Insurance ClaimsClaims Handling

June 23, 2021

At  AP Law Group we understand the difficulties injured victims can have with handling their own claim management. Insurance company claims procedures are all designed purposely to benefit the company, and any technicality the claims adjusters can use to justify reducing will be applied by virtue of standard claims handling principles for the company. Claims handling procedures are used daily by insurance adjusters who are focused on protecting the company bottom line regardless of the claimant’s extent of injuries. This claim processing system is in place in practically every insurance company in the nation, and the most difficult ones can often be the big box companies with major advertising budgets. Most of those budgeted dollars come from denied or severely reduced payouts engineered by their insurance claims handling. The typical novice injured person is no match for these trained professionals, and it is always best to have an experienced personal injury lawyer in Houston like AP Law Group for professional claim management legal counsel.


Building Your Case


There are certain steps a personal injury attorney can take that the injured victim cannot when it comes to insurance claims handling. The first is the ability to conduct a thorough investigation into the material facts of the case, including specific information that could counter the insurance claims management of the benefits provider. The most common defense to whole damage claims handling guidelines is comparative negligence presented by the insurance provider. Texas uses the 51% bar rule, which means that any claimant found to be over half responsible for an accident producing their injuries can be denied financial compensation per the claims handling guidelines. Most case settlements hinge on this problem, and though it can increase claims handling costs, the information gathered by your professional insurance claims management attorney can be the difference in maximum award or no award at all. And, the latter is always the goal of the insurance provider claim processing system.


Potential Damages


Insurance claims handling principles govern what damages may be claimed by injured victims. Physical property damage is one of the first issues addressed, especially when claimants need immediate access to dependable transportation. Many times this can include a rental car until a damaged vehicle is repaired or a payoff on the assessed vehicle value. The most valuable element of a claim is typically financial recovery for non-economic general damages for ongoing pain-

and-suffering as a result of injuries received in the accident. Punitive damages can be applied when there is evidence of gross negligence on the part of an at-fault driver, such as driving under the influence at the time of the accident. In addition, insurance companies can also be sued for bad faith when they violate standards for claims handling procedures. This happens more often than many claimants realize, but must be awarded by a jury when a case advances to a full trial.


Taking an Insurance Claim to Court


Many times it is necessary to take a claim to court when insurance companies are being particularly difficult in the negotiation process. Although this can contribute to increased claims handling costs, it can also be what makes an injured claimant financially whole after all is said and done. Insurance companies understand well that comparative negligence defenses cannot be discreetly applied in negotiation, as they are actually determined during the court process and handed down by a jury after a full trial. Ensuring the claimant is less than 51% responsible for their own damages is always the goal of the plaintiff legal counsel, along with procuring maximum financial recovery for an injured client. This is assuredly what is stressed at AP Law Group, and we will not hesitate to process a case to the full extent of the law.


Never attempt your own insurance claim management because insurance providers can be ruthless when it comes to avoiding or reducing the value of a claim. Even when the responsibility is obvious, the insurance provider will always try to take advantage of an injured claimant who does not have solid legal counsel. Your claim may be much more valuable than you realize. Always call AP Law Group for comprehensive and aggressive legal representation.

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