Insurance Claim

Once the client has finished their treatment a demand package is created and forwarded to the liability carrier. The package includes all claims, allegations, medical history and monetary demand for settlement. The carrier upon receipt of the package will review the same and make an offer. One of the most important aspects of an experienced personal injury attorney is explaining to their clients how insurance companies determine the value of claims. Many times, the aspects of your case that you consider the least significant can have the most influence on the value of your case.

We counsel all of our clients to examine their automobile insurance policy, specifically UIM. UIM coverage applies when your injuries exceed the liability policy of the at fault parties insurance. North Carolina follows the set off rule, which gives the UIM a credit for any money paid by the liability carrier. For example, consider an individual with a $100,000.00 UIM policy and a case worth $130,000.00. If the liability carrier pays $30,000.00 the UIM carrier only has to pay $70,000.00. This differs from SC where in the same situation the UIM carrier would have to pay the entire $100,000.00.

Getting your insurance company to pay UIM is another issue. The relationship with your insurance company when you try to get your UIM becomes adversarial. Further, there are statutory requirements which must be followed or you void your coverage. This is why our attorneys suggest that our clients don’t speak with any insurance company, including theirs, following an accident. The other advantage of UIM coverage is the ability to arbitrate against your own carrier. When you are dealing with liability insurance your only option, if you can not settle your case, is filing a lawsuit and having a jury trial. However, when going against your own carrier you can arbitrate your case. Arbitration is a more informal process which takes place in the plaintiff’s office. Arbitration is heard by a panel of three arbitrators, one of whom is selected by the plaintiffs attorney. The decision is binding on both parties. While every case is different, arbitration is typically faster and more efficient that third party litigation.

Insurance companies typically want to avoid arbitration if possible. This can be used as leverage during negotiations. Because of this carriers look to disclaim coverage if possible. Carriers need to confirm to NC Rate Bureau policies. If their policy fails to conform it is void and reverts to the standard policy. Policies must also contain the language found in NCGS section 20. If it fails to conform it is void and the statutory language is written in.

Assuming a claim has been denied by the liability carrier for lack of coverage the only way to get compensation for your injuries is through your own uninsured motorist coverage, “UM”. UM coverage must be offered to North Carolina policy holders since NC is a mandatory insurance state. The only way to not get UM coverage is to specifically sign a waiver disclaiming coverage. We counsel all of our clients to get as much UM coverage as they can afford considering there are a large number of individuals driving without insurance.

When a UM claim is filed your carrier steps into the shoes of the other driver and acts like their insurance company. This is why it is advisable not to speak with your insurance company. Anything you said to your carrier could be used against you at this time.

You insurance company is free to use any of the defenses available to the at fault party, including contributory negligence. Many times clients seek our counsel after their own insurance company has denied their case based on their original statement. Sometimes the statement can be fatal to their case. You have no legal obligation to speak with your insurance company following an accident. The NC policy does require that you cooperate with your carrier but cooperation is not defined in the policy.

There are a multitude of ways your carrier, especially the ones you see on TV all of the time, will attempt to take advantage of you. For example, your carrier will not explain that the NC statutes set the deductible rates under UM. For instance, if you used your collision coverage following an accident you may have paid your deductible, lets assume it was $1,000.00. However, if the claim is moved under UM the most the property damage deductible can be is $100.00. AS such, your carrier is required to refund you $900.00. Many times the carrier will “fail” to let their customers know this and our office will have to demand the money be refunded.

One of the most important attributes of a UM claim is the ability to arbitrate it. If you are unable to agree with your carrier on the value of the claim you can demand arbitration. Arbitration, unlike a jury trial, is an informal process which would take place in our office. You can think of an arbitration as a very simplified trial without a judge or jury. We present our case to a panel of arbitrators who render a binding decision on the value of your case. Our attorneys take the time to explain arbitration and how it can be used to maximize the value of your claim.