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Handling Insurance Companies in Personal Injury Cases

The following is an excerpt from an interview with an attorney who has experience dealing with insurance companies.

Is it safe to speak to an insurance company without an attorney?

The insurance companies have attorneys on their side and everything they do is for a specific purpose. Every bit of information they ask for is used to build a case against the person. The whole purpose of them talking to the person is to build a case against them. If the individual does not have an attorney on their side, they may be helping the insurance company build a case without even knowing it. An attorney can advise a person of all the traps and tricks the insurance companies will try to spring on them. It is best to have an attorney on their side to make it a fair fight.

What happens if an individual does not have health insurance but is injured?

It depends. If they are involved in a car accident, then most likely either their insurance or the insurance company providing coverage for the vehicle they were riding in at the time will provide no-fault insurance coverage. If they slip and fall, they have to use their health insurance to cover any treatment. However, if they don’t have health insurance, they would have to try to get treatment on a lien basis. They would owe money for any treatment they receive from a doctor and they would have to pay them out of any recovery, either through a settlement or a verdict, that they might receive from the person they are bringing cause of action against. In a slip and fall case, that would probably be the property owner, managing company, or tenant of the location where the injury occurred. They could also apply for Medicaid. They will receive treatment and be charged, but they won’t owe money for the treatment. Medical care can be expensive for people who do not have medical insurance and it can be daunting when someone is being hounded by hospitals and medical providers for payment for treatment because they didn’t want to have that treatment; they were hurt because of someone else’s actions or inactions. They required medical treatment in order to get their state of health back to the way it was before the accident. They can recover those costs as part of their lawsuit, so those are factored into the decision as to what they are willing to accept in the settlement. Someone should never accept a settlement offer for an amount that is lower than their medical bills because then they would owe the remaining balance on top of whatever they are recovering.

What happens if the at-fault party does not have insurance?

If it is a slip and fall case, it is very unlikely that the at-fault party would have insurance, but if it is an automobile accident, then the plaintiff can make a claim with their own insurance. Most policies have an uninsured or an underinsured motorist endorsement, meaning that if an individual has coverage in the amount of $50,000 and someone else who hits their car has coverage in the amount of $30,000 (underinsured) the person who was hit could go after them for that $30,000 and then make a claim against their own insurance policy for the remaining $20,000. That is also dependent on the extent of their injuries. A person cannot go after someone else simply because they do not think they got enough money. They have to recover the full amount from the offending party before they can go after their own insurance. If a person is hit by someone without insurance, they can make a claim against their own insurance policy to cover their injuries.