Insurance Claims and Personal Injury Cases

Insurance Claims and Personal Injury Cases

Insurance Claims and Personal Injury Lawsuits


If you’ve been injured in a motor vehicle accident, you may be wondering about the difference between making an insurance claim and taking legal action in the form of a personal injury lawsuit. While the two things are very different, they are related.  An insurance claim, can involve a claim for property damage and accident benefits.  You can make these claims irrespective of who was at fault for the   Generally speaking, when you’ve been injured in a motor vehicle accident due to the actions or negligence of someone else, you can file an insurance claim and attempt to negotiate a settlement with the company.  The person involved in your accident will not be a part of these negotiations. With a personal injury lawsuit, some other person or party must be at-fault for the accident.  You can sue the person or party responsible for your accident in a court of law. While an injured party will almost always file an insurance claim, your case may not warrant launching a lawsuit. A personal injury lawyer will be able to explain what is applicable to your situation.


Filing a Personal Injury Claim


After you’ve been in an accident, there are some important steps to take. If you are unable to take these actions due to your injury, a family member or someone close to you should make sure that they are completed.

  1. Get medical assistance, follow doctors’ orders, and keep records. If you’ve been injured, first seek medical assistance. If the doctor prescribes medication, treatment, or therapy, do everything he or she recommends. Make notes of the names of any medical professionals with whom you consult and save receipts from any medical expenses. Begin keeping a diary that contains details of your injury and how it is affecting your daily life.
  2. Report the accident to the police. Make sure that police are informed about the accident as soon as possible. In any accident where there is an injury, police must be informed right away. Ask for a copy of the police report. If possible, get someone to get the names and contact information for any witnesses to the accident, and have photos taken of the accident scene.
  3. Hire a personal injury lawyer. You must file an insurance claim very soon after the accident (often within seven days, but depending on the company, you may be required to file within 24 or 48 hours after the accident occurs.) It’s important that the process begins with the right information and that the claim be filed properly, so hiring a personal injury lawyer to take care of this aspect is very important.
  4. Filing a claim. With the help of your lawyer, you’ll file an insurance claim. This initial step is basically informing the insurance company that an accident has taken place and that you have been injured. Be as honest as possible; any misrepresentation can have legal repercussions.
  5. The insurance company will investigate. An adjuster will be assigned to your case. The company will review your medical records, the police report, and other evidence.
  6. Your lawyer can assist you in obtaining the benefits you are entitled to and advocate on your behalf when benefits being claimed get denied.
  7. Negotiation and Settlement.  Often times, the insurance company will wish to resolve all your claims for a lump sum payment.  Your lawyer can assist you to negotiate a settlement.  If the insurance company makes an offer, your lawyer can offer you advice on whether the offer is reasonable or not so you can make an informed decision whether or not to accept or reject the offer.

Personal Injury Lawsuits


Your lawyer will sometimes file a lawsuit after attempts to settle with the insurance company fail. There are some limits on who can file a personal injury suit in a motor vehicle accident claim, and there are strict deadlines that must be observed. An experienced personal injury lawyer will be able to advise you as to whether or not a lawsuit is a good option for you.

  1. Statement of Claim. After researching all of the records and relevant case law, your lawyer will file a “Statement of Claim” detailing the facts of the accident and injury and asking for a specific amount of money.
  2. Statement of Defense. The insurance company of the at-fault party (or “defendant”) will respond with a defense and any contentions they have about facts in evidence. You and your lawyer may then file a “Reply” to this statement.
  3. Mediation. In Ontario, a mediation of at least three hours is mandatory. Your lawyer will prepare a brief. You will be required to attend, along with your lawyer(s) and the defendant and their lawyer(s).
  4. Discovery. This step of the process consists of an exchange of all relevant documents in sworn affidavits. Both teams will have time to examine the documents, and each team will be questioned by the other team’s lawyer(s) under oath.
  5. Settlement Conference. Before a trial takes place, both sides will attend a settlement conference with a judge. Many cases are settled at this stage and going to trial may not be necessary.
  6. Trial. Witnesses are examined in front of a judge and/or jury. If the judge/jury decides that the case has merit, they will make an award.

The key to success to getting the compensation you deserve is finding the right lawyer. Insurance claims and personal injury lawsuits are similar but need to be handled in different ways. Contact a personal injury lawyer today and learn more about your options.