You were in an accident six months ago. Rear-ended by a careless driver. You hired a personal injury lawyer three months ago who specializes in this kind of case. You’re still in pain. You have an MRI scheduled on your low back in a couple weeks and follow-up appointment with your orthopedist shortly afterwards. Because of pain from the accident, you’re struggling to sleep, to get through a day at the office, and there’s no way you can do a load of laundry with all the bending that requires.
“Am I ever going to heal?” You ask yourself.
“Will I get back to my old self?”
“When am I going to get paid for all this pain and suffering, and when are the medical providers going to bill the at-fault driver’s insurance company instead of me or my own health insurance company? After all, it’s his fault. His insurance company should be paying.”
“Am I going to have to sue the person who hit me?”
“Why won’t the insurance company just pay?”
“How long is this going to take?”
These are all good and important questions, and questions that I hear regularly as a personal injury lawyer. Hopefully, I’m hearing these questions on the first phone call or visit with my client and not three months into representation, because these are all questions that ought to be answered (or at least discussed) in an initial consultation with a personal injury lawyer.
In this article, we’ll discuss how long a personal injury claim might take to get resolved. In the next article, we’ll discuss the related question of when you should expect to be paid. We’ll discuss the other questions in future articles.
How Long Does a Car Accident Claim Take to Get Resolved?
You might not know this, but many car accident cases can and should be resolved before filing a lawsuit in a court of law. This avoids unnecessary costs, stress, and the backlogs inherent in the judicial system, but it doesn’t necessarily mean your case will be quick or easy. In fact, it most likely won’t be. Insurance companies don’t readily part with their money unless they have to. This is important to keep in mind throughout the process of your car accident claim. Insurance companies do not want to give you money!
With that in mind, here are some brief overviews of the stages of a car accident claim and how long each stage might take, or at least the factors that determine how long each stage might take, because sometimes, we just don’t know…
Stage One: OPEN CASE
1. Sign Representation Agreement
2. Get Police Report
3. Inform Insurance Cos. of Claim and Representation
You have met with or talked to a Car Accident or Personal Injury Attorney and the Attorney believes your case is worth pursuing. You now complete your Intake Forms and sign a Representation Agreement. The Attorney’s office will obtain the Police Report, photographs, dash cam footage, witness statements, and any other records related to the case. The Attorney’s office will also obtain contact information for all insurance companies involved – auto, health, first-party, third-party, etc. and send Representation Letters to all insurance companies.
This stage shouldn’t take more than a week or two, although there can be exceptions for complicated cases or police departments and government agencies that don’t respond as quickly as we’d expect them to.
Stage Two: TREATING
1. Client progresses to MMI
2. Attorney/Client contact monthly for treatment status
You are going to a doctor or another health care provider and obtaining treatment for your injuries. Receiving consistent treatment is the right thing to do for your health, and it’s critical for the case. If you don’t obtain treatment, or there are large gaps in treatment, the insurance adjuster and a jury might assume that you weren’t hurt in the first place, or that you miraculously got better the day of your last appointment. Thus, if you are still experiencing pain, it is imperative that you continue to receive treatment, and that you consistently receive treatment in accordance with your doctors’ recommendations. You should keep your Attorney updated regarding your progress and treatment, and at the same time, your Attorney should try to contact you at least once a month. He needs to be aware of your progress (or lack thereof) and to know as soon as you have reached Maximum Medical Improvement (MMI) and are released from care. MMI is the point at which you have recovered 100% or there is no further treatment that will improve your condition.
This stage is one that cannot be predicted. If your car accident resulted in minor bumps and bruises, this stage might only take a few weeks. If the car accident resulted in broken bones or damage to your spine or a traumatic brain injury, this stage might take six months, a year, or even two years. It’s helpful to focus solely on your recovery during this stage and not worry about your legal claim or case. Let your lawyer worry about the legal aspects while you work with your doctors to try to recover.
Stage Three: GET RECORDS
1. Provide an updated list of providers
2. Attorney will obtain Payment Summaries
3. Attorney will obtain Medical and Billing Records
You have reached MMI (Maximum Medical Improvement), which means you’ve ended your medical treatment and are back to 100% or have recovered as much as possible. This is the time when the Attorney’s office will obtain all payment summaries from insurance companies that have paid medical expenses, all medical, chiropractic, and therapy records, and billing records on your behalf.
In order to obtain these records, you will need to provide your Attorney with a list of your health care providers from whom you have received treatment for your injury. In that list, you’ll want to include the name of the clinic, the name of the treating physician, and the contact information for the clinic and physician (name, phone number, address, etc.).
You’ll also need to provide your Attorney a list of any and all past health care providers from whom you received treatment for the five years prior to your injury. Information regarding treatment prior to the injury will help your Attorney prove that your current injury is unrelated to any prior incident or condition.
This stage can be a bottleneck in the process, not because your Attorney is sleeping on the job, but because medical facilities and their records departments are large bureaucracies that take time to respond to records requests. Your patience during this step is appreciated, but the hope is that all records are obtained in 4-6 weeks.
Stage Four: REVIEW RECORDS
1. Attorney to review all medical records
2. Attorney to draft detailed Demand Letter
3. Attorney to obtain Expert if necessary
The Attorney will review all the records and photos and other documentation and then put together a detailed settlement package (sometimes called a “demand letter” or “demand package”) to be submitted to the negligent driver and insurance company. The Attorney will call you during this process to get the latest information about how you’re doing now, how this has affected your life, etc. And if your Attorney has been keeping in touch with you monthly, you may not need to add much to what he already knows. The Attorney will also seek your approval prior to sending out the settlement package..
It's important to keep in mind that the doctors who have provided you care aren’t necessarily helpful in a legal case. Hopefully, they’ve been very helpful in giving you medical treatment, but most doctors don’t like to get involved in legal proceedings or insurance disputes. Your Attorney will do everything he can to seek your providers’ cooperation, but it’s not guaranteed. That being the case, the strength of your case sometimes hinges on what your treating providers say and what they’ve written in their medical records.
If you have no helpful treating providers, your Attorney will consider retaining an expert, which is someone in the relevant field hired to assist with a legal case.
This stage takes 1-2 weeks.
Stage Five: NEGOTIATION / MEDIATION
1. Attorney to Negotiate
2. Push Mediation
3. Prepare for Mediation
The settlement package has been submitted to the insurance company. Generally, it takes 4-6 weeks to hear back. As soon as your Attorney hears from the insurance company, he will notify you to discuss the offer. The hope is to get a strong first offer and resolve the case in short order. However, depending on the initial offer, it may take time to negotiate with the insurance company to obtain the best offer for you. Your attorney may need to provide additional documentation or clarification to the insurance company. Questions may need to be answered. Take these requests from the insurance company as opportunities to prove and strengthen your case (or at least learn more about your case).
During this step, your Attorney is also working with medical experts, notifying lienholders (health insurance companies or other entities who have paid for your medical expenses) of potential settlement, in order to obtain approval of the settlement, and negotiate the liens down. Lienholders have a right to be reimbursed from the responsible party’s insurance company for amounts they’ve paid in medical expenses.
If the case is scheduled for Mediation, your Attorney will prepare as if going to trial. He will create a detailed submission to the mediator (sometimes called a “Mediation Statement”). He will think about and address all the weaknesses of your case. He will prepare your case to get the best offer available from the opposing party. And he will prepare you for the mediation as well by meeting with you and discussing what to expect.
This stage usually takes around 8-12 weeks.
Stage Six: SETTLE & CLOSE
1. Sign Release and Settlement Agreement
2. Get Check
3. Negotiate Liens
4. Distribute Funds
5. Close Case
Good news! The case is settled! But the case isn’t done until the money is in the bank. This is another area that gets bottlenecked.
Your Attorney will provide the insurance company everything it needs to send the Release and Settlement Agreement (e.g., Tax ID number and payment instructions). You will need to sign the Release and Settlement Agreement, which will allow the insurance company to issue a check. But your attorney will also need to negotiate with the lienholders during this time. These are the insurance companies who have paid for your medical expenses who are entitled to be reimbursed out of the settlement. Depending on who that entity is (it could be Blue Cross Blue Shield or some other health insurance company, the VA, Medicaid, or Medicare), this process can take anywhere from one month (that’s usually the case when dealing with a private insurance company like BCBS) or one year (which is usually the case when dealing with Medicaid).
Once the liens are resolved, you will receive a Distribution Sheet from your Attorney which shows the total settlement, the amounts deducted (for your Attorney’s fee, expenses, reimbursement claims, etc.), and the amount that goes to you. Once you approve of the Distribution and the check from the insurance company clears, we issue you a check.
At that point, your case is closed!
Yes, there are lots of stages, and your case might take six months, a year, or even multiple years to resolve, but hiring a personal attorney to go about it the right way will benefit you in the end.