The Role of Insurance Companies in Personal Insurance Lawsuits

Personal injury lawsuits are normally contentious issues. Sometimes they are clear in terms of negligence and responsibility, but that is not always the case. Tort cases are actions between primary parties. In most cases the defendant, which is called the respondent in a tort claim, will have a common insurance carrier depending on the facts of the case. In some cases the petitioner has insurance coverage also, so the material facts of the case can be confusing.


The first role of the insurance company in a possible negligence case is to assess the parameters of coverage. This can be problematic if the company has a responsibility caveat. Insurance policies are always subject to scrutiny in terms of coverage. And insurance companies have those stipulations in place for this reason. If they can reasonably avoid compensating the injured party, then rest assured that they will.

The first meeting with the insurance company will be with the adjuster. Settling the case as cheaply as possible is the adjuster’s goal. Assessing the injuries before hand in terms of damages is always a good practice for the injured party. This will help the victim not undersell. The adjuster is also concerned with a quick settlement if the petitioner will settle for a minimal amount. Patience is clearly an advantage at this stage of a potential court claim.


The insurance company will then evaluate the merits of the case. There should be copies of all medical records on file, including diagnosis and status of the injury. A prognosis is always important also because it can establish the inevitability of future medical problems resulting from the injury. Very often the insurance company will want to avoid any future claims and a validation of coverage liability can be limited to the cap of the policy.

It is important to understand that the insurance company’s involvement in the matter stops at the point that they pay the maximum on the policy. Any additional claims will need to be pursued against the primary respondent in the event that negligence is established. The fact that an insurance company will pay a claim before court does not preclude a court decision in the respondent’s favor. The insurance carrier should not longer be involved or have a recourse.


When a case goes to court the insurance company will be represented well with professional counsel. The victim should do the same, preferably with solid experienced legal counsel. When cases actually go to trial the parties both need effective counsel to determine both compensatory and punitive damages, as well as establish materials facts and merits of the litigation. A reputable personal injury lawyer is always essential in negligence cases that actually move to court.

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