Pedestrian accident claims may seem straightforward on the surface.
You were struck by a negligent driver while walking and are dealing with injuries. Since the accident was not your fault, you deserve compensation for the related medical bills, lost wages, emotional stress, and more. You tally up all the damages and the driver’s insurance company should cut you a check.
Unfortunately, it’s not that simple.
Insurance companies are big businesses. They have an obligation to maximize their bottom line – and that generally means minimizing your payout – by any means necessary. In this article, we’ll break down what insurance companies take when processing claims for injured pedestrians, and how you can protect your rights after an accident.
The Importance of Understanding the Claims Process
According to data by the Illinois Department of Transportation, pedestrian accidents account for around 5 percent of all injury claims.
If you plan on pursuing a pedestrian accident case, it’s very important to have (at the very least) a basic understanding of how the claims process works – for both minor and severe injuries. When you hire a pedestrian accident lawyer, they will handle the bulk of the legal process – gathering evidence, forming your case, and negotiating with insurance companies.
Being informed about how these companies operate can do a lot to help your lawyer build a strong claim and maximize your payout.
Opening a Claim After a Pedestrian Accident
When seeking compensation for a pedestrian accident, it’s up to you to initiate the claims process with the insurance company. This involves filing a claim with the at-fault driver’s provider.
The insurance company will then start evaluating the accident to determine who is responsible. It’s your job to provide details about the accident, the driver’s information, and any medical treatment you’ve received.
Keep in mind, you need to be VERY careful about how to speak to insurance companies about your pedestrian accident injuries. Even the slightest implication of fault can compromise your claim. Simply state the facts. Do not – under any circumstances – let your emotions get the best of you. This may be used against you in the claim.
Pro Tip: Keep detailed records of any communication with the insurance company. Save any emails you had with the company, and if possible, record the calls you have with them.
Initial Contact from the Insurance Company
After you file your claim, you’ll be contacted by an insurance adjuster.
This person’s job is to investigate the accident and assess your claim to determine liability. This will form the basis of how the insurance company will value your settlement. The adjuster will likely ask for a statement about the accident.
Again, be very, very careful when providing details, as they may use your words against you later. Even the slightest admission of fault can have a big impact.
For example, say you were struck by a motorist who ran a stop sign while you were crossing the street at a marked crosswalk. It may seem like the driver was fully at-fault. However, if you mention you were wearing headphones, they may use this to argue that you were not paying attention when crossing the street. This could make pursuing a fair settlement more difficult.
We strongly recommend meeting with a pedestrian accident attorney before speaking with the insurance adjuster. They will provide guidance on how to manage this step of the process.
Investigation of the Accident
After the initial insurance adjuster does their job, the insurance company will conduct a more thorough investigation to determine who was at fault. This typically involves reviewing the police report, assessing witness statements, and analyzing any available evidence, such as photos or videos of the accident.
What Insurance Companies Examine
There are many, many moving parts to pedestrian accident claims. Insurance companies take the following information into account:
- Police report
- Witness statements (if applicable)
- Photos and videos
- Medical records
- Driver and pedestrian behavior (if either party was violating traffic laws)
- Accident location
- Weather and road conditions
- Comparative negligence – (whether the pedestrian or driver may have been partially at fault)
- Previous claims or medical history
- Driver’s insurance policy
These details will be examined under a microscope to determine the value of your claim. From here, they will more than likely offer a lower settlement than what you deserve. When you work with a personal injury attorney, they will counter low offers and make sure you get the compensation you are rightfully owed.
Determining Fault
Fault in some pedestrian accidents is irrefutable, but in many, it’s not immediately clear. Even if you believe the driver was clearly at fault, their insurance company will do everything possible to argue that you were at least partially at fault.
One of the most common arguments we see in pedestrian accident cases from insurance companies is the victim crossed a street against a signal – or was distracted while walking. This puts claim into hearsay, which can be very difficult to argue without a skilled attorney.
Comparative negligence
Illinois follows a “comparative negligence” rule. This means your compensation may be reduced by your percentage of fault. For example, say you were hit crossing a street while jaywalking, but the driver was distracted and driving under the influence of alcohol. You may be ruled 10 percent responsible for the accident – and your compensation will be reduced by 10 percent.
Medical Examinations and Documentation
Insurance companies will likely request access to your medical records to verify your injuries – and whether or not they were caused by the accident.
In some cases, they may also ask you to undergo an independent medical examination (IME) by a doctor of their choosing. The insurance company will use medical records to determine how much to offer in compensation.
In almost every injury case, the insurance company will try to argue that your injuries are not as severe as you claim.
Pro Tip: Never sign any release forms or agree to an IME without first consulting your attorney.
Settlement Offers
Once the insurance company has completed their investigation, the next step is to make a settlement offer. This is the amount they are willing to pay to resolve the claim without going to court.
Ninety-nine times out of one hundred, this is a lower settlement than what pedestrian accident victims deserve. Insurance companies bank on the idea that you’ll accept a quick settlement to avoid a long claims process – and resolve the matter quickly.
It’s very important that you do not accept the first offer without reviewing it with your attorney. You may be entitled to more compensation than you believe.
Negotiating a Fair Settlement
If the initial settlement offer is too low – which is almost always the case – the personal injury attorney you hire will negotiate a higher amount. Plain and simple: this is THE most important reason to hire a skilled lawyer to protect your best interests.
The negotiation process involves providing additional evidence of the accident, records that show the depth of your injuries, and the financial impact it has had on your life.
This process can take a long time. With some cases taking months – or years – to resolve. If you were injured due to someone else’s negligence, you deserve every penny you’re entitled to. Be patient, let your attorney do the negotiating, and don’t give up with a low settlement.
What Happens If the Insurance Company Denies Your Claim?
In some cases, the insurance company will flat out deny your pedestrian accident claim. This tends to happen when victims do not have a personal injury attorney working on their behalf.
Denying a claim can happen if the insurance company believes you were mostly at fault, or if they dispute the severity of your injuries. Or, they may claim not enough evidence to prove liability or that your injuries were pre-existing.
Keep in mind, an insurance company denying your claim is NOT final. Your attorney can appeal this decision and fight for the compensation you deserve.
Filing a Lawsuit If Negotiations Fail
Now, before we get into it, we want to clarify that very, very few personal injury cases ever see the inside of a court room – less than 5 percent. Most are settled out of court.
Why is this?
Behind closed doors, insurance companies generally know what an injury claim is worth. They are simply obligated to minimize it. Moreover, they know that taking a claim to court is very expensive. They measure the strength of the claim against all of the court costs and decide if fighting a lawsuit is worth it.
Negotiations tend to fail if there is a lack of evidence, liability is not clear, or there is a irreconcilable disagreement over damages. When this happens, it’s crucial to have an attorney with trial experience represent you in court.
Types of Compensation You Can Receive
In a pedestrian accident claim, there may be many potential forms of compensation to pursue. These include (but are not limited to):
- Medical expenses (current and future)
- Lost wages
- Pain and suffering
- Property damage
When you work with an attorney, they will direct you in gathering and organizing all records, receipts, and estimates to support your compensation demand.
The Importance of Keeping Detailed Records
After a pedestrian accident, records and documentation is the foundation of your case.
This is instrumental in establishing the facts of the accident, prove the extent of your injuries, and demonstrate the financial impact of the incident. Insurance companies will scrutinize every part of your claim, so having thorough records can protect you from disputes or low settlement offers.
Medical Records
Medical records are the key to proving your injuries and connecting them directly to the accident. This includes doctor visits, treatments, medications, and any future medical care you may need. Keep copies of all bills and receipts related to your medical care.
Evidence of the Accident
Photos and videos of the accident scene, your injuries, and any property damage (like damage to your personal items) can also strengthen your claim. Visual evidence helps to show the severity of the incident and the conditions at the time of the accident.
You should also maintain written records of any communication with the insurance company, as well as a personal journal tracking your recovery. Noting down how the injury affects your daily life, including any pain, mobility issues, or emotional distress directly supports your demands for damages related to pain and suffering.
Time Limits for Filing a Claim
In Illinois, you have a limited amount of time to file a pedestrian accident claim. This is known as the statute of limitations. For most personal injury cases, you have two years from the date of the accident to file a claim.
If you’ve been injured in a pedestrian accident, you need to start the process as soon as possible to make sure this timeline is met. Otherwise, it can be difficult to earn a fair settlement – as the insurance company may argue the injury was not severe enough to warrant a claim.
The Next Step
Pedestrian accident claims with insurance companies can be a long, drawn out process. From filing the initial claim to negotiating a settlement, knowing what to expect can help you protect your rights and secure the compensation you need.
Working with an experienced injury attorney makes all the difference in navigating this process and giving you the best chance of receiving a fair outcome. If you’ve been injured in a pedestrian accident, don’t hesitate to reach out for legal help.
At Midwest Injury Lawyers, we offer FREE consultation to understand the depth of your situation, damages to pursue, and your options to seek compensation. Schedule a meeting with a skilled attorney today to get started.