When you are injured in an accident, determining who is at fault is one of the most critical steps. The determination of fault informs you of your rights and can also significantly affect the value of your claim. Liability decides whether or not you are even eligible for financial recovery from another party.
Typically, you must prove fault to an insurance company, which will only provide payment for your injuries if adjusters agree the policyholder was to blame. However, the process can be much more complicated than it initially seems. While insurance companies are expected to make unbiased and fair decisions, they often have financial incentives to minimize the amount they pay out on claims, which can lead to tactics that shift the blame onto victims.
When you’re involved in an accident and dealing with serious injuries, never try to prove fault or deal with insurers alone. You should allow a Trinity personal injury attorney to determine and prove fault in your claim, handling all insurance communications. Your legal advocate can evaluate your claim, gather pertinent evidence, and do everything necessary to accurately exhibit fault and get you one step closer to securing proper compensation.
What Does “Fault” Mean?
In the context of an accident, the term “fault” refers to the responsibility or blame for causing the incident. When one party is found to be at fault, they are considered legally and financially responsible for the event and resulting injuries and damages.
For example, in a car accident, fault may be determined based on certain factors, such as:
- Negligence: A driver engaging in negligent driving behaviors, such as running a red light or driving distractedly.
- Violation of laws: A driver breaking traffic rules, including speeding or failing to yield.
Determining fault helps assign liability for insurance claims and legal consequences and compensate victims. Fault can be shared by multiple parties (e.g., both drivers in a car crash), or one party may be fully responsible.
How Insurance Companies Investigate Claims
Insurance companies have a well-established process for investigating accident claims, designed to determine who is at fault and what damages should be paid. The investigation typically involves a few key steps:
Claim Filing and Initial Review
After an accident, you can file a claim with the insurance company. The adjuster will begin by reviewing the basic details provided, including:
- The date and time of the accident
- The location of the accident
- The parties involved
- The type of vehicles involved
- The insurance policy details
Once the claim is opened, the adjuster will contact the parties involved, gather initial statements, and look at any available evidence.
Investigation and Fact-Finding
Next, the adjuster will conduct a more thorough investigation to gather additional facts about the accident. It can include:
- Reviewing police reports: The police report often provides critical details such as road conditions, weather, and whether any traffic violations were observed.
- Inspecting the vehicles: The adjuster may have the vehicles inspected to assess the type of damage sustained and determine how the collision likely occurred.
- Obtaining medical records: If there are injuries, the adjuster may request medical records to assess their extent and link them to the accident.
The investigation process is often the most time-consuming, but it is necessary for adjusters to fully understand how the accident happened and the severity of the injuries and property damage.
Evaluating Evidence and Making a Determination
After gathering all the relevant information, the adjuster will evaluate the evidence and decide who is at fault for the accident. The adjuster may also determine if there are any mitigating circumstances (e.g., bad weather, road conditions) that can affect the outcome.
Once fault is established, the insurer typically offers a settlement to cover damages.
Final Decision and Payout
Once the fault has been determined, the insurance company will proceed with determining the payout. It can include compensation for:
- Vehicle repair costs
- Medical expenses
- Lost earnings
If the other driver is determined to be at fault, their insurance will typically cover your expenses, provided that the at-fault driver has sufficient coverage.
How Insurance Companies Use Sneaky Tactics to Reduce Liability and Minimize Payouts
While the claims process may seem straightforward, insurance companies often have financial incentives to reduce payouts as much as possible. To do so, they may employ various tactics to undermine the victim’s case and shift blame onto the victim. Some common tactics include:
Denying Liability and Downplaying Fault
One of the most common strategies insurance companies use is denying liability altogether or minimizing their insured’s degree of fault. For instance, an adjuster may claim the other driver did not cause the accident, even when the evidence clearly shows they did.
Alternatively, they might argue that both parties were equally to blame, even if the other driver’s actions were more dangerous or reckless.
Disputing the Severity of Injuries
Another tactic is to downplay the severity of your injuries. Insurance companies may claim that your injuries are pre-existing or not directly related to the accident. They may also argue that you did not seek timely medical attention, which can reduce the credibility of your injury claims.
Using Recorded Statements Against Victims
In some cases, insurance companies will ask for a recorded statement from the claimant, often shortly after the accident. While the intention may seem innocent, any inconsistencies or misstatements in your recollection of events can be used to discredit your version of the accident and shift blame. This tactic is particularly effective when you’re still in shock or dealing with the emotional aftermath of the accident.
Outright Blaming the Victim
In some instances, insurance companies may engage in victim-blaming. They might argue that the injured party was partially at fault for the accident, even if the evidence points to the other driver. For example, they may argue that the injured party was distracted, speeding, or not following traffic laws despite no such evidence.
Does Fault Need to Be Determined in No-Fault States?
If your accident occurs in a state that operates under a fault-based system, determining fault is one of the most critical aspects of the claims process. However, what happens if you are in a no-fault state?
In a no-fault state, fault for an accident does not need to be determined to seek compensation for your injuries. The primary feature of no-fault insurance laws is that drivers and passengers involved in an accident will generally file claims with their own insurance companies, regardless of who caused the accident.
Still, while fault doesn’t need to be established for injury claims, it can still be relevant in certain situations, such as:
- Serious injury threshold: In many no-fault states, like Florida, there is a requirement that the injuries meet a certain level of severity (e.g., permanent disfigurement, loss of limb, etc.) before an injured party can file a lawsuit against the at-fault driver. This is typically known as the “serious injury threshold.”
- Property damage: No-fault insurance laws usually apply to injuries but may not apply to property damage. If your vehicle is damaged in an accident, the fault may still need to be determined to decide who is responsible for paying the repairs.
- Subrogation: Even in no-fault states, if your insurance company provides compensation, they may pursue reimbursement from the at-fault driver’s insurance company (through a process called subrogation) to recover those costs if the other driver was responsible for the accident.
So, while no-fault insurance simplifies the claims process by eliminating the need to establish fault for injury claims, fault can still play a role under certain circumstances.
Why a Personal Injury Attorney is Crucial in Determining Fault
While insurance companies have a vested interest in minimizing payouts, your personal injury attorney primarily aims to protect your rights and secure fair compensation for your injuries. This is why having your lawyer determine fault is essential instead of relying on the insurance company’s evaluation.
Here are just some of the reasons why working with a personal injury lawyer is beneficial when determining fault in an accident:
Advocacy and Experience
Personal injury attorneys are skilled in investigating accidents, negotiating with insurance companies, and presenting evidence that supports their clients’ claims. They understand the nuances of accident laws and can uncover hidden factors affecting fault, such as road design flaws or vehicle mechanical issues.
Handling Insurance Tactics
Your attorney can protect you from the unfair tactics used by insurance companies. They will advise you on what to say and when to avoid giving recorded statements that can hurt your case. They will also fully document your injuries and losses, preventing insurance companies from undervaluing your claim.
Gathering and Presenting Evidence
A personal injury lawyer can work with accident reconstruction specialists, medical professionals, and other experts to build a strong case for your version of events. They can gather and present evidence in a way that strengthens your argument and minimizes the chances of being blamed for the accident.
Negotiation Skills
Insurance companies often rely on claimants, not knowing the actual value of their cases. A personal injury attorney will negotiate on your behalf to secure the best possible settlement. Your attorney can take the case to trial to ensure you are fairly compensated.
Ensuring Accountability
Your attorney can help ensure the responsible party is held accountable for their actions. It may involve proving that the other driver acted negligently or recklessly, establishing their liability, and ensuring you are not wrongfully blamed for the accident.
Evidence Your Lawyer May Use in Establishing Fault for Your Claim
In an accident claim, evidence is crucial. Your attorney can use evidence and documentation to establish fault and show who is responsible and should bear financial liability for damages or injuries. The following types of evidence are commonly used to establish fault in accident claims:
Police Reports
Police officers often respond to accidents and create a report summarizing the incident’s facts, including witness statements, the officer’s observations, and any traffic violations that may have occurred.
These reports include critical information, such as parties involved, location, time, weather conditions, vehicle damage, and sometimes a preliminary determination of fault (e.g., if one party was cited for a traffic violation).
Witness Statements
Eyewitnesses to the accident can provide an unbiased account of what happened before, during, and after the crash. People who saw the accident can give details about who appeared to be at fault (e.g. if one driver ran a red light or failed to stop at a stop sign).
Photographs and Videos
Visual evidence can help establish vital details about the accident scene, such as the positions of the vehicles, traffic signs or signals, skid marks, vehicle damage, and other relevant factors. This evidence can include photos or video footage from the scene taken on cell phones, surveillance cameras, traffic cameras, or dashcams.
Traffic Citations or Tickets
If any of the drivers were issued a citation at the scene (e.g., for speeding, running a red light, or driving under the influence), this can help establish that one party violated a traffic law and is, therefore, at fault.
Allow a Personal Injury Attorney to Determine and Prove Fault in Your Claim
Determining fault in an accident is a complex process. While insurance companies are tasked with investigating claims and making decisions based on the evidence, they are also motivated by the desire to minimize their payouts. Insurance companies often use various strategies to shift blame onto the victim and reduce the compensation you are entitled to.
Having an experienced personal injury attorney by your side can level the playing field. Attorneys are adept at handling insurance companies, gathering evidence, and protecting your rights. They can advocate for you in a way that maximizes your chances of receiving fair compensation for your damages, whether the case is settled out of court or taken to trial.
If you’ve suffered an injury in an accident and need help navigating the claims process, consider consulting with a personal injury lawyer who can provide the guidance, support, and resources necessary to protect your interests.
James Wayne Holliday
James Wayne Holliday has been practicing law since 1995. He has been named as a “Best Attorney” Lifetime Charter Member in Florida, an honor awarded to less than one percent of the nation’s lawyers.
Mr. Holliday has earned a reputation as a relentless trial lawyer because of his outstanding work ethic and thorough preparation of his cases for trial.
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