Handling Your Personal Injury Claim

B. When You Might Need a Lawyer

Sometimes, the skills of an experienced personal injury lawyer, or at least the threat that such a lawyer presents to an insurance company, are worth the money you have to pay that lawyer to represent you. You may need a lawyer because of complex legal rules involved in your claim, because your injuries are so serious that the potential amount of your compensation might vary greatly, or because an insurance company refuses to settle the matter with you in good faith.

Hiring a lawyer later in the process. If, after you have presented your claim and negotiated with an insurance company as explained in this book, you do not feel the insurer is offering a fair settlement, you can retain an attorney to finish the process for you. Or you may be able to consult an attorney on an hourly basis to see if he or she can spot a particular legal argument that might help you to move the insurance company toward a more reasonable offer. (See Chapter 11.)

There are no hard and fast rules about when you do and do not need to hire a lawyer. Much of the decision has to do with how you feel things are going as you attempt to settle your claim on your own. At some point, you may feel overwhelmed -- by too much work, or by some obscure legal rule the insurance company decides to throw at you. Or you may be stonewalled by an insurance adjuster who blusters that the company does not have to honor your claim at all, or who offers you only a piddling amount to settle it. In these situations, you may want to consult an attorney for advice, and perhaps have him or her take over handling the claim. These situations are discussed in detail in Chapter 11.

There are a few types of injuries and accidents that almost certainly require that you hire a lawyer. They include the following situations.

Serious Long-Term or Permanently Disabling Injuries

Some accidents result in injuries that permanently or for a long time -- more than one year -- seriously affect your physical capabilities or appearance. Figuring out how much such a serious injury is "worth" can be a difficult business that may require an experienced lawyer. Even if you decide to handle the matter yourself, an injury with a long period of recovery or a permanent physical effect really requires that you consult a lawyer for an hour or two to make sure you have covered all the bases in your claim.

Severe Injuries

The amount of your accident compensation is mostly determined by how severe your injuries were. And the severity of your injuries is measured by the amount of your medical bills and your lost income, as well as the length of time you remain in pain or disabled. Once your medical and lost-income figures begin to rise, not only does the amount of compensation rise, but it becomes more difficult to gauge the range of fair compensation an insurance company is willing to pay. And once these figures get high and the range gets broad, it may be worth the fee you would have to pay to have a lawyer handle your claim.

In Chapter 5, we explain how to gauge how much your claim may be worth. In a less serious case, with medical costs and income loss of a few thousand dollars, it is rarely worth your money to hire a lawyer.

EXAMPLE: Your medical costs and income loss are $2,500 and you fully recover from your injuries in a few months. Applying the damages formula (discussed in Chapter 5), you know that your compensation will be between $5,000 and $10,000 -- no lower and no higher. Therefore, you can negotiate within that range to get the highest possible amount without worrying that you might instead have received $20,000 or $30,000 if you had hired a lawyer to negotiate for you. Also, you know that even if you got $7,500 on your own and a lawyer could have obtained $10,000, the lawyer's fee and costs would have reduced your actual compensation to less than $7,500, anyway.

But when the injuries are severe and the medical costs are high -- over $10,000 or so -- the range of potential compensation can become very wide -- from $20,000 to $100,000. Because the difference between the low end of this range and the high end is so great, it may be a good idea to take advantage of the experience of a knowledgeable personal injury lawyer to ensure that you get the highest possible amount, even taking into account that the lawyer's fee will eat up a large part of your final award.

EXAMPLE: Your medical bills are $15,000 and you are able to get a settlement offer of $50,000 by yourself, but a lawyer might be able to get $75,000 to $100,000 for you. Even after the lawyer takes one-third as a fee, you would be left with between $50,000 and $67,000 -- up to $17,000 more than you obtained on your own. And the lawyer will have done the work.

No fixed cutoff point in medical bills and lost income determines when you should consider hiring a lawyer. Some people feel more comfortable hiring a lawyer as soon as their bills reach a couple of thousand dollars, regardless of any other factors in the case. Other people would handle a similar claim on their own and avoid the lawyer's fee, even if their medical bills reached $10,000 and their potential compensation $100,000.

The only way to know whether you feel comfortable handling your own claim is to understand how compensation amounts are calculated and apply those criteria to your situation to get a rough idea of what your claim might be worth. (See Chapter 5.) Then decide -- either right away or after negotiating for a while with the insurance company -- whether to continue handling the case on your own, consult with a lawyer on an hourly basis, or hire a lawyer to handle your case. (See Chapter 11.)

Medical Malpractice

If you have suffered an injury or illness due to careless, unprofessional, or incompetent treatment at the hands of a doctor, nurse, hospital, clinic, laboratory, or other medical provider, the complexities of both the medical questions and the legal rules involved almost certainly require that you hire a lawyer experienced in medical malpractice matters.

Toxic Exposure

We sometimes become ill because of exposure to chemicals in the air, soil, or water, in products we use, or in food we eat. Even some molds that are naturally occurring can cause severe health problems. Claims based on such exposures are difficult to prove, however, and often require complex scientific data. Because the chemical and other industries have erected a huge wall to protect themselves from legal exposure while they continue to expose us to chemicals, the required evidence is very hard to come by. As a result, fighting a claim for toxic exposure requires the services of a lawyer experienced in such cases.

When an Insurance Company Refuses to Pay

In some instances, regardless of the nature of your injury or the amount of your medical bills and lost income, you will want to hire a lawyer because an insurance company or government agency simply refuses to make any fair settlement offer at all. This is often referred to as "stonewalling," because negotiating is like talking to a stone wall. An insurance company may stonewall when it denies that its insured is at all responsible for the accident, or denies that the insured was covered for the type of accident that happened. You can also run into stonewalling when your claim is against a governmental body that claims it is immune -- legally protected -- from responsibility for the accident. These situations are discussed in detail in Chapter 11.

If, after repeated efforts, you are unable to obtain a fair offer, you might be forced to see whether an attorney can do better for you. In these cases, something -- what the lawyer can get minus the fee charged to get it -- may be better than nothing.

Back to Top