I’ve been injured, now what do I do?

I've been injured, now what?

If someone else is more at fault for your injury than you are, you may make a claim against that person or business and their insurance company, if any. The type of accident and the cause of the accident may affect whether you are entitled to compensation, as in the following examples:

• Motor vehicle accidents: Fault or "negligence" is determined by traffic regulations and which driver's carelessness contributed most to the accident and injuries, including your own conduct such as failure to use seatbelts.

• Commercial accidents (such as in stores): Injuries are compensable only if caused by an unsafe condition that the owner should have known of, appreciated and corrected before the accident.

• Home/farm/apartment/recreation injuries: Renters, owners or residents may be found liable for injuries they cause by negligent maintenance, oversight, or attacks by pets.

• Workplace injuries: Injuries at work generally are covered by worker's compensation benefits which compensate for medical expenses, lost wages and permanent impairments, without regard to fault by anyone.

• Intentional injuries: Injuries inflicted on purpose by any means are not usually covered by the guilty party's liability insurance, although the responsible party may be personally liable for such harm.

Which insurance policies will cover my costs?

Most automobile, homeowners and commercial liability policies contain "medical payments" coverage for medical expenses incurred after an accident without regard to fault. This coverage in auto policies applies to the insured family members and vehicle passengers, while homeowners and commercial policies cover only "others" or visitors to the premises.

Health, worker's compensation, disability insurance carriers and HMOs usually will pay benefits arising from accidental injuries. However, if your claim against another person succeeds, then the insurance provider will probably require you to repay these benefits to them.

If the accidental injury is primarily your own fault, then only health insurance (such as through your employer), worker's compensation or medical payments coverage may apply.

Should I hire a lawyer?

If you know for certain that your injury is a minor one that will not result in time lost from work or school or substantial medical care, then you may want to settle it yourself in small claims court. (In Wisconsin, this court handles claims up to $10,000.) Of course, insurance claims adjusters generally try to settle claims inexpensively and on terms favorable to the insurer. If you have been seriously injured or are unsure as to the outcome of your injury, then an experienced personal injury attorney should always be consulted before you give any statements or sign papers of any kind and as soon after the injury as possible.

Personal injury attorneys usually handle claims on a "contingent" or percentage basis depending on the type, difficulty, and expense of the case.

How and when will my claim be settled?

If the person responsible for your injury has insurance, an insurance adjuster will gather and try to verify the necessary medical treatment records, medical expense and wage-loss information and what permanent impairments have been caused by the accident. If the insurance company makes an offer that you (and your attorney) find acceptable, then the claim process is over. If no acceptable offer is made, then you may file a lawsuit.


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