Visitor Question

Other driver’s insurance admits fault but won’t pay my injury claim?

Submitted By: Anonymous (Bonita, California)

I was in a car accident and the driver’s insurance company claimed responsibility for the accident. They are paying to fix my car but denied my claim for bodily injury because they say the accident photos don’t look like they would result in injury. Who makes that determination? A doctor, or a claims adjuster with no medical experience?

I hurt my back in that accident, went to urgent care and was taken out of work for 1 day. I’ve shown my burden of proof, so what else can I do? This is not right. I’m out money and time due to that driver’s error. My car had less damage than his because I’m up high in a jeep and his car was low to the ground. He ran into me.

Disclaimer: Our response is not formal legal advice and does not create an attorney-client relationship. It is generic legal information based on the very limited information provided. Do not rely upon the information in our response, or anywhere else on this site, when deciding the proper course of a legal matter. Always get a personalized case review from a local attorney.

Answer

Dear Anonymous,

To succeed in your personal injury claim will require convincing the insurance company and its claims adjuster their insured was negligent, and that negligence was the sole cause of your injuries. Doing so does not require you to meet a legal burden of proof. Satisfying that legal burden of proof might only be necessary if the case can’t be settled, and must be tried in court. That is unlikely.

Contrary to what you believe, insurance claims adjusters have substantial experience in evaluating car accidents and injury claims. They go through continuing education courses, and rely heavily on computer software which takes into account factors such as types of injuries, type of accident, previous settlements, previous court awards, and other factors which help the insurance companies determine the amount of compensation to offer claimants.

To convince the claims adjuster to fairly compensate you for your injuries and resultant expenses will require a physician’s medical narrative or medical records verifying the type and extent of your injuries, and that those injuries were caused by the collision.

If you’re successful in convincing the insurance company to settle your claim, be sure the amount of compensation covers  your medical bills, your out-of-pocket expenses, lost wages, and an amount for your pain and suffering.

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from a licensed attorney. Find a local attorney to give you a free case review here , or call (888) 647-2490.

Best of luck,

Published: June 29, 2017

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