Accident Claims
FAQ

When it comes to accident claims, there are two main types of coverage involved. The first type is the insurance you buy and pay for, such as Medical Payments coverage, Under-Insured Motorists (UIM), or Uninsured Motorists (UM) coverage. These coverages directly protect you and your losses. The second type is the coverage that another person buys and pays for, such as auto liability coverage or personal umbrella coverage. This coverage is responsible for compensating the other person for losses they are legally liable for. Although both types of coverage may exist within the same policy, they serve different purposes.

While your own insurance or health insurance coverage typically pays for your medical expenses initially, the other person’s insurance may not be willing to assist you promptly. This is because insurance companies are for-profit corporations whose primary goal is to minimize claim payouts. They often prefer to keep accident claims open, causing injured individuals to accumulate debt and deal with collection agencies before attempting to resolve the claims against their insured party.

As explained in the previous question, your own insurance coverage plays a crucial role in such cases. Using your own insurance can provide several benefits. First, it may entitle you to better pricing for medical services compared to paying out-of-pocket. Major medical carriers, including Medicare/CMS, typically have more favorable rates. Second, the high costs of medical treatment may exceed what most people can afford to pay directly. By using your insurance coverage, you can receive the necessary care without incurring overwhelming out-of-pocket expenses, preventing bills from going to collections and negatively impacting your credit and overall well-being.

Additionally, even if the other person is clearly at fault for the accident, insurance companies still often dispute accident claims. This is because the determination of damages, including the extent of injuries and their impact on your life, becomes a contested matter. Insurance adjusters tend to focus on disputing charges and disregarding important aspects of physical injuries that should be considered.

As discussed earlier, you will likely need to reimburse your health insurance or other relevant insurance carriers for the expenses they covered. This reimbursement is often referred to as subrogation or reimbursement, and it is typically outlined in insurance policy language and statutes. Even if you receive a seemingly decent offer from the other party’s insurance company, it may not account for the full extent of your own insurance obligations, potentially leaving you with little or no compensation for significant injuries and recovery. It is essential to be cautious when evaluating offers and consult with a legal professional who can guide you through the reimbursement process.

Yes, you should aim to return to work and your daily routine within the restrictions and limitations set by your doctor. The law generally requires individuals to mitigate their losses by making reasonable efforts to work and minimize lost wages. Returning to employment can also help assess your abilities and limitations following the injury. While some people may be unable to resume work due to their injuries, most individuals fall into a gray area where they need to determine the tasks they can perform on a daily basis and whether these tasks constitute meaningful employment.

The amount of coverage available to you varies depending on your specific insurance policy. In South Dakota, auto-related injury claims operate under a “difference of limits” system. This means that the coverage limits cannot be combined to determine the total coverage available for a particular accident. For example, if you have $50,000 in UIM coverage, and the other driver has a $100,000 policy, the total auto insurance coverage available would be $100,000. It is advisable to consider purchasing higher UIM coverage as it provides additional protection for you and your family at a comparably low cost.

While it is true that lawyers typically receive a percentage (often one-third) of the settlement or judgment as their fee, their expertise can greatly benefit your case. Insurance companies handle accident claims on a daily basis, whereas individuals may only experience a single crash in their lifetime. Adjusters are trained to offer low settlements and pay as little as possible to resolve claims. Having a competent and experienced attorney on your side ensures that you receive fair compensation for your injuries and damages. An attorney can also navigate complex aspects such as reimbursement and subrogation, identify additional coverages, and potentially increase the value of your claim. Ultimately, the decision of whether or not to hire an attorney depends on whether you believe their services are worth the potential benefits.

South Dakota law heavily favors insurance companies, as they have significant influence through lobbying efforts. One of the laws designed to protect insurance companies involves jury trials, where juries are not informed about the existence or amount of insurance coverage. This lack of information leads juries to speculate on the availability of coverage. Pursuing a lawsuit against the other driver is not usually a waste of time unless the defendant is judgment-proof, meaning they are unable to pay the verdict. In most cases, insurance companies pay the majority of claims, and if an insured individual is exposed to an excess verdict, the insurance company is typically responsible for covering the amount beyond the policy limits.

The outcome depends on the circumstances. In the majority of cases, claims are paid by insurance companies, and there is no need to pursue an individual defendant for a judgment if they are insured and have the ability to pay. However, if a wealthy person chooses to save money on insurance and maintains unreasonably low coverage limits, they may be personally responsible for paying the excess verdict. Insurance companies often manipulate civil defendants, making them appear sympathetic to juries and hiding their role in decision-making, hiring defense lawyers, and arranging defense medical examinations. It is important to remember that insurance companies have usually had the opportunity to settle insurance claims within policy limits before a jury becomes involved, but they frequently prioritize saving money at the expense of their insured.

Even when fault is admitted or clear, insurance companies rarely agree on the seriousness of injuries or their monetary value. Experienced attorneys can help increase the value of your claim by demonstrating the impact of the injuries beyond medical bills and lost wages. It is important to remember that cases involve two key elements: fault and damage. While fault may be established through a ticket and guilty plea, damages need to be thoroughly assessed and proven to ensure you receive fair compensation.

The duration of accident claims or personal injury cases can vary significantly. Traditionally, significant cases would be ready for jury trials 18 to 24 months after the accident. However, this timeline can be prolonged due to factors such as case complexity, jurisdiction, court backlogs, and the impact of external events like the COVID-19 pandemic. In some instances, where there is a clear timeline and no pending criminal charges, the resolution may not take as long. However, if criminal charges are involved, it can slow down the process as the state may possess critical information necessary for the civil case. Working with an attorney who specializes in personal injury cases can help navigate the legal process and potentially expedite the resolution.