Get the compensation you deserve. Here’s 7 essential steps to filing a slip and fall injury claim with the at-fault party’s insurance company.
Falls account for approximately 8 million hospital emergency room visits per year in the U.S., representing the leading cause of all visits (21.3%).¹
Given the frequency with which these accidents occur, it’s important to know that slip and fall victims can file an injury claim with the at-fault property owner’s insurance carrier to seek compensation for their losses.
The insurance claim process can seem daunting if you’re not familiar with injury claims. To help you see the big picture, we take your through the seven essential steps in the slip and fall insurance claim process.
Follow along as we unpack each step, from the scene of your injury to final settlement.
Steps of a Slip and Fall Claim
Claimants are often surprised to learn that the life of a slip and fall claim begins before the actual filing of the claim with an insurance company.
Immediately after a slip and fall accident, it’s imperative that you protect yourself by taking action. The worst thing you can do is pick yourself up from the floor and leave without telling anyone you were injured.
Even if an ambulance wasn’t called to your accident scene, you should go to your primary health care provider, hospital emergency room, or a walk-in urgent care clinic as soon as possible.
Getting prompt medical attention is necessary even if you don’t immediately experience any pain or suffer any injury symptoms. Sometimes accident victims experience some type of slip and fall injury even without knowing it.
By explaining your incident to your medical provider, including when, where, and how it happened, you create a record of how your injuries relate to the slip and fall accident.
Continue seeking treatment until your medical provider tells you it’s no longer necessary. It’s also important that you follow any advice or recommendations that a health care provider gives you.
If you stop seeking treatment or ignore a doctor’s advice, a claims adjuster will likely deny your claim or offer a low-ball settlement because you failed to mitigate your damages.
Once you do receive treatment, you’ll soon get medical bills from every treatment provider. You must keep these bills as they’ll form some of the most important evidence in your slip and fall injury claim. Without proof of a physical injury, your claim will likely fail.
As the victim in a slip and fall accident, you have the burden of proof. This burden means you have to prove that another party was at fault for causing your slip and fall accident and related injuries.
You can only succeed in this job if you support your claim with valid and credible evidence. You’ll have to show evidence that a property owner was responsible for your slip and fall and evidence that you suffered injuries.
Try to gather as much evidence as you can immediately after your slip and fall accident. If injuries prevent this from happening, return to the accident scene as soon as you practically can.
An incident report provides evidence that you slipped and fell on someone’s property. You should complete this report as soon as practically possible after your fall.
Most businesses have their own incident report that they’ll give to a customer who has slipped and fallen on the company’s property. These reports are typically generic forms where an accident victim fills in some blanks, checks some boxes, and summarizes what took place.
If a company doesn’t have a standardized report, you can create your own incident report. Keep a copy for your records and send the original to the property owner or manager.
2. Send Injury Claim Notification Letters
Soon after your slip and fall, you’ll have to notify the at-fault party and the party’s insurer of your accident. You perform this task by sending letters to each respective party.
Your notification letters should include the date and approximate time of your injury and your name and contact information.
With the letter to the at-fault party, include a request for the party’s insurance company’s contact information. You’ll also ask the at-fault party to preserve any evidence they may have of your slip and fall accident, like surveillance camera footage.
Even if you’ve sent the at-fault party an incident report, you still need to send them a notification of your intent to file an injury claim.
3. Organize an Injury Claim File
Once you officially file a claim, you’ll need to create a claim file to help organize all your information and evidence that supports it.
You might want to purchase an accordion-style folder, the kind with lots of dividers inside. You can also use three-ring binders.
With either a folder or binder, organize it into sections that correspond to the different aspects of your slip and fall and your accident claim. For example, you’ll want sections for medical bills, medical records, photographs, correspondence to and from the insurance company, and so on.
In addition to a claim file, it’s helpful to keep a separate calendar for your claim. Put on the calendar every medical appointment and therapy date related to your injuries.
Make entries on dates you agreed to contact an adjuster and dates the adjuster agreed to contact you. Your calendar will help you hold the adjuster accountable for their commitments.
If you’re working with a slip and fall attorney, enter the date and time for any meetings or phone calls with your lawyer.
4. Calculate Your Slip and Fall Claim Value
Claimants can’t just sit back and let adjusters tell them what a fair settlement is. When you’re ready to discuss settlement, be prepared to tell the insurance company the amount of money you think is fair compensation for your damages.
If you are handling your own injury claim, wait until you’ve fully recovered and gathered all your bills. Then, calculate your claim’s value by adding together your economic and non-economic damages.
The first step in calculating the value of your claim is to add up your economic damages. Economic damages are measurable costs incurred by the injury victim.
Economic damages in a slip and fall case include:
- Medical expenses
- Lost wages
- Out-of-pocket expenses
- Replacement cost for broken glasses or other property
Economic damages are supported by bills, receipts, and wage statements. Use the total cost billed by medical providers, before any insurance offsets.
Non-economic damages are typically known as pain and suffering.
There are no receipts or assigned values when it comes to non-economic losses. However, you can calculate a fair estimate of non-economic damages by adding up all your medical bills and other economic losses, and adding one or two times that amount to account for your pain and suffering.
If your injuries are mild to moderate, most insurance companies are willing to negotiate a settlement for damages in this range.
5. Send a Demand Letter to the Insurer
When you’re ready to negotiate you’ll prepare and send a settlement demand letter to the insurance company.
A demand letter tells the insurance company how much compensation you are seeking, and explains the facts of your case, a description of your injuries, and why the property owner is responsible for your injuries.
Your demand packet will include your letter, copies of your bills, receipts, and wage statement.
Other supporting evidence may be a copy of relevant medical records, photographs, and witness statements.
6. Negotiate Your Claim with the Adjuster
Once you submit your demand letter, you’ll begin active settlement negotiations with the claims adjuster.
Before speaking with the adjuster and talking numbers, it’s a good idea to plan your negotiation strategy. Advance preparation can lead to a higher payout from the insurance company.
Adjuster are trained to find reasons to reduce or deny injury claims. For example, the adjuster might try to shift some of the blame on you, or argue that your injuries are from a pre-existing condition.
When you’re prepared to deal with the adjuster’s negotiating style and tactics, they won’t be able to take advantage of you.
Negotiating slip and fall hard costs should be fairly straightforward, so long as your medical treatments was reasonable and necessary, and you can justify the amount of time you missed work.
Non-economic damages are more subjective, but you can successfully negotiate compensation for pain and suffering if you understand how to present it to the adjuster.
Professional negotiators understand that there has to be some give-and-take before both sides can agree to a settlement. Still, sometimes injury claim negotiations stall, or completely fall apart.
High-dollar or complicated claims should always be handled by an experienced injury attorney. Insurance companies are notorious for low-balling offers to claimants who are not represented by counsel.
You don’t have to wait until negotiations come to a standstill. If an adjuster is especially difficult, or if you’re having a hard time showing that a property owner was at fault, you may want to speak with an attorney.
You have the right to consult a slip and fall attorney at any time before settling your claim. Most attorneys offer a free consultation and work on a contingency fee basis. This fee arrangement means that you don’t have to pay your attorney unless they settle your claim are win your case in court.
If you reach a fair settlement with the insurance company, confirm the terms of your agreement in writing right away.
Send a letter or email to the adjuster that summarizes what you two agreed upon. Your confirmation should mention the date you came to an agreement.
You’ll want to include:
- The settlement amount
- The injuries or damages that the settlement amount covers
- The date when the company will issue your settlement paperwork and payment
It’s understandable that you want to get your compensation and put your slip and fall ordeal behind you. If you encounter a delay in receiving your settlement check, there’s usually a reasonable explanation.
Your final compensation check might be delayed if there are medical liens against your settlement. Most states require liens to be paid before the remaining funds are issued to the claimant.
If you are represented by an attorney, pick up the phone. Your attorney will let you know the status.
If you settled your claim without an attorney, most insurers won’t issue a check until you’ve returned a signed copy of the release and settlement agreement. If you’ve returned the signed agreement, allow at least a week or two, then call the adjuster. If they say it was sent, ask for tracking information.
Follow up with the adjuster at regular intervals. If a month or more goes by, consider contacting an attorney, or filing a complaint with your state’s insurance department.
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