accident attorney Insurance Claims and Negotiations 3

Question 1

What is 'coverage dispute' in an accident claim and how is it typically resolved?

Accepted Answer

A disagreement between insurer and insured over whether the policy covers the claim, resolved by declaratory judgment or negotiation

Answer

A dispute over the amount of medical bills

Answer

A conflict between two insurers over which policy is primary

Answer

A disagreement about the accident reconstruction

Question 2

What is an 'insurance adjuster's' role in a personal injury claim?

Accepted Answer

To investigate the claim, assess liability, evaluate damages, and negotiate settlement on behalf of the insurance company

Answer

To independently represent the injured party's interests

Answer

To provide medical opinions on the plaintiff's injuries

Answer

To represent the insured in court

Question 3

What is 'coordination of benefits' (COB) in multi-insurance accident claims?

Accepted Answer

Rules determining which insurer pays first (primary) and which pays any remaining balance (secondary) when a claimant has multiple policies

Answer

A process for combining policy limits of two carriers

Answer

An agreement to split fault between two insurers

Answer

A court-ordered payment plan involving multiple defendants

Question 4

What is 'lost future earnings' and how is it typically calculated in a serious injury case?

Accepted Answer

Compensation for the reduction in earning capacity due to permanent disability, calculated using actuarial life tables, vocational analysis, and economic expert testimony

Answer

Lost wages during the recovery period only

Answer

The plaintiff's last year's salary multiplied by years until retirement

Answer

Income the plaintiff expected from a job not yet started

Question 5

What is 'interinsurer arbitration' and when is it used?

Accepted Answer

A process where two insurance companies arbitrate which of them bears liability or owes contribution, rather than litigating in court

Answer

Arbitration between the insurer and policyholder over claim value

Answer

A method of resolving uninsured motorist claims without court involvement

Answer

An ADR process required by state insurance regulations

Question 6

What is a 'consent to settle' clause in a liability policy and how does it affect plaintiffs?

Accepted Answer

A clause requiring the insured's agreement before the insurer can settle a claim, which can delay or block settlement

Answer

A requirement that the plaintiff consent to arbitration

Answer

A clause allowing the insurer to settle without notice to the insured

Answer

A provision requiring court approval of all settlements