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Understanding the Claims Process


Personal Injury

Like most accident victims, you may be unfamiliar with the processes involved in seeking damages for a personal injury, and therefore,  may have multiple questions regarding what will occur during the claims process. Our attorneys are dedicated to providing our clients with the personal attention necessary to alleviate any concerns that our clients may have. The following is offered by the auto accident attorneys of the Law Office of Alba & Yochim P.A. as a general overview, to assist clients in understanding the claims process. However, because every accident is unique, we encourage you to contact us for specific inquiries related to your particular matter.

Understanding provisions of Florida law pertaining to auto insurance coverage is a critical component to understanding the claims process.  Likewise, through knowing the difference between necessary and optional coverage, as well as what coverage under a particular policy applies to which person or loss, you are better able to assess the claims process from the perspective of a claimant.

The most fundamental consideration is that any communications, other than those with your attorney, should generally be dealt with from an oppositional standpoint. Put simply–be careful what is said, and to whom. While this approach may seem overly adversarial, it is important that appropriate measures are taken to protect your legal rights and interests.

Most auto policies contain provisions requiring the insured to report an accident within a specific time period, often within 24 or 48 hours of the incident. If legal representation has not been secured within this period, the victim must communicate with their insurance company in order to adhere to accident reporting requirements. It is crucial to remember that, at this stage, the victim may not know or fully understand the extent or availability of coverage held by the at-fault party, as well as the magnitude of injury, losses, and damages. This is probably the most important reason which demonstrates and supports the beneficial necessity of securing legal representation as early as possible.

When it is necessary to communicate with an insurance provider, whether to report an accident or claim, or during the resolution of property damage, it is important to remember that such communications should remain limited. Generally, the only information necessary to report a claim is the date, time, and location of the accident, and, when available, the contact and insurance information of the parties involved.  The provisions contained within your auto policy should provide you with the accident reporting requirements and procedures.

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Often time, the insurance company may inquire as to liability, injuries, medical treatment, or other matters outside the reporting requirements contained within your policy. If you are unsure as to what information may, or may not be, appropriate  to disclose, the best way to handle this is to inform the insurance carrier of your intent to secure legal representation. If you are still pressured to provide further details, kindly explain that your attorney can answer any additional inquiries they may have.

Upon reporting an auto accident, you will be provided with a claim number. Either immediately, or sometime thereafter, you will generally be assigned an adjuster, claims representative, or similar agent who will be responsible for handling your claim. Documenting the claim number, and any other information provided to you, will assist your attorney in handling the claims process in the quickest manner possible.

In addition, if you were able to obtain contact and insurance information for the at-fault party, and any other evidence, such as photographs, a police or incident report, or even just the report numbers, your attorney will be able to more accurately assess your matter during consultation. However, it is also important to know that your attorney can also obtain such information on your behalf.

Another vital consideration in the claims process is understanding statutory restrictions of time pursuant to Florida law. In particular, there are two key time limitations  that can greatly impact your right to assert a claim for damages following an motor vehicle collision. First, under recent revisions to Florida’s PIP statute, a victim who sustains injury in an auto accident, must seek medical treatment within 14 days following the accident.

Second, claims for damages must be asserted within the statutory period proscribed by Florida law, referred to as the statute of limitations. The statute of limitations can vary depending on the type of action. For example, Personal Injury Actions (with a surviving victim), Wrongful Death, and Medical Malpractice claims each have their own statutory time limitations. Consequently, consulting with an attorney as early as possible following an accident, is imperative.

Insurance providers generally want to settle claims as quickly as possible. When an insurance company knows that you are not represented by legal counsel, they will often request that the victim to make a recorded statement. Knowing the difference between what is appropriate to discuss with others following an accident, and what should be left for your attorney, can significantly impact your legal rights to compensation.

By consulting with an attorney as early on in the claims process as possible, you can ensure that the appropriate measures are taken to safeguard your legal rights, which can allow you the time necessary to focus on recuperating from injury.