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The Maryland Insurance Claims Process
The claims process begins after you or a loved one has been in accident or suffered an injury. Typically, insurance companies will be contacted by both parties to report the incident, be it a car accident or premises liability claim. Once a claim has been filed with the insurance company, the claim will then be assigned to a claims adjuster. The claims adjuster’s job is to settle the claim for the insurance company. Keep in mind that the insurance adjuster will be seeking to settle the claim as inexpensively as possible as it is their job to look out for the best interests of their employer. Insurance adjusters can use devious tactics in order to gather evidence such as:
- Recorded Statement: The adjuster may request to record your conversation to secure a statement. During this interview, the adjuster may ask questions specifically designed to get a particular answer (for example, one which minimizes your injuries) and then later attempt to use this statement to minimize your claim.
- Surveillance: You may be put under surveillance by the insurance company in an effort to catch you behaving in a manner that is contrary to the injuries you are claiming. For example, if you have a shoulder injury and an adjustor captures footage of you carrying heavy bags of groceries, this would obviously show you are not as injured as you claim.
- Surprise Visits: Instead of surreptitiously watching you, an adjuster just may show up unannounced at your door in effort to catch you acting in a way that would hurt your case, or to try and obtain information from you when you are not adequately prepared or expecting to answer questions. These visits may even occur immediately following your release from the hospital, while you are still taking pain medication or sedatives, which can impair your ability to communicate clearly.
- Delay: Instead of constantly pestering you, an insurance adjuster may avoid you or constantly make requests for more information in an effort to delay the claims process in hopes you will give up or settle the claim for less than you are owed.
- Deny Liability: Insurance companies will look for some way that their client was not at fault so they can deny they owe you anything.
In order to get help dealing with insurance adjusters and any sneaky tactics they may use, you can choose to contact an attorney immediately after you have been in an accident or suffered an injury. At Gilman & Bedigian we assist our clients at all stages of the claims process including the initial dealings with the insurance company.
Property Damage Claims in Maryland
As part of the insurance claims process, as it relates to car accidents, claimants are usually seeking compensation for their damaged or destroyed car as well as injuries to their person. There are a couple of issues to be aware of relating to property damage.
- Rental Car: If you car is totaled or in need of repairs you may need to get a rental car in order to continue your day to day business. The party at fault is usually responsible for the cost of renting a car. However, the initial cost of rental may fall to you, or your insurance company if you have rental insurance as part of your plan, as the claims process can be quite lengthy, especially if the other side is disputing liability. If you do not need a rental then you can still recover compensation for the loss of use of the car.
- Repairs: Typically the insurance adjuster will estimate the amount of money they believe it will take to repair the car. You may take your car wherever you choose to get repairs done, you do not have to use the locations recommended by the insurance company. If the repair estimate is inadequate, the repair shop will have to contact the insurance company to seek additional compensation.
- Replacement Value: If your car is beyond repair then you are likely going to be seeking compensation to replace your vehicle. A car is totaled when it costs more to repair the car than the car is worth. Insurance companies only have to pay you the value of your car at the time it was totaled, not the value you paid initially or the amount it would take to replace the car. This can create a gap between what you are paid and what a new car is worth. Some insurance companies offer gap insurance to provide coverage in those cases.
Maryland PIP Insurance
Personal Injury Protection Insurance (PIP), also called no fault insurance, is a type of insurance that some states have where you file a claim with your own insurance company for medical bills and lost earnings. The insurance company then pays your claim up to an amount specified by the no fault laws in the state. Some states have mandatory PIP laws while others have none at all. Maryland does not currently require drivers to carry PIP insurance but you can add it on to your policy. The amount of coverage from a PIP policy is usually fairly limited and will not be enough cover injuries from more serious accidents. In addition, you may still seek compensation from the at fault party’s insurance company even if you have PIP insurance.
The Legal Claims Process in Maryland
If the injured party and the party at fault are able to reach a mutually satisfactory agreement then the case will end prior to the court system becoming involved. The injured party will sign a form releasing the party at fault from any further liability or future claims. It can be advantageous for parties to attempt to settle out of court because the parties will have the most control over the negotiation process and there is less of a time delay. However, if out of court negotiations are unsuccessful, then legal proceedings typically begin.
A lawsuit commences when a complaint is filed in the appropriate court. Md. Rule 2-101(a).* A complaint is a document that “states the basis for the court’s jurisdiction, the basis for the plaintiff’s claim, and the demand for relief.” Black’s Law Dictionary 323 (9th ed. 2009). It must include a “a clear statement of the facts necessary to constitute a cause of action and a demand for judgment for the relief sought.” Md. Rule 2-305.
After the suit is filed and the defendant receives the complaint, a defendant a few ways to respond. He or she can file an answer or file a motion. An answer is a document where the defendant responds to the allegations in the complaint and raises any relevant affirmative defenses and counterclaims.
A motion is “[a] written or oral application requesting a court to make a specified ruling or order.” Black’s Law Dictionary 1107 (9th ed. 2009). There are several reasons a defendant may file a motion at the outset of litigation. For example, if certain legal defenses are not raised prior to filing an answer to a complaint, those defenses will be waived. Md. Rule 2-322(a). Typically the motion filed will be a motion to dismiss on the grounds of failure to state a claim or for lack of jurisdiction. A hearing is held where each side argues their case and the judge then rules on the motion. If it is denied, the defendant then must file an answer within a specified period.
If you or a loved one has suffered an injury or been in accident, please do not hesitate to contact our office. We assist clients at all stages of the claims process from the initial dealings with the insurance companies all the way through trial. At Gilman & Bedigian we evaluate each and every case presented to us, so please don’t hesitate to call even if you are unsure whether or not you have a legal claim.
*Citations are to the Rules of Civil Procedure for the Maryland Circuit Court.