Rights and Obligations - Yours and Theirs

After 35 Years settling Personal Injury Claims, this retired adjuster is sharing some secrets.

Logic would seem to dictate that the less severe the injury, the simpler it should be to resolve your Personal Injury Claim. However, that is not always the case. There seems to be a perverted sense of "logic" that is running ramped among insurance companies. All too many insurance companies are refusing to be fair in settling Personal Injury Claims, knowing full well that consumers will have to seek a qualified attorney to collect what is rightfully due. The operative word there is "qualified" attorney. Believe it or not, this approach actually works out to the best advantage of the insurance companies on either the short term or the long term basis (or both). The reasoning behind this aggravating approach to adjusting will be discussed in greater detail in the Techniques section of this page. For now, suffice it to say, the insurance company is probably not going to bend over backwards trying to be fair with you. Therefore, what you are about to learn here should be invaluable in your efforts to understand and deal with insurance companies when you have a Personal Injury Claim. With this in mind, let us proceed with the first topic.


If we were to go into details and subtleties here you would probably lose all interest in proceeding further, so let's try to keep this simple. To begin with, you have the obligation to prove who is responsible for your personal injury. Because this is a "comparative negligence" state, YOU also have to prove that YOU were NOT guilty of any negligence that may have contributed to you having sustained a personal injury. Then YOU have the obligation to "mitigate" (minimize) your damages and YOU have to prove your damages. Are you beginning to see a pattern here?

Just within the scope of what is discussed here, there are a few questions that could arise:

1. What constitutes "comparative negligence"?
2. How is negligence apportioned?
3. What is "reasonable mitigation"?
4. What constitutes proof of my damages?

These details and subtleties will not be discussed here. Remember . . . we're trying to keep this simple. Suffice it to say, if any of these questions become a part of your claim, GET PROFESSIONAL HELP!

If liability is clear (other party struck you from the rear while you were legally stopped in traffic AND there is a police report to verify these circumstances AND the other driver was cited AND you received no citation AND you were wearing your seat belt at the time of the accident) . . . if your injuries were obvious at the accident scene AND the police accident report notes that you were injured . . . if the insurance company for the other party quickly commits to paying for your damaged vehicle AND puts you into a rental vehicle at no cost to you AND acknowledges they may have to pay you for any reduction in resale value of your vehicle after it has been repaired . . . if the adjuster advises you of the insurance policy coverage limits up-front . . . if those limits are sufficient to cover your expected damages (vehicle damage + diminished resale + rental car costs + medical expenses + lost wages + projected future medical expenses + "pain & sufferance" compensation with NO expected residual disability) . . . AND you are comfortable dealing with the insurance adjuster yourself, then you will PROBABLY not need professional help. After all, some Personal Injury Claims actually are simple and some insurance companies will actually step-up, treat you with respect and pay what they owe. However, if your situation does not meet ALL of the criteria specified above, we suggest you consider talking with an Attorney.

Now that we have discussed your obligations, let us review the obligations of the insurance company. This part is simple. Once you have proven their insured is 100% liable for you damages and you have proven your damages, then the other party's insurance company has an obligation to protect the interests of THEIR INSURED by paying for your damages. Did you notice that? THE OTHER PARTY'S INSURANCE COMPANY HAS NO OBLIGATION TO YOU! Their obligation is to their own insured.