Preventable accidents claim the health, livelihoods, and even lives of innocent, hardworking South Carolinians every day. When that happens, victims want their medical bills paid, lost income replaced, and the chance at a fair settlement for what they've been through.
Unfortunately, it's hard. That's when you get sucked into the vortex of the South Carolina personal injury insurance claims process. Because it's such a confusing, frustrating foreign land, I'm shedding some light on the South Carolina insurance claims process here.
I'm giving you vital information about how the insurance company typically processes accident injury claims. To get a settlement, you've got to give them what they need; this is what they're looking for. I've written separate articles about my law firm’s own process to maximize your shot at a fair settlement. This article only covers getting a settlement without a lawsuit. Many times, in South Carolina personal injury cases, the insurance company just won't reach a fair settlement without one. That requires us to file a lawsuit, which you shouldn't do without professional help any more than you’d operate on yourself.
I'm using a slip and fall or trip and fall accident as an example of the claim that's being handled. In my experience, a victim has about a 50-50 shot at settling the case without a lawsuit. Other South Carolina personal injury cases virtually guarantee the need to file a lawsuit, especially nursing home or assisted living facility neglect, medical malpractice, or defective products. I've also revealed the South Carolina car or motorcycle accident claim settlement process.
Folks hurt in accidents rightly have lots of questions, and they don't know where to turn. I'm an experienced Spartanburg, South Carolina personal injury attorney, and I'm here to answer your questions in the easiest way for you, with no pressure to hire me. Call me toll-free at 888-230-1841 or fill out a Get Help Now form.
Here's the typical insurance claims settlement process in a South Carolina trip and fall or slip and fall case.
Step One: Report the Accident Immediately and Start Proving Fault
When you fall at a business, whether a store, hotel, or anywhere else, it's not just painful; it's humiliating. Your first instinct will likely be to gather yourself, get up like nothing happened- if you can- and get out of there as fast as possible. Then the agony sets in, and you find yourself in the emergency room getting X-rays and referred to a specialist.
Meanwhile, back at the business, you should expect there's already been a cleanup on aisle 4 and a good old-fashioned coverup is well underway. Don't let that happen to you. Report the fall and your injuries as quickly as you can. There are critical reasons why:
- The store may have video surveillance cameras. The cameras may have captured your fall and its severity, and how what you fell on got on the floor and didn't get cleaned up in time to save you. Because these cases are so hard fought about whose fault it is, this evidence can be pure gold. The trick is, these tapes are regularly erased and taped over. You've just got to assume if they contain something the store doesn't want anyone to see, it disappears fast. When you hire me, one of the first things I do is send a letter to the insurance company and the business telling them to keep those tapes.
- You're a good person. You don't want this to happen to someone else, so you let management know so they can fix it.
Don't be surprised if management begins to point the finger at you the instant you approach them about the fall. “Why didn't you look where you were going?” is a favored attack by a manager who just 30 minutes ago was delighted to see you coming in to spend money in their store, but now you're the enemy. They may make you fill out an incident report in a manner that makes a disgruntled DMV employee seem like a saint. Hopefully, they'll also get witness statements. If you can, get witness contact info on your own, just in case.
You will likely sense the store turning against you. As the wagons get circled against you, remember everyone around you is a professional. You're the only amateur in the room.
You need to know what they know: the law to prove fault, or liability, is complicated, and it really helps the business more than you. You don't get a settlement just because you fell. You've got to prove it was the business's fault that whatever you fell on got put there or stayed there as long as it did without the business warning customers like you. Your every move around the fall will be scrutinized and dissected to prove it's your fault, not theirs. Let me land the plane for you on how hard winning your case can be for an amateur: a legitimate defense in a fall case can be, “We didn't know it was there.”
You've got a tough case, and you need advice, especially in dealing with the character you're about to meet.
One Character Who Definitely Needs an Introduction: The Claims Representative
Assuming the business actually reports the fall to its insurance company, you'll be contacted by the claims handler, claims representative, or, as we commonly call them, the adjuster. I can't predict how they'll treat you. Sometimes they're friendly, sometimes they’re a nasty foe. It's always strange to me how the ones my clients tell me are the meanest get really nice when I contact them. When I hear the change in the adjuster’s tune, I know their cruelty towards my client was nothing more than a shameless intimidation strategy. It's one of several key advantages to hiring an experienced South Carolina personal injury attorney. You don't have to worry about foul treatment from a claims handler.
And here's why the adjuster does everything they do, which is typically geared towards delaying or denying your claim: their sole purpose in life is to get the insurance company out of your case as fast and cheaply as possible. They are highly trained to do it, they enjoy great success against wounded amateurs who don't hire an experienced attorney, and they've got a laundry list of tricks up their sleeve to do it.
If you're worried about how you should handle the claims adjuster in your South Carolina personal injury case, don't. Just call me. I’m a Spartanburg, SC personal injury attorney, and I'll give you a free, no-pressure strategy session about your case. Call toll-free at 888-230-1841.
Step 2: Your Medical Treatment
The most important thing you can do in your case is just get better. And yes, South Carolina personal injury settlements are based on the severity of your injury, which is often determined by the cost and duration of your medical care.
PRO TIP: pay your accident injury medical bills with health insurance, Medicare, or Medicaid. It's a better deal for you in the end.
The doctor is one of the most important witnesses in your case. Be honest and thorough with your doctor. Be honest about your pain. Be thorough about how it affects your life, especially the limitations it puts on you from living normally.
Never exaggerate your symptoms to the doctor or anyone else. This is a form of lying, and the insurance company will pounce on it to make you look like a liar. You've got to address your case as if you might go to court, and neither judges nor juries like liars. The easiest thing to do is stick to the truth because you don't have to think too much about telling it.
When you're severely injured, you unknowingly give the insurance company another way to cheat you. When it comes to evaluating a fair settlement, you're an amateur. The adjuster is a professional devoted to short-changing you even though the adjuster may know full well your claim is worth way more than you get offered. Even if you think your fall case is a slam dunk – which I have yet to see in my career – you are setting yourself and your family up to be shortchanged out of a fair settlement if you suffer injuries requiring:
- Hospitalization
- Fixing a broken bone
- Surgery
- Referral to a specialist
Those cases are high stakes and potentially big money, meaning the insurance company will fight you even harder. Don't go it alone. Get advice from an experienced South Carolina personal injury attorney. Call me toll-free at 888-230-1841 or fill out a Get Help Now form.
When you hire us, we look after you during the treatment phase of your case. And we offer another huge benefit; we weave your medical treatment into the story of your case. You can't just send your medical bills and records to the adjuster and expect them to come up with a fair settlement. I can't tell you how powerful it is to let the adjuster know that you know what's in your medical records. You do that by summarizing your injuries and the highlights of your treatment. That can involve wading through hundreds or even thousands of complicated medical records with foreign terms. I do that for a living. I can find what's important, and let the adjuster see it in letters I write to make it easy for them to give you a fair settlement.
If you've had a prior injury, be prepared for the adjuster to try to shut your case down, saying, “You were already hurt,” or “This would have happened anyway.” An experienced South Carolina personal injury attorney knows how to tell them not so fast, my friend. If necessary, I'll get your prior medical records, then compare them to the current injury and even meet with your doctor to confirm the fall worsened it or caused a new injury. Often, I submit this critical medical evidence to the insurance company in a questionnaire filled out by the doctor showing how he'll testify on this vital element of your case.
Step 3: Settlement Negotiations
Assuming the adjuster lets your claim go this far without an attorney, this is where victims get discouraged and distracted. Adjusters pull out all the stops to argue against why you shouldn’t get a fair settlement, which may include false statements of the law. But since you're not an attorney, how would you know?
I kick off settlement negotiations with a demand letter, which may just be the last in a series of letters to the adjuster updating them on your case. It includes a summary of why the business is at fault, including the law favoring you, a listing of your medical bills, a summary of your medical treatment, admissible evidence of lost income and future medical care, and the human story of your case – your human loss.
“Human loss” is what most lawyers call pain and suffering. I don't call it that because there's more to it than just pain and suffering. Again, this requires knowing the law that injured fall accident victims just don't know. If you're seriously hurt with long-term effects, this is where an experienced South Carolina accident injury attorney can take your experience and make it into a compelling story of why you should be compensated fairly in a settlement.
The whole point of the demand letter is the settlement offer. If you have no legal experience and you're not a claims adjuster, you just won't know how to do that. You could walk away leaving a lot of money on the table. Before I send the demand letter, my clients review it and we have a settlement evaluation discussion so they know how much their case is worth and why. I send the highlights of the evaluation to them in writing.
If you can reach a settlement agreement with the adjuster, your case still isn't over. You've got to sign the settlement document before getting a check, which is another process in itself.
Step 4: The Settlement Phase
Reaching a settlement agreement isn't the end of your claim. It's just the final push. The settlement document is called a “release,” which is a perfect title because it releases the business and its insurance company from any further responsibility for your fall.
And you may not be done negotiating. Your health insurance or your doctors will need to be repaid from the settlement in a process called subrogation. Those amounts can be negotiated as well, to get you more money in your pocket from the settlement. This is yet another situation where an experienced South Carolina personal injury attorney can worry about it for you, so you don't have to.
At long last, you get your portion of the settlement. Better yet, it's tax free!
There's a Lot at Stake. The Deck Is Stacked Against You. Get Some Advice.
If you've been hurt in a South Carolina fall accident, hasn't the universe screamed at you, “Better safe than sorry?” It's bad enough you've been hurt, don't make it worse by being taken advantage of by an insurance company.
A driving force behind my law firm is to restore your peace of mind. I will answer your questions for free, and if you don't need a lawyer, I'll tell you and give you free advice to help you along the way. If you hire us, you are set free from dealing with the insurance company. All you do is focus on getting better and helping us help you.
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