There are many people involved when it comes to car accident claims. Here is a brief list of some of the most important "cast members" involved in your personal injury claim.
1) The Insurance Adjuster - This is the person who works for the insurance company. They might work for the responsible party's insurance company or they might work for your insurance company. Sometimes, they are called "claims adjusters" or "claims examiners." Either way, they represent the interests of the insurance company. Like anything else in life, there are some who are better than others. Some are more compassionate and others think everyone making a claim is lying. Some are actually doing their best to help you, and other are bitter and jaded. There is nothing you can do about this. At first, you might speak with an general "intake" person at the insurance company. Their job is to figure out what your claim is about and assign you to another adjuster.
2) Property Damage Adjuster - In many companies, they have insurance adjusters who only handle property damage claims. This is the person who will interface between you and the body shop. This person also works with appraisers whose job is to get out "in the field" and examine vehicles all day. They also might help with a rental car claim, damage to child car sets, and other "property" loss resulting from the car accident.
3) Bodily Injury Adjuster - This is another type of claims adjuster whose job is to evaluate your claim for bodily injury. In some cases, they use software to analyze your case. In other cases, some injury adjusters will use their own independent judgment based on various guidelines. They are always trying to figure out if your treatment was "necessary" and/or "reasonable." They almost always conclude your treatment was unnecessary and/or unreasonable. In more severe accident cases, they are generally more forgiving. Again, I'm generalizing. Again, we are talking about human beings here so there will be differences among them.
4) The Claimant - That is the person actually making the claim. If you are making the claim, then you are the "claimant."
5) The Insured - This is the person insured by the company. For example, if Mr. John Smith has insurance with Mercury Insurance, then he is their "insured." Sometimes the insured is both the driver and the owner of the vehicle. Sometimes, it's one or the other. You are also an "insured" of your own insurance company.
6) Plaintiff's counsel (aka plaintiff's attorney) - This is the attorney representing the injured party.
7) The Plaintiff - Once a lawsuit is filed, you are no longer the "claimant" (unless it's an uninsured motorist claim). You become the "plaintiff."
8) The Defendant - This is the person being sued. In most cases, you are not going to be suing the responsible party's insurance company. Many people have the mistaken belief that they are going to sue someone's insurance company. The insurance company wasn't the party that hit you. It was Mr. Jones who hit you so he is the person you are going to sue. Now, his insurance company will hire a lawyer to defend Mr. Jones, and it will be his company's decision whether or not to settle your claim with you or not. In most cases, Mr. Jones will have little to nothing to do with your case unless liability is disputed. In some cases, other than being sued, Mr. Jones will have very little involvement with the lawsuit your attorney filed against him.
9) The Defense Attorney - If you file a lawsuit against someone for a car accident, the insurance company for the responsible party will hire a lawyer to defend their "insured." In some cases, they will hire an outside law firm. Be mindful of that because that law firm usually gets paid by the hour, and they arguably have no incentive to settle your case as long as they can keep billing that insurance company. Some outside firms will defend the case on a flat fee basis. In many cases, the insurance company will have "in-house" lawyers who will defend their insureds in a lawsuit. Now, while the defense attorney is technically defending the "insured' individual, their salary is paid by an insurance company. To some extent, it presents a dilemma for the defense lawyer because they are arguably beholden to the insurance company - at least to some extent. I use to work as a defense attorney for a major insurance company, and I can tell you there were many times I was frustrated because of insurance company decisions. They were controlling the litigation, and my hands were often tied. That's one of the main reasons I left my defense job and starting representing victims of serious auto accidents.
If you have a question about the process and/or need help with your serious injury case, please contact our office at (661) 414-7100 to see if we can assist you.
by Robert Mansour
Robert Mansour is a personal injury lawyer serving Santa Clarita, Valencia,