

After liability is determined and if it deemed their insured's fault, an estimated reserve is set. To attain a full scope of injuries, medical records are attained, bills for services are gathered and salary information is collected. Once the representative has taken all the steps necessary and taking in any future expenses that may arise out of the loss the claiming party has suffered he/she will make an offer to settle the bodily injury claim. This process can take days to months to complete, depending on the severity of the injuries. Their goal is to get the claim settled quickly to fulfill their obligation to their insured and contain their losses.

By knowing how the insurance company looks at handling a bodily injury claim, one can be made aware of the process and can see their motivation in getting the claim settled. Looking objectively can also aid the injured party in negotiating their position. Involving emotions in the process can only hinder the settlement of the claim, sometimes escalating it to an arbitration or court proceeding. By incurring additional expenses the compensation received is less or may not be adequate enough to cover all the expenses and the injured party becomes responsible. To avoid this additional inconvenience would be to learn to negotiate with the insurance representative.

In beginning the negotiation process the injured party must parallel the steps that the insurance representative takes; one, by knowing where the fault lies and two, knowing the amount of damages that have been incurred and an idea of any future losses that are directly related to accident.

Begin by writing down the facts of the incident in which the injury occurred. Obtain a police report of the incident if it is available. Collect medical bills as soon as possible. If they are not readily available, calling the provider may help in approximating you medical expenses. Get a copy of your medical records, including notes, diagnosis and prognosis of the injury. The injured party has access to all the medical records, though some providers may require the request in writing. Determine any lost wages that have arisen from the injury. This includes days missed and any future time off for treatment.

Losses due to pain and suffering are subjective and depending on the severity of the injury can be difficult to determine. Loss of limb or function and permanent damage that cannot be treated or repaired can cause much emotional distress and can be difficult to determine. However, for more minor or basic injuries such as whiplash, cuts, abrasions and injuries that can be treated medically without future complications it can be easier to set a value of damages.

Having in mind the expenses that have or will be incurred a value can be determined for settlement. To start the negotiation process you must determine a ballpark range for settlement. Keep in mind a reasonable value that you are willing to take as compensation and let that be your low number in your range. If you are still unsure on how to go about determining your range be aware that most insurance representatives will settle, on average, up to three times the damages that was incurred. This value allows for pain and suffering that the injured party incurred. This does not mean that the company will not settle lower than the average, but it is a good starting point for you to know in which dollar amount the claim may settle in.

Once a range of settlement is set and the insurance representative has not approached with a settlement offer, you may initiate settlement once you feel comfortable. Initiate with an offer of settlement remember, not to start out with the lease amount that you are willing to take. Do not be outrageously high with the initial offer of settlement. The key to remember is that the insurance representative is a skilled and trained individual in the art of negotiating a claim. They are aware of that time can wear down a persons resolve.

When making your initial offer:

· Familiarize yourself with your position. Know the reasons why you came up with your conclusions so that you are convinced of your position. If you are hesitant then the representative will not take your position as seriously as you would like giving him/her an opportunity to shoot down your argument.

· Be concise when expressing your point and be direct. These are the reasons that you are willing to settle for the amount stated. Things you can state, to support your argument, are liability, medical bills, diagnosis, prognosis, lost wages and any pain and suffering that you may have endured.

· Set your own pace. Don't give into the pressure to settle your claim if you are not ready. The initial settlement offer made by the insurance representative is not necessarily the last.

· Be objective. Being the injured party, it may be difficult to separate your emotions from the settlement, but looking at it objectively will help you not to over-inflate your claim and will aid in settling your claim quicker.

· Be reasonable. As a good negotiator you must be willing to listen to their argument as well and take into account if what they have to say has any bearing on your position.

· Know your limits. By knowing what you are willing to settle for and sticking by that and your rationale behind your case you will not be out-maneuvered by the representative. It may become a waiting game. However, when contact is made and you continually state your position and argument behind it then they will know that you are firm.

Remembering that the interests of the company bind the insurance representative, but most importantly, they are bound by the limitations of the policy. Knowing this will help to keep your argument grounded in reality. The insurance company cannot pay out higher than their limit of liability set forth by their contract.

Once a settlement has been agreed on then a document will be signed releasing both the insurance company and their insured from any further action. If the claim is complex and will exceed the limits of liability the situation becomes harder to deal with on your own and an attorney may be needed. Once a release is signed no further action can be taken against the liable party, which includes punitive damages if they displayed gross negligence in their action. If you are limited by the complexity of the case then it is best to seek professional advice, however, if it is a matter that can be handled by you then it is beneficial to settle the matter without intervention.

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