You were injured as a result of a car accident and there is no dispute as to who was at fault for causing the accident. The insurance company “accepted liability” and paid for the damage to your car but now the insurance company does not want to pay for your injury claim. New clients often come to us frustrated and confused by the hold up to be compensated for their injuries. The question becomes, “they were 100% at fault for the accident and have accepted liability, why aren’t they paying me for my injuries?”
When you are making a personal injury claim as a result of a car accident you have to prove:
(1) negligence of the other driver;
(2) the negligence of the other driver was a substantial factor in causing you harm; and
(3) the harm or damage that was in fact caused by the other driver’s negligence.
Negligence of the Other Driver
The first hurdle is establishing that the other driver was in the wrong for causing the accident. You must prove that the other driver failed to exercise the reasonable duty of care required of every driver on the road. When the other driver is clearly at fault for the accident (e.g. they rearend you while you are at a stop for a red light) the insurance company will accept liability and pay for the damages to the car. The insurance company has only acknowledged that their driver was negligent and caused the accident, they are not acknowledging that the negligence caused you to be physically injured.
Bear in mind that the claim for the damages to your car and your claim for bodily injury are two separate claims. We bring this to your attention because it is fairly common for the insurance company to accept liability and pay for damages to the car but later fight liability on the personal injury claim. They will attempt to attribute partial liability to the personal injury claimant. It sounds crazy and irrational, we agree! Welcome to the world of insurance claims.
Substantial Factor in Causing Harm
Once it is established that the other driver was at fault for the accident, at least in-part, then you have to establish that any injuries that you are claiming were more likely than not caused by the accident. Some injuries are clearly caused by an accident and the insurance company has a tough time fighting claims for those injuries (e.g. broken bones). Contrarily, claims for soft tissue injuries (e.g. ligament tears or disc injuries of the spine) see more push back from the insurance companies.
Insurance companies are skeptical of claims and want to determine whether those injuries were pre-existing rather than caused by the car accident. We find that some of our client’s do have pre-existing conditions. However, a pre-existing condition does not preclude someone from being compensated. If a pre-existing condition is aggravated or made worse by the negligence of another person, that negligent person(s) is liable for the additional damage they have caused.
The Damage Caused
Finally, if you are able to prove that the other driver was negligent and that negligence was a substantial factor in causing you harm you are left to prove what the total damages are that are a result of your injuries suffered in the accident. Damages in a personal injury claim vary but you are entitled to recover past and future medical expenses, past and future loss of earnings or loss of earning capacity, and pain and suffering. These damages are discussed in more depth in this damages blog.
If you have been involved in a car accident and have questions please contact our trusted Carlsbad car accident attorneys from our office to learn about your rights. Your initial consultation is free and if you retain our services no fee will be payable to our firm unless we obtain compensation for you.