You suffered an injury, and you are out of work. The financial pressure is building. You are looking at a long recovery, and reduced income for weeks or months, but your expenses do not decrease.
You know your current situation is not sustainable, and you are hoping that your accident settlement happens sooner rather than later. But it seems to be taking forever, and you want to know why.
Why Personal Injury Claims Take so Long
While you may feel frustrated waiting for a settlement offer, especially if you feel like your lawyer is taking too long, you need to understand the entire process of handling a claim.
You need to know the best time to file an initial demand. Adequate personal injury claims require making certain determinations.
Remember, an early step in all accident settlements is determining the amount of the demand.
Your attorney will often consult your doctor and ask about maximum medical improvement. This means that your doctor has determined that regardless of any additional treatment you might receive, your current overall health will remain the same.
Once you have reached maximum medical improvement, then your attorney will need to determine a dollar amount to demand as a reasonable settlement for your injury. Let’s take a look at what steps an attorney needs to take to determine the dollar amount to request when filing a claim.
Money Lost Due to Being Out of Work
Typically, one of the most significant categories of compensation someone may claim after suffering a personal injury is lost wages. This is not always as clear-cut as it sounds.
Some of the factors to consider when calculating lost wages include:
- Expected return to work date – how long a person will remain out of work while they recover will factor in the calculation for lost wages. The longer your injury keeps you from your normal job, the more complicated this calculation. Your personal injury lawyer will also have to consider whether you will be able to return to your usual employment or if you will require retraining for another job after you have fully recovered.
- Lost benefits – while some employers offer short and long-term disability benefits for those who lose work due to injuries, it does not cover some of their benefits. For example, if your employer matches your deposits to your company-sponsored retirement plan, you could be losing those benefits. This calculation may include your use of sick days, personal days, and vacation days before using or applying for disability payments.
- Other perks – tips, potential productivity bonuses, and other similar perks that you may have earned if your injury hadn’t knocked you out of work may also go into a final calculation of your lost wages.
As you can see, “lost wages” is not always as simple a calculation as it may initially appear to be on the surface. To arrive at this number, your personal injury attorney may have to request certain documents to ensure the amount of the demand they issue on your behalf is as accurate as possible.
Medical Expenses Are Not Always Clear
Your medical expenses may be included in a settlement demand. However, determining the full extent of those expenses may not always be as straightforward as they may appear to be on the surface.
Some of the things your Houston personal injury lawyer will have to take into consideration include:
- Out of pocket expenses – in the immediate aftermath of an accident, you may be covered by an employer-sponsored health plan. Assuming this is the case, you may only have minimal expenses related to your care. However, the longer your recovery takes, the more your out-of-pocket expenses may be. You may wind up paying higher premiums because you have to switch to a COBRA plan, you may face a new year of insurance, meaning you may now have a new deductible threshold to meet, or you may have to undergo new treatments which your insurance does not cover. All of these expenses will play a role in the amount of the settlement demand your lawyer makes on your behalf.
- Future medical care – surgical procedures, follow-up care, rehabilitation therapy, and other treatments you may need in the future due to your injury will also play a role in your demand for settlement. All these costs will be derived from what your physician advises your Houston personal injury lawyer about what future potential care you may need for your injuries.
Calculating the costs of medical care in the future is not always the easiest task since it requires determining how much costs may rise over time. As you can see, your attorney will have to make some determinations as to what the future may hold, and the only way to do that is to talk to others who are experts in their fields.
Your Houston personal injury attorney will have to determine your damages before they can submit a final demand for settlement.
Remember, every personal injury case is different, but you may seek these general damages:
- Loss of enjoyment
- Pain and suffering
- Scarring or disfigurement
Remember, these damages are always considered subjective since there is no price on how much an injury can affect an individual. Your case is unique, even if someone else suffers a similar injury resulting from a similar accident.
Insurance Companies Add to Delays in Settlements
There is a good chance if you contact the insurance company they will tell you they are still reviewing your claim. Remember, under Texas law, insurance companies must abide by the Consumer’s Bill of Rights. This means they have a limited amount of time to respond to your claim.
Settlements are handled slightly differently. The larger the settlement demand, the more likely the insurance company is to drag its feet. After all, the last thing they want to do is pay out a large chunk of money on a claim. After all, their bottom line is going to be impacted.
That said, remember this as well: They do not want bad publicity.
Chances are once your personal injury lawyer submits a settlement demand, several things may occur which will simply add time to the processing of a settlement:
- Demand for proof of damages – the insurance company will ask your Houston personal injury attorney to submit all of the documents that enabled them to arrive at the damages you claim. This will be the first step they take to slow down your payout.
- Insisting the claim is bloated – insurers do not want to make big payouts, so they may begin whittling away at what your attorney demands on your behalf. This is a common tactic and one that your lawyer will expect and prepare to handle on your behalf.
- Questioning liability – do not be surprised if the insurance company takes an opportunity after your attorney has submitted a demand for settlement to claim they do not have liability for your injuries. They may claim you had a preexisting condition, that you were partially responsible for the injury, or someone else was responsible.
Insurance companies often believe by dragging their feet they can get you to accept a lower settlement. This is one of the reasons why it is so important that you work closely with a skilled and experienced personal injury lawyer after a Houston accident
Direct Settlement Versus Court Verdict
Victims have a legal right to file a lawsuit if they are not getting a satisfactory response to a demand for settlement, or if they feel the insurance company is treating them unfairly. Under the Texas Civil Practice and Remedies Code 16.003(a), for example, victims have up to two years from the date of an accident to file a lawsuit.
Remember that insurance company adjusters are aware of this deadline. You should also be aware that most personal injury claim cases do not wind up in court. This is because whether you elect a bench trial (judge only) or a jury trial, there is a considerable amount of preparation time and expense. The insurance company is probably already paying a lawyer to help them fight back against your settlement demand. The last thing they want to do is to land in court for a trial, which would result in additional legal expenses.
The other thing to remember is that in court, the insurer (and you, the victim) are facing a bigger risk than if the settlement was handled outside of court. That is because it is impossible to guarantee that one party would be viewed more favorably than the other. The insurer knows that if one juror (or the judge) has faced a prior bad experience with an insurer, then they may be predisposed to finding against the insurer and making them pay more money than what you are demanding.
Your Lawyer Will Not Cause Unnecessary Delays
There is a fairly good chance that when the accident that resulted in your injuries first occurred, you contacted the insurance company first. You probably called a personal injury law firm after that initial contact. There is also a good chance that once you informed them you had hired an attorney they told you it would slow down the process. Do not get fooled into thinking the process is slower because there is an attorney involved.
Insurers would prefer that you represent yourself for all types of reasons, including:
- Understanding of the law – most of us who do not have legal training do not fully understand personal injury law as it pertains to liability or negligence. Insurance companies can capitalize on this lack of understanding and hope to get you to accept part of the blame that would reduce your potential settlement.
- You are under stress – accidents in which you suffer an injury are a strain on you and your entire family. While you are coping with your injuries, your bills are also piling up, placing you under more stress. Insurers know that you may be more likely to settle for less than an attorney would advise you is a good settlement simply to get some of the bills paid off.
Remember, once you have accepted a settlement offer, the insurance company is off the hook permanently. No longer do they have to worry about your losses, regardless of how those losses may place a burden on you and your family.
There is something else to keep in mind despite the insurer telling you that your attorney is the one dragging their feet, they are not getting paid until you get a settlement that you approve. That is because of the contingency fee arrangement you have. Your lawyer has nothing to gain by dragging the process out further than necessary.
Contact a Personal Injury Law Firm
Because each personal injury case is unique, they all present different challenges. What may seem black and white to you, the victim, is not always as clear to the other parties. This is why you must consult an experienced lawyer who understands what you need to prove your case.
Whether you are a victim of an accident that, through no fault of your own, resulted in an injury, or a family member was seriously injured or died in an accident, seek immediate legal help so you can recover financially.
Since starting his firm in 1999, Stewart J. Guss has had the honor of representing clients from all over the world, helping them recover from even the most catastrophic injuries.
Today, thanks to a strong belief in those values of compassion, respect, and approachability, the firm has grown to employ over 120 legal professionals in numerous offices across 4 states, with nationwide reach.