How Insurance Companies Handle High-Value Catastrophic Injury Claims

Even a mild, fully recoverable injury can quickly become expensive when a large emergency room bill arrives at the same time that you’ve missed a week of work, but what about a catastrophic injury with permanent, life-altering effects? While the negligent party’s appropriate insurer pays on claims when their policyholder is proven liable for the damages, how does an insurer handle the enormous costs of a catastrophic injury? Our catastrophic injury attorney in Chicago can help with your injury claim if you’ve sustained a severe injury.

First, What Is Considered a Catastrophic Injury?

All injuries are painful and distressing, but some have serious, lifelong consequences across all aspects of life. When an injury causes permanent harm, it’s considered catastrophic. Examples of catastrophic injuries include the following:

• Spinal cord damage causing paralysis
• Traumatic brain injuries (TBIs) with impairment
• Severe scarring or disfigurement
• Severe burns
• Loss of limb
• Organ loss
• Loss of hearing or vision
• Multiple fractures
• Hip fractures in the elderly

When someone else’s actions caused the injury, they may be held responsible for the catastrophic damages. Typically, the at-fault party’s insurance pays the claim. For instance, auto insurance after a car accident, or a property owner’s liability insurance after an apartment fire. Contact our car accident lawyer in Chicago today for assistance if you received a catastrophic injury due to an auto accident.

Understanding Catastrophic Injury Damages

A catastrophic injury claim is a high-value claim, typically reflecting lifelong damages from the permanent injury. Common damages recovered in catastrophic injury claims include the following:

• Total past and future medical expenses and out-of-pocket costs, including for home assistance, adaptive equipment, and exceptional medical needs
• Total past and future income loss
• Reduced earning ability due to disability
• Life-plan projections for catastrophic injury costs
• Compensation for pain and suffering, loss of enjoyment of life, and diminished quality of life

In many cases, a catastrophic injury causes significant emotional damages as well. A claimant may seek compensation for PTSD, anxiety, and depression.

How Does an Insurance Company View a Catastrophic Injury Claim?

Insurers know a catastrophic injury claim is a substantial expense and affects their bottom line. In these cases, the insurance company often assigns special units to investigate the claim. These experienced insurance adjusters scrutinize every aspect of the accident or incident that triggered the claim to minimize their policyholder’s liability. They also alert their corporate legal teams because litigation is more likely in a catastrophic injury claim.

They may also allocate a financial reserve for the claim to support their fiscal planning around the maximum possible payout. Then, the team of insurance adjusters assigned to the case often uses common strategies to reduce what they have to pay the catastrophic injury victim.

A Catastrophic Injury Attorney Protects Against Insurance Company Tactics

A catastrophic injury lawyer protects their injured client against common insurance company tactics meant to protect the company’s profits by devaluing the claim. Common tactics include:

• Quickly offering a lowball settlement before the injury victim knows the full extent of their future damages
• Searching the injury victim’s medical history for preexisting conditions or previous injuries they can claim are responsible for the injury victim’s symptoms
• Challenging the injury victim’s level of disability
• Challenging the injury victim’s life care plan projections as invalid or exaggerated
• Analyzing the injury victim’s career trajectory and devaluing their total future lost earnings

Finally, one of the most effective tools an insurer uses against a catastrophic injury victim is to assign them a portion of fault for the injury to reduce the amount they have to pay on the claim by the percentage of fault assigned to the injury victim under Illinois’ modified comparative negligence law.

A catastrophic injury attorney for the injury victim conducts an independent investigation and consults with medical experts to strengthen the injury victim’s case for the full value of their compensation during negotiations for a settlement or in court.