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Articles Posted in insurance coverage issues

Car accidents make up a whopping 99% of all non-fatal transportation injuries in the US, according to the National Highway Traffic Safety Administration’s 2020 Report. Millions of victims and their families are expected to file insurance claims for their losses. Even if you do not have a legal background, you probably hear a lot about how fault plays a role in the process. Legal liability concepts are central to your rights and remedies, but they work a little bit differently after a Miami car accident. In many cases, fault may not be key because you will seek compensation from your own insurance company under Florida’s no fault rules. 

However, there are some instances in which you qualify to file an injury claim with the other driver’s insurer – and proving fault is definitely a requirement to obtain compensation. Your Miami car accidents attorney can explain the details, but you might find the following information useful.

Why Fault Matters in a Miami Auto Crash

helloquence-51716-unsplash-copy-300x200According to the Florida Department of Highway Safety and Motor Vehicles Traffic Crash Facts, there are more than 248,000 people hurt in Florida car accidents every year, and almost 32,500 injured victims in Miami-Dade County alone. For many of these individuals, the legal process for recovering compensation starts with filing an insurance claim. You might be working with your own insurance company, since Florida is a no-fault state; however, in some cases, you will file a third-party claim with the insurer for the responsible driver.

In either situation, you may be presented with a “release,” a document that carries very important implications for your rights as a victim. As such, you should always consult with a Miami car accident lawyer before signing, and these warnings about releases should convince you of the reasons why.

  • You Give Up Your Rights: The point of a release is to resolve your auto crash claim with the insurance company. In exchange for your signature, the insurer will offer a payout to cover your losses, with the stipulation that you have no further rights or remedies. When you are injured and facing an uncertain financial situation, the settlement amount may seem attractive. However, by giving up your rights, you risk being under-compensated. 

bill-oxford-8u_2imJaVQs-unsplash-copy-200x300When you are hurt in an accident and want to seek compensation from the responsible person or entity, you will typically file a claim under an auto, business, property, or other insurance policy. Because the nature of your injuries is a key factor in getting monetary damages, you can expect that the insurer will want to see your medical records. On its face, this does not seem like an unreasonable request, so you may think there is nothing wrong with providing them. 

However, the exact opposite is usually true. You could be making a huge mistake that has extensive, negative implications for your rights. Instead of discussing the issue with the insurance company directly, you should trust a Miami personal injury attorney to deal with an adjuster. After reviewing the information below, you will understand why.

Reasons You May be Asked to Provide Medical Records

When you have been hurt in a Miami car accident, you are probably aware that recovering compensation for your losses starts with filing an insurance claim. Once you submit the initial paperwork, you can expect a call from the responsible driver’s insurer, since the company will want information regarding the crash, your injuries, and related details. Because you know that Florida law imposes a four-year statute of limitations, you are probably eager to get this discussion out of the way. 

While the adjuster may seem friendly and helpful during the conversation, you should note that this person is NOT just seeking basic information to get payment to you quickly. Instead, the insurance company’s employee is trying to figure out strategies to deny your claim. Because of the implications for your rights, it is best to have your Miami car accidents attorney handle the discussion. Still, you should be familiar with some of the questions the adjuster might ask.

Avoid Responding to Questions That Affect Your Rights

kyle-glenn-629501-unsplash-1-copy-300x200It is no secret that your insurance rates could increase considerably when you are at fault in a motor vehicle crash. As such, you probably understand the other driver’s similar sentiment when he or she was negligent in causing a crash in which you were hurt. There is a strong temptation to resolve the matter without getting an insurance company involved, and that motorist’s offer may seem very attractive at the time. The problem with not going through the proper claims process is that you could put your rights at risk through various legal issues – which you are certainly not considering when the at-fault driver pulls out a checkbook. 

A Miami car accidents attorney can explain the drawbacks of bypassing an insurance company after a vehicle crash, but you should be aware of the key pitfalls that could threaten your interests.

Reasons an At-Fault Driver Will Not Use Insurance: You can probably relate to some of the top reasons another motorist would refuse to exchange auto insurance information or suggest not calling the company about the crash:

taylor-grote-L3qUP8MpExc-unsplash-copy-300x200Dealing with an insurer’s claims adjuster may be the last thing on your mind after suffering injuries in a Miami auto crash, but you can expect the phone to ring in the days that follow. Though you may view the conversation as an annoyance, keep in mind that it is a necessary part of the process when you are filing an injury claim. Typically, the insurance adjuster will be seeking information regarding fault and the severity of your injuries, so what you say – and DO NOT say – is critical. It is always important to seek the advice of a Miami car accidents attorney before you answer the call, but you may find some tips to be useful. 

Be Calm and Courteous

Start things off on the right foot, even if you are angry, anxious, or frustrated. You should stay calm during the conversation and be polite. The person on the other end of the call is just doing his or her job, even if you do have opposing interests in the claim.

When you are hurt in a Miami auto collision, your first step in seeking compensation for your losses is to file a claim with the responsible driver’s insurance company. Like many victims, you might expect the process to be clear and simple — complete the necessary forms, send them to the insurer, and wait to receive payment. You may be shocked and dismayed when the response is an outright rejection of what you believe is a valid, legitimate claim.

Though it may provide seemingly valid reasons for a denial, the primary motivation of the insurance company is to look out for its own interests. Your claim is a threat to profits, so the insurer will seek any possible reason to reject or make a low counteroffer to resolve your claim. Do not put your rights at risk by accepting anything less than what is fair and reasonable to compensate you for your losses. With help from a Miami car accident attorney, you can recover the highest amount of compensation allowed by law – even when the insurance company responds to with any of these excuses.

  • You Delayed Filing Your Claim: It is true that Florida has a four-year statute of limitations on motor vehicle crashes based upon negligence, but this time period refers to filing a lawsuit in civil court. You should file a claim with the responsible driver’s insurance company as soon as possible after an accident. When you wait, key evidence may be unavailable and your recollection about the collision will become foggy.

Last week Government Employees Insurance Co., known as GEICO, filed a massive lawsuit against Path Medical and Pain 411, alleging that since 2014 the defendants defrauded the company for millions of dollars worth of medical procedures that were, “medically unnecessary, illusory, unlawful, and otherwise unreimbursable health care services, including initial examinations, follow-up examinations, diagnostic imaging, and physical therapy, and chiropractic services [], that purportedly were provided to automobile accident victims (“Insureds”) who were eligible for coverage under GEICO Florida no-fault insurance policies.”

In addition to seeking compensatory damages for the allegedly fraudulent payments, GEICO is also seeking declaratory judgment that it is not legally obligated to reimburse the more than $200,000 in additional pending, allegedly fraudulent no-fault insurance claims.

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If you are injured in an accident, and the negligent party was drunk and under the influence of alcohol, it may appear that your case is a slam dunk. Generally speaking from a liability standpoint this may be true.  However, collecting from the insurance company for the full amount of your damages may not be as simple as you think. Some insurance policies have exclusions for certain acts.  This means the insurance company may not be required to cover an insured’s negligence  such as an intentional act, or if there is a claim that arises based on conduct that is  excluded or not covered under the insurance plan language. This can include a claim that arises out of a fight in a night club, use of alcohol, or even for punitive damages such as an insured in a drunk driving accident. These exclusions are common in premises liability cases, such as bars, nightclubs, and other commercial property insurance policies. For these reasons, it is always a good idea to ask for a free consultation with a personal injury lawyer in Miami to discuss if any of these potential issues may apply to your case.

Recent Case Enforces Alcohol Exclusion

This does not mean that the tort feasor is entirely off the hook. Injury victims can always pursue legal action regardless of insurance that is available. It just means that the an action to collect some or all of a  judgment for claims that are not covered under insurance may have to come directly from the at fault party, as opposed to the insurance company. However, the reality of collecting against an uninsured or under insured  defendant directly just may not make sense.

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