Fighting the Insurance Company After a TBI

Traumatic brain injuries (TBIs) can dramatically alter a person’s life, leading to significant medical expenses, lost income, and emotional distress. Often, after suffering a TBI, a person is never the same.

If you or a loved one have suffered a TBI due to someone else’s negligence, navigating the insurance claims process can be daunting. Insurance companies often prioritize their profits over fair compensation, making it important for victims to understand their rights and steps to take in order to secure the financial recovery they deserve.

A TBI lawyer can battle against the insurance company. Experienced attorneys have the skills and resources to protect your rights and reach the best possible claim result.

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Understanding Traumatic Brain Injuries

TBI acronym - Traumatic Brain Injury on white background.

A traumatic brain injury occurs when an external force causes injury to the brain. Common incidents that result in TBIs include:

Vehicular accidents, including car, truck, and motorcycle crashes
Falls, including slip and falls and falls from heights
Violent encounters, including assaults and domestic violence

Brain injuries are often caused by negligent or intentional actions of another. If you’ve suffered a TBI at the hands of someone else, you can have a valid claim to pursue compensation.

Common Types of TBIs

There are several types of brain injuries that can cause significant and lasting impacts on a person’s life and well-being. Some of the common types of TBIs include:

Concussions: Concussions are caused by a blow to the head or body, leading to changes in brain function. Symptoms can be short-lived or long-lasting, depending on the severity of the trauma.
Contusion: A bruise on the brain resulting from a direct impact. Contusions can cause localized bleeding and swelling in the brain tissue.
Diffuse axonal injury: A more severe form of TBI where the brain’s axons (nerve fibers) are stretched or torn, often due to rapid acceleration or deceleration. This type of injury can lead to extensive cognitive impairment.
Subdural hematoma: A collection of blood between the brain’s surface and its outer covering (the dura mater), often caused by head trauma. The injury can increase pressure on the brain, making it dangerous.
Epidural hematoma: A buildup of blood between the outer protective covering of the brain and the skull, regularly resulting from a skull fracture.

The type of brain injury a victim suffers highly depends on the type of accident, the details of the incident, and the location of the injury. Each kind of TBI can have different symptoms and potential long-term effects, making prompt diagnosis and treatment critical.

Lasting Consequences of a Brain Injury

The lasting impacts of a traumatic brain injury can vary widely based on the severity and location of the injury, as well as individual factors. Some potential long-term effects of TBIs include:

Cognitive impairments: Difficulties with memory, attention, problem-solving, and executive functions can persist long after the injury.
Emotional and behavioral changes: Individuals may experience mood swings, anxiety, depression, irritability, or personality changes.
Physical disabilities: TBIs can lead to motor impairments, coordination problems, and balance issues. Some individuals may have difficulty with fine motor skills.
Sensory changes: Vision, heading, and other sensory functions can be affected, leading to problems such as blurred vision or tinnitus.
Chronic pain and headaches: Persistent headaches and other types of pain can occur following a TBI.
Seizures: Some individuals may develop seizure disorders as a result of their brain injury.
Increased risk of neurodegenerative diseases: Studies suggest that individuals with a history of severe TBIs may have a higher risk of developing conditions like Alzheimer’s disease or other forms of dementia later on in life.

In the most unfortunate cases, TBI victims end up in comas, vegetative states, or succumbing to their injuries and passing away. If you’ve lost a loved one due to a TBI, you may have a valid claim for wrongful death and should consult with a personal injury lawyer.

Financial Implications of a TBI

Traumatic brain injury on white note on a beautiful background from dollar bills

Suffering a traumatic brain injury doesn’t just affect a person physically and mentally, but also financially. This is particularly the case when a TBI impacts a victim in the long term, requiring extensive medical care, ongoing treatment, and lifestyle changes.

Expenses after a TBI can be too much for some to handle. Medical treatment can be rather costly, and a victim may be unable to work in the short or long term. After a TBI, financial burdens quickly add up.

Recovering financially for a TBI caused by another’s wrongdoing is one of the primary reasons to file a claim for compensation. If you’ve sustained a serious brain injury, you should not have to deal with the financial difficulties on your own. Securing fair compensation can help alleviate some of the pressure and protect you for the future.

The Role of the Insurance Company

After experiencing an accident, like a car accident or slip and fall, you may have the opportunity to file an insurance claim. Insurance companies play an important role in the aftermath of a TBI, as they are often responsible for compensating victims. However, the primary goal of most insurance companies is to protect their money and minimize payouts. Some of the tactics they use to accomplish these goals include:

Delay tactics: Insurance adjusters may stall the claims process to pressure victims into accepting lower settlements.
Lowball offers: Initial settlement offers are often significantly less than what is needed to cover present and future medical expenses and other damages. Additionally, these low offers may come in early on in the process when victims are unaware of the true value of their claims.
Claim denials: Insurers may deny claims outright based on technicalities or lack of sufficient evidence.

Although the insurance company does have a large role in your journey toward financial recovery, dealing with insurers can be overwhelming. This is one of the primary reasons why it’s essential to have legal representation. Having a strong legal advocate on your side can help ensure your claim is handled fairly and promptly without setbacks and runarounds.

Steps to Take After Suffering a TBI

Diagrammatic presentation regarding steps after TBI

Victims of traumatic brain injuries and their families often feel stressed and confused, unsure of what to do or where to turn. It’s essential to understand that the steps you take after suffering a brain injury can affect your rights and future compensation.

After sustaining a TBI, you should:

Seek proper medical care: Traumatic brain injuries are serious and require immediate attention. Receiving timely treatment helps prevent certain complications and allows you to begin healing as soon as possible. Additionally, getting medical care establishes a record of your injury, which is vital for your claim.
Document everything: Aim to keep detailed records of your medical treatments, bills, lost income, and how the injury has affected your daily life. Photographic evidence of the accident and witness statements can also be helpful.
Notify the insurance company: Contact your insurance company (and the at-fault party’s insurer when applicable) to report your injury, even if you were not at fault. However, be cautious about what you say; avoid giving recorded statements without legal representation.
Consult with a lawyer: An experienced personal injury attorney can handle your insurance claim and advocate for your rights. They can provide guidance on the types of damages you may be entitled to, such as medical expenses, lost income, and pain and suffering.

These steps can help get the claims process going and put you in a better position to obtain the financial recovery you need.

Dealing with the Insurance Company

Every case is different, but in most cases, dealing with insurance companies is no easy feat. However, understanding what you can expect can help you feel more confident as you proceed with your claim.

Initial Claims Process

When filing an insurance claim, you’ll typically start by submitting a claim directly with the insurance company with supporting documentation. Your TBI accident attorney can tackle this process to ensure everything is filed timely and you have adequate evidence to support your claim.

The insurance company will assign an adjuster to your case, who will review the evidence and determine whether to approve or deny the claim. During this time, the adjuster may try to contact you for additional information. Should the insurer reach out, avoid speaking to them directly and have your TBI accident lawyer handle communications.

Negotiating a Settlement

After reviewing your claim, the insurance company may approve it and make a settlement offer. The first offer is often much lower than you may be entitled to, so it’s important to be prepared to negotiate.

It’s essential to understand the value of your claim. Your attorney can thoroughly investigate and review the specifics of your case to properly calculate your damages. This gives you a solid basis for negotiations.

Additionally, you should not rush through negotiations. Although you may want to settle as quickly as possible, it’s best to take your time. Allow your attorney to evaluate the offer and consider their opinions and recommendations.

What if the Insurance Company Denies My Claim?

Unfortunately, it is rather common for insurance companies to deny otherwise valid claims. Often, insurers get away with denying claims, especially when claimants are unaware of their rights and don’t seek legal counsel on the matter.

If the insurance company denies your claim, your attorney will ask for a detailed explanation as to their decision. Then, they can make a plan to continue the pursuit of fair compensation, which may include filing a personal injury lawsuit.

Legal Action: When to File a Lawsuit

When negotiations with the insurance company fail or the insurer denies your claim, you may need to proceed with filing a lawsuit. Your attorney can engage in litigation and protect your best interests as they fight for your right to favorable monetary recovery.

Assessing Your Case

Discuss with your TBI accident attorney whether your case has strong grounds for a lawsuit. Important factors to consider include liability and damages.

You can trust your attorney works with your best interests in mind and will give you professional guidance, aiming to achieve the best possible outcome.

Sending a Demand Letter

Often, your TBI accident lawyer will begin by sending the insurance company a demand letter. Within the letter, your attorney includes information about the accident and your injuries, details about the insured’s fault, and the value of your claim. The point of a demand letter is to “demand” settlement. Should the insurance company still not settle the claim adequately, your lawyer can proceed with a lawsuit.

Filing a Lawsuit

The legal process has several parts. Every one is important, and your attorney will handle all tasks to ensure your case is handled properly.

Complaint

To initiate a lawsuit, your TBI accident lawyer will draft and file a complaint. The complaint outlines the details of the case, and the relief sought. Once the complaint is filed, the opposing party receives a copy of court documents and has a certain number of days to file their response to your claim.

Discovery

Discovery is one of the most important parts of the litigation process. During discovery, both sides exchange evidence and information relevant to the case. This is usually done with the help of certain legal tools, including depositions, requests for production, and interrogatories.

Negotiations

After discovery, negotiations usually ensue. During negotiations, your lawyer tries to work with the opposing party to come up with a mutually agreed-upon settlement. If your case settles, you don’t have to go to court.

Trial

Although a majority of personal injury claims settle during negotiations, some do not. If your case goes to trial, your attorney will continue to provide the highest quality representation, from jury selection to verdict.

After Suffering a TBI, Seek Legal Support

Fighting the insurance company after suffering a traumatic brain injury can be a challenging process, but understanding your rights and the steps involved can empower you to seek the compensation you deserve. A personal injury attorney can be with you during every step of your legal battle.

If you or a loved one have sustained a traumatic brain injury, you don’t have to take on the challenge alone. Consult with a reputable personal injury law firm in Williamsport right away to get started on your claim.