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Chicago Insurance Claim Lawyer
Helping Illinois plaintiffs negotiate with adjusters and try jury cases when insurance companies are unreasonable
In most personal injury cases, at-fault parties themselves are not usually the ones who write the check for damages. It’s the insurance company for that person or business that ultimately pays out on a claim.
To facilitate this process, car owners in Illinois are required to maintain certain minimum amounts of insurance coverage. Similarly, most homeowners and business owners carry premises liability and other kinds of insurance to cover costs in the event that someone is harmed on their watch. Doctors and health care providers also maintain coverage in the form of medical malpractice insurance to protect themselves in the event that they cause harm to a patient in their care.
If you’ve been injured as a result of another party’s negligence, you may find yourself relying on insurance providers to help you access the funds you need to account for your losses. At Gainsberg Injury and Accident Lawyers, our Chicago insurance claim lawyers understand insurance law and insurance litigation, which means we’re familiar with many of the common obstacles clients encounter when filing claims for compensation.
After an accident, it might be tempting to settle for the first offer you receive from an insurance company. In our experience, however, clients often fare better if they partner with an experienced personal injury attorney who can support them during negotiations. A skilled lawyer understands what a case is worth, what offers should be made, and what it takes to push back against common insurance tactics.
If you were injured in a negligence-related accident in or near Chicago and you’re locked in a battle with an insurance provider, contact our team to discuss what options may be available to help you advocate for fair compensation under the law.
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Table of contents
- What is a third-party insurance claim?
- Damages sought in third-party claims
- What types of insurance claims and disputes do we handle?
- Why are insurance claims denied?
- What should I do if my insurance claim is delayed?
- How does the insurance claims process work?
- How to challenge a denied claim
- What is insurance bad faith?
- Chicago insurance claim frequently asked questions
- Speak with a reliable Chicago insurance attorney today
What is a third-party insurance claim?
It’s important to understand what a third-party insurance claim actually is if you’re planning on pursuing one. Here’s the breakdown in legal language:
- The first party, also called the insured, is the car owner, homeowner, business, or professional who wants to make sure they have enough money to pay damages if someone else is injured.
- The second party is the insurance company that the insured contracts with. The insured pays the insurance company monthly or regular premiums in return for the assurance that the insurance company will pay any valid claims.
- The third party is the person who is hurt, or – in cases involving wrongful death – the decedent’s personal representative acting for the benefit of the surviving spouse and next of kin.
If you were injured as a result of another person’s actions or inactions, you may file a third-party insurance claim with the insurance company that insured the alleged at-fault party. The goal here is for you to recover compensation for your accident-related losses without filing a claim against your own coverage or dipping into your own pockets.
Damages sought in third-party claims
Third-party claimants usually demand the following payments when the first party causes them harm:
- All medical bills: This payment includes compensation for all necessary hospital stays, doctor visits, medications, and medical devices the injured person needed or may need.
- Property damage: If any personal property – like a car or motorcycle – is damaged in an accident, the victim can ask to be compensated for the loss.
- All lost income: Typically, this means lost salary, lost wages, or lost self-employment income.
- Pain and suffering: This sum is for the physical anguish and emotional anxiety the injured person suffered or may continue to suffer as a result of their accident.
- Loss of support: In wrongful death cases, the damages may include the loss of any financial and/or emotional support the deceased would have given to family members.
Our Chicago insurance claim lawyers demand all the damages the law allows when someone else is liable for your injuries.
What types of insurance claims and disputes do we handle?
Our Chicago insurance claims lawyers will do whatever it takes to compel insurance companies to compensate you in accordance with the law. When your own insurer fails to uphold its obligations under the policy, we’re prepared to take legal action when appropriate. We can handle cases related to:
Car accidents
When accidents happen, there are two basic types of claims: first-party and third-party. In first-party claims, the insured seeks to have their own company pay benefits. In third-party claims, the injured person seeks payment from the insurance company of the person who caused the accident.
If, for example, you suffered $100,000 in damages and the person who crashed into you only had $30,000 in coverage, then we might work to recover up to that $30,000 through a third-party claim and pursue available underinsured-motorist benefits under your own policy or file a personal injury lawsuit against the individual who injured you.
Personal injury
There are countless personal injury scenarios that could result in civil litigation. When one party’s negligence results in another party suffering an injury, a third-party insurance claim might be warranted. We often see personal injury cases involving slip-and-fall accidents, defective products, and nursing home abuse, among many other things. After our team settles the case or obtains a verdict in your favor, we generally seek payment from the insurance company that covered the at-fault party.
Medical malpractice
Improper diagnosis, incorrect procedures, lack of informed consent, and other errors in healthcare settings can all cause serious harm to vulnerable patients. When someone is injured as a result of medical malpractice, they may be able to file a third-party claim against the provider’s medical malpractice insurance. These cases can be complicated because they often involve high-level technical concepts, but our team is prepared to advocate for injured patients when they need us.
Life insurance
These insurance policies generally dictate how much money gets paid out upon a person’s death and designate specific individuals as beneficiaries of such a payout. In these cases, the beneficiaries of a life insurance policy file claims for benefits under the deceased person’s policy. If a company disputes a beneficiary's eligibility or pushes back against the value of a claim, our team can step in to help with negotiations.
RESULTS
$91,000+ Order for Injury Victim Whose Claim Was Wrongfully Denied by Unique Insurance Company
April 5, 2017 - A judge awarded more than $90,000 to our client after his insurer, Unique Insurance Company, wrongfully denied his claim. Our client sustained bodily injury in an accident with an uninsured driver. His personal injury damages, medical bills, pain and suffering – the original claim – did not exceed the $20,000 policy limits. The insurer for the at-fault party denied coverage for non-cooperation. Unique Insurance Company, therefore, was contractually bound to honor the claim. Instead, contrary to IL law, Unique insisted we had the burden to sue the insurer for the at-fault party and provide non-coverage. The court awarded our client the full amount of the attorneys’ fees, as well as $60,000 in sanctions against Unique Insurance Company for violating section 155 of the Illinois Insurance Code, and acting unreasonable in responding to an uninsured motorist claim. [Final Order] [More Verdicts]
Why are insurance claims denied?
Many of us are familiar with the waiting game that ensues after filing any kind of insurance claim. The possibility of a denial can be incredibly anxiety-inducing for many accident victims. Unfortunately, insurance companies do tend to deny claims for a variety of reasons. Some of these reasons are legitimate, but others may be worth challenging.
Some common reasons for claim denials include:
- Alleged policy exclusions
- Missed reporting deadlines
- Incomplete documentation
- Coverage disputes
- Disagreements about liability
- Inflated claims of comparative negligence
- Allegations that damages are unrelated to the claimed event
- Failure to cooperate with an insurance investigation
Remember that a denial doesn’t always signal the end of the line. Policies are often lengthy and complex, and some elements may be subject to variable interpretations. A Chicago insurance claims attorney can review the denial and determine whether the insurer’s position is supported by the policy or if there is enough reason to challenge it.
What should I do if my insurance claim is delayed?
Insurance companies are expected to investigate claims within a reasonable timeframe, but things don’t always shake out that way. Many injured victims encounter frustrating delays after filing insurance claims. If you think that your claim has stalled and you’ve not been provided any reasonable update or explanation, you may want to consider taking the following steps:
- Request updates in writing: Rather than trying to get a hold of people over the phone, it’s often best to stick to written communications that provide a paper trail of your concerns and their responses. Try to record the dates and times of these updates as well.
- Continue documenting your losses: Save medical records, repair estimates, receipts, photographs, and any other new or evolving information related to your claim.
- Review the policy language: The best defense is a good offense, which means you’ve got to understand the ins and outs of your policy. This will come in handy in the event that the insurance company tries to use the fine print against you.
If your claim continues to drag on without a reasonable explanation, having an experienced lawyer in your corner becomes paramount. Your legal representation can help you pursue all possible options for ensuring the insurance company doesn’t attempt to run out the clock on your claim.
How does the insurance claims process work?
The claims process can take a lot of twists and turns, but the bare-bones process usually looks something like this:
- The injured party files a claim
- The insurer investigates the circumstances surrounding the claim
- The insurance company reviews the evidence and decides who was likely at fault
- The insurer evaluates claim eligibility based on the policy's fine print
- The insurance company makes an initial offer to the injured party if appropriate
- The injured party and their lawyer may negotiate with the insurance company for a different settlement amount
- The insurer disburses agreed-upon funds to the appropriate parties
Sometimes, an insurance company will deny a claim after gathering evidence and evaluating coverage. If this happens to you, don’t panic. You and your lawyer may still be able to request reconsideration or use any appeal procedure available under the policy.
How to challenge a denied claim
Before you ever think about filing a challenge, you need to do your best to understand why it was denied to begin with. If you look at all the information available to you and still believe that the denial was unwarranted, you may want to bring a challenge.
If the denial had to do with a lack of supporting documentation or inaccuracies, you should be able to remedy these errors fairly easily. Correct your mistakes and submit any missing documentation, and try again.
If the insurance company cites coverage exclusions or otherwise questions the validity of your claim, you may need to add new information to the mix. You might incorporate an expert opinion into your claim or provide testimony from a previously unidentified witness.
If an agreement still cannot be reached, your lawyer may advise you to consider alternative legal options like litigation. This may or may not be appropriate in your case, so it’s important to consult with an experienced attorney who understands how your claim intersects with Illinois insurance law.
What is insurance bad faith?
Insurance denials can be hard to swallow, but they aren't necessarily evidence that an insurance company is acting in bad faith. They're supposed to conduct thorough investigations and make decisions based on the information and policy requirements available to them. Sometimes, the process just doesn't yield the outcome claimants are hoping for.
There are some cases in which insurance companies actually do violate their legal obligations, however. They may deny a valid claim without cause or misrepresent eligibility criteria to avoid paying a victim what they're owed. Sometimes, insurers will delay claims in the hope that victims will give up or settle for low-ball offers just to get things wrapped up.
If your insurance company breaches the policy or acts vexatiously and unreasonably in handling a covered claim, you may be able to pursue relief under the policy and Section 155 of the Illinois Insurance Code.
Chicago insurance claim frequently asked questions
Every claim is different and subject to its own timeline. Some claims resolve quickly, while others require more intensive investigations or go through multiple rounds of negotiations.
Yes. An insurance company can request a recorded statement, but it’s important to consult with an insurance claims lawyer before providing one so you don’t inadvertently compromise your claim.
Medical records, repair estimates, invoices, photographs of damages or injuries, witness information, and other documentation can be used to strengthen and support your insurance claim.
You can challenge the insurer's valuation by providing additional evidence, negotiating further, or pursuing legal action when appropriate.
In some situations, yes. If your insurance company breaches the policy or acts vexatiously and unreasonably in handling a covered claim, you may be able to pursue relief under the policy and Section 155 of the Illinois Insurance Code.
An examination under oath is a formal proceeding during which an insurance company asks questions regarding a claim while the claimant is under oath.
Disputes may be resolved through negotiation, mediation, arbitration, or litigation, depending on the circumstances and specific policy requirements.
If your claim is denied, undervalued, delayed, or otherwise disputed, it may be time for you to consult with an attorney about the future of your case.
Typically, attorney fees aren’t recoverable in litigation unless they are authorized by a specific statute or contract stipulation. Your lawyer can help you better understand how their fee structure works and how you’re expected to pay them.
Speak with a reliable Chicago insurance attorney today
When it comes to insurance claims, being represented by a Chicago lawyer who focuses on working with insurance companies can make it much easier to settle any claim disputes that may arise.
At Gainsberg Injury and Accident Lawyers, our Chicago insurance lawyers will review your claims and advise you of your legal rights under your policy. We are standing by to help in litigating any disputes involving insurance claims.
To learn more about your legal options, call, text or stop by our office at 77 W. Washington St., Suite 1215 to schedule a free case review with a member of our team.
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