When you’re injured in an accident, you may find yourself dealing with an insurance company to receive compensation for your injuries. You may wonder what the insurance company’s obligation is to you in an injury claim. In this article, we will discuss the insurance company’s obligation and what you can expect from them in an injury claim.

Duty to Act in Good Faith

Insurance companies have a duty to act in good faith with their policyholders and the people who file claims against their policyholders. This means that they should take reasonable steps to investigate your claim and pay out any benefits that you’re owed.

What is a Claims Adjuster?

A claims adjuster is a person who works for an insurance company to investigate and evaluate injury claims. When you file a claim with an insurance company, the claims adjuster is the person who will often handle your claim. This person will usually request information from you, such as medical records or police reports, and will also talk to witnesses and other parties involved in the accident.

Time Frame for Responding to Claims

Insurance companies generally have a legal duty to respond to your claim within a certain timeframe. The exact timeframe will vary depending on the state that you’re in and the type of claim that you’re making. In many states, the insurance company has to acknowledge your claim within a certain number of days and then respond substantively within a certain number of days after that.

Investigating Your Claim

The insurance company’s claims adjuster will investigate your claim to determine the extent of your injuries and any damages that you may be owed. This process can involve reviewing your medical records, obtaining witness statements, and consulting with experts in various fields.

The insurance company may also request that you provide a recorded statement under oath. It’s important to understand that the purpose of this statement is to obtain information that can be used to deny your claim or minimize the amount of compensation that you’re owed.

Making an Offer

If the insurance company determines that you’re owed compensation, they will typically make an offer to settle your claim. The offer may be an initial offer or a counteroffer, depending on your negotiations and the information that the insurance company has obtained during their investigation.

It’s important to understand that the offer that the insurance company makes is not necessarily the full amount that you’re entitled to. You have the right to negotiate and to reject offers that you feel are too low.

Denying Your Claim

If the insurance company determines that you’re not owed any compensation, they may deny your claim entirely. When this happens, they should provide you with a written explanation of the reasons for the denial.

If you disagree with the insurance company’s decision to deny your claim, you have the right to appeal the decision. You may also consider hiring an attorney to assist you with your appeal.

What if the Insurance Company Acts in Bad Faith?

If you believe that the insurance company has acted in bad faith by failing to investigate your claim properly, delaying payment, or denying your claim without a valid reason, you may have a right to sue the insurance company for bad faith.

An attorney can help you determine whether you have a case for bad faith and can assist you with filing a lawsuit against the insurance company.

Conclusion

In summary, the insurance company has a duty to act in good faith with policyholders and people who file claims against their policyholders. They must investigate your claim and respond to your claim within a certain timeframe. If you’re owed compensation, they will typically make an offer to settle your claim, but you have the right to negotiate and reject offers that you feel are too low. If they deny your claim, they should provide a written explanation of the reasons for the denial, and you have the right to appeal the decision. If you believe that the insurance company has acted in bad faith, you may have a right to sue them for bad faith.