Denial

It’s not just a river in Egypt (old joke, not worth explaining).

Seriously, I get this question often from prospective clients, “can the insurance company deny my claim?” The answer, of course, is a decided “yes.” Another variant is, “can the insurance company deny my claim based upon the police report?” Again, a resounding “yes.”

In short, insurance companies base their denials of claims upon multiple factors, and they only need to base it upon some good faith belief to avoid being penalized for acting in bad faith.

How can you avoid a denial of your claim, and what can you do if the police report or other factors appear to be lined up against you?

The Incident

Defense lawyers and insurance adjusters call them accidents. Plaintiffs’ lawyers call them incidents, crashes, or occurrences, highlighting the responsibility of the other party(ies).

Let’s begin with a car crash. You’re stopped at a red light; someone behind you isn’t paying full attention to the road conditions, and slams into you from behind. It might be a minor incident, and it might be serious enough to require you to have surgery. Either way, you got hurt because the driver behind you screwed up.

But what if you don’t speak English well? Or you don’t feel particularly well after getting hit? Or you’re already in an ambulance? I’ll bet you the police officer will only get one side of the story. It might even contain lies that make it appear that you were at fault, having stopped suddenly or otherwise violated the rules of the road. This happens all the time.

The first thing you should do is make sure you file your own report as soon as possible. If one already exists, insist on filing an addendum to that report. Document everything.

Second, take photos of your injuries, the positions of the vehicles, skid marks (or lack of them), and damage to both vehicles. Again, this documents what happened.

Third, do NOT talk to the insurance company about the incident without first talking to a lawyer. No matter how innocuous or even helpful the claims adjuster may seem, their job is to get you to provide information they can use to deny the claim based upon admissions of fault you make.

Get medical attention as soon as possible. The longer you wait to do this, and the more gap there is between initial treatment and any follow-up treatment, the less likely you are to be able to connect your injuries to the crash.

Incident Part Two

Not all personal injury cases involve motor vehicle crashes. There are some involving bicycles, scooters, pedestrians, and others that involve premises liability (“slip and fall”), among others.

What about the proverbial slip on the floor of the grocery store? Well, first, remember that just because you fell and got hurt doesn’t mean the store is responsible! It’s complicated, but the store owner or manager must either know of a dangerous situation, or a dangerous situation has to have existed for a reasonable period so that the store is “constructively aware” of it (in other words, they should reasonably have known).

In short, “notice” is the word of the day here. You need to prove the spilled olive oil in Aisle 5 was there for a long enough time that the store should have known about it and cleaned it up before you came upon it, and you need to show you could not have reasonably seen and avoided it.

The law in this area is very complex, requiring lots of mental gymnastics best left to lawyers who handle these cases regularly. (Trust me—if you think you can handle your own premises liability case, you probably think you can perform your own root canal. Good luck!)

So what can you do if you fall or trip on something? The first thing you should do is pull out your phone and document what you fell on. Are there foot prints in the olive oil (showing it had been there for a while)? Is it seeping out from under the display so the average careful aisle walker wouldn’t see it? Is there a sign saying “be careful?” Did you hear any announcements for “cleanup in Aisle 5?”

The very next thing you should do is inform the manager of the situation. Fill out a written incident report. Ask for a copy (you may not get it).

Get medical attention. If you can’t walk, or feel very unwell, ask for an ambulance to be called. Don’t try to tough it out or play hero, as that WILL be used against you later (“no apparent injury” or “declined medical treatment”).

As always, do NOT talk to any store representative or insurance adjuster about what happened—leave that to a lawyer.

The law in premises cases is a myriad of complexity, and I haven’t even touched on parking lots, snow and ice, which are even more headache-inducing.

Let me be clear: call a lawyer. If you have a viable case, a lawyer will help you on a contingency basis, meaning you only pay a fee if you collect from that settlement or verdict. There is no risk to you in retaining counsel, and lots at stake if you don’t have a personal injury attorney. And while it’s true that your lawyer will take a percentage of your recovery for their services, insurance industry research shows that represented plaintiffs tend to recover around 3.5 times as much as unrepresented plaintiffs. So yes, your lawyer gets a piece of the pie—but it’s a much larger pie.

Takeaways

• Document the circumstances of your injury as soon as possible after you get hurt
• Seek medical attention as promptly as possible
• Never talk to the responsible party or insurance company
• Call a lawyer

Contact Chicago Personal Injury Lawyer Stephen Hoffman

If you have been injured, whether by an auto accident, bike or pedestrian crash, dog bite, work accident, or slip and fall, seek medical attention immediately. Report accidents to the police and your own insurance company, or to your employer if you were injured at work. Then contact a lawyer with experience in your type of injury matter.

If you have been in an accident and have questions, contact Chicago personal injury attorney Stephen L. Hoffman for a free consultation at (773) 944-9737. Stephen has over 30 years of legal experience and gets results; he has collected millions of dollars for his satisfied clients. He is listed as a SuperLawyer, has a 10.0 rating on Avvo, and is BBB A+ accredited. Stephen is also an Executive Level Member of the Lincoln Square Ravenswood Chamber of Commerce.

Stephen handles injury cases on a contingency fee basis, which means you pay nothing up front, and Stephen only gets paid if you do. You have only a limited time to file a claim, so don’t wait another day; contact Stephen now to get started putting your life back together.