How to Handle Your Insurance Claim

When you’re injured by error or in an accident, you will likely have to deal with several insurance companies, including health insurers, workers’ compensation insurers, short term/long term disability insurers, automobile insures, and/or general liability insurers.  It is thus extremely important that you understand what the insurance companies want from you and how they plan to go about it.  The CT Injury Law Center can guide you through the process by informing you of what to expect and by communicating with the insurance companies on your behalf.

To better understand how to deal with insurance companies, it is important to understand the basics.  First party insurance is your own insurance company.  You either pay the premium yourself or someone pays it on your behalf (employer, household member, etc.)  A first party claim is thus one that you might file with your own insurance company to cover your medical expenses, lost wages or property damage.   Insurance benefits such as “no fault”, “med pay”, or “personal injury protection” fit into the realm of first party insurance.  These claims typically encompass those where it does not matter who was at fault, whether it be you, the owner of house you were in, the driver of the car you were in, your employer, etc.  When dealing with first party insurance companies, you have a duty to cooperate in order to maintain your benefits.  Your insurance company might also require you to attend a mandatory IME (Independent Medical Examination), but keep in mind that this examination may not be independent at all.

At any point in the process, you may be required to release medical and/or accident records to the insurance company.  You may also be required to give a recorded statement or examination under oath.  A lawyer can properly advise you how to present yourself for the IME.  They can prepare you for your recorded statement and examination.  They can present your records in a way that highlights your right to benefits and seek to otherwise maintain as much privacy for you as possible.  An attorney is especially helpful if the insurer wrongly denies payment of expenses.

In cases where someone else caused your injury, you will have to deal with a third party insurance company.  The third party insurance company is the wrongdoer’s insurance company.  You have no duty to speak to them and you should not do so without a lawyer.  A lawyer can and will coordinate communications, assemble only those records that are necessary to prosecute your case, make demands, and negotiate on your behalf.

Situations also arise where the first and third party insurers are the same company.  If you find yourself in this position, proceed with caution and hire a lawyer.  A lawyer will prepare you for your recorded statement and for your EUO (Examination Under Oath), and will treat the first party claim as if it were a third party claim.  Also, if you have a health insurer (including medicare), workers’ compensation, or other first party claim, a lawyer can help resolve any attempt by the insurer to obtain a portion of your financial recovery from the wrongdoer’s insurer.

You should give all papers from the insurance company to your lawyer, as any information at all might help your case.  Remember also to hire a lawyer as early as possible, as you may have to give prompt notice of your claim to the insurance company under contract or by law.  The CT Injury Law Center is here to assist you in dealing with insurance companies and recovering what is rightfully yours.

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