A traumatic brain injury (TBI) can change your life in an instant. It can leave you facing not only physical and emotional trauma but also significant financial strain from medical bills, lost income, and other damages. While insurance is meant to provide a safety net after an injury, fighting the insurance company for fair compensation can be a long and frustrating process—especially when dealing with the complexities of a TBI.
Insurance companies often focus more on protecting their bottom line than fairly compensating injured individuals. They may use various tactics to reduce or deny your claim, leaving you in a difficult position at a time when you need support the most. It’s essential to be aware of the challenges that victims of TBIs face when dealing with insurance companies and how an experienced traumatic brain injury attorney can help fight for the compensation you deserve.
Understanding the Severity of a TBI
Traumatic brain injuries (TBI) range from minor concussions to severe brain damage, and their impact can vary widely from person to person. Even a so-called “minor” TBI, such as a concussion, can have long-lasting effects, including cognitive issues, memory loss, and emotional instability. More severe TBIs can lead to permanent disabilities, requiring lifelong medical care and rehabilitation.
The consequences of a TBI can extend beyond medical expenses. You may face lost income due to time away from work, diminished earning capacity if you are unable to return to your previous job, and substantial pain and suffering as you cope with the emotional and psychological toll of the injury. Insurance companies often fail to fully account for these long-term consequences when determining settlements, which is why it’s essential to fight for full and fair compensation.
Common Causes of a Traumatic Brain Injury (TBI)
Traumatic brain injuries (TBIs) occur when an external force causes damage to the brain, leading to a wide range of cognitive, physical, and emotional impairments. TBIs can result from a variety of incidents, often stemming from the negligence of another, with some of the most common causes including:
- Falls: Falls are the leading cause of TBIs, particularly among young children and older adults. Slipping on wet surfaces, falling from ladders, or tumbling down stairs can result in head trauma severe enough to cause a brain injury.
- Motor Vehicle Accidents: Car, motorcycle, and bicycle accidents frequently result in TBIs. The violent impact of a collision can cause the brain to collide with the skull, leading to concussions or more severe injuries. Whiplash from rear-end collisions can also contribute to brain trauma.
- Sports Injuries: Contact sports, such as football, hockey, and boxing, are significant contributors to TBIs. Repeated blows to the head, even if they seem minor, can accumulate and lead to long-term brain damage.
- Assaults and Violence: Physical assaults, including blows to the head or gunshot wounds, can lead to severe brain injuries. Domestic violence and child abuse are also unfortunate contributors to TBIs.
- Explosions and Combat Injuries: Military personnel are at an increased risk of TBIs due to the nature of their work. Explosive blasts, particularly in combat zones, can cause brain injuries from the force of the shockwave or shrapnel penetrating the skull.
Challenges When Dealing with Insurance Companies After a TBI
While insurance policies are designed to cover losses following an injury, insurance companies are profit-driven entities that will often prioritize their financial interests over the needs of claimants. Here are some of the common challenges TBI victims face when dealing with insurance companies:
Questioning the Severity of the Injury
One of the most frequent tactics insurance companies use is to question the severity of the injury. TBIs can be difficult to diagnose and quantify, especially in cases where symptoms like memory problems, mood changes, or cognitive impairments aren’t immediately visible. Insurance adjusters may downplay the seriousness of the TBI, claiming that the injury is minor or that symptoms are unrelated to the accident.
Insurance companies often rely on medical experts they hire to evaluate your injury, and these experts may minimize the severity of your TBI or suggest that your symptoms are the result of pre-existing conditions. Fighting this tactic requires strong medical evidence and expert testimony to prove the extent of your injury and its direct impact on your life.
Delaying Your Claim
Delaying the processing of your claim is a common strategy insurance companies use to pressure you into accepting a low settlement offer. The longer the insurance company takes to evaluate your claim, the more financial strain you may face as medical bills pile up and lost income accumulates. Some claimants, feeling desperate, accept inadequate settlements to resolve their financial issues.
In TBI cases, these delays can be especially harmful, as the full extent of the injury and its long-term impact may not be immediately apparent. Insurance companies may use this delay to argue that your injuries are not as serious as initially claimed or that your symptoms have improved over time. Working with a skilled personal injury attorney can help ensure that your claim moves forward promptly and that you are not forced into settling prematurely.
Lowball Settlement Offers
Even when insurance companies acknowledge the severity of a TBI, they may still offer settlements far below what you deserve. This is particularly common in cases where the insurer knows the injured party is struggling financially and may be more likely to accept a low offer to cover immediate expenses.
Lowball offers typically fail to account for the long-term costs of a TBI, which may include ongoing medical treatment, rehabilitation, therapy, and adaptations to your home or vehicle. They also often overlook non-economic damages like pain and suffering or loss of quality of life. Insurance companies are notorious for undervaluing these types of damages, leaving TBI victims without the resources they need for long-term recovery.
Disputing Liability
In many personal injury cases, the issue of liability can be contentious. Insurance companies may dispute who is at fault for the accident that caused your TBI, especially in cases involving motor vehicle accidents, workplace injuries, or slip-and-fall incidents. If they can shift some or all blame onto you, they may reduce or deny your claim altogether.
Proving liability in TBI cases often requires a thorough investigation, including gathering witness statements, accident reports, and possibly even expert testimony. Insurance companies may use liability issues to their advantage, making it critical to have legal representation that can build a strong case on your behalf.
How a Personal Injury Attorney Can Help You Fight Back
Managing the claims process after a TBI is challenging, especially when you are already dealing with the physical, emotional, and financial toll of the injury. An experienced personal injury lawyer can be your advocate throughout the process, ensuring your rights are protected, and you receive the compensation you need. Here’s how a lawyer can help:
Gathering and Presenting Evidence
A personal injury attorney will gather all the necessary evidence to support your claim, including medical records, expert testimony, accident reports, and witness statements. In TBI cases, the attorney may work with neurologists, neuropsychologists, and other medical experts to document the full extent of your injury and its long-term impact. This evidence will be vital in proving both the TBI’s severity and the responsible party’s liability.
Handling Communications with the Insurance Company
Insurance adjusters are skilled negotiators who work to protect the insurer’s interests. Your personal injury lawyer will handle all communications with the insurance company, ensuring you don’t say or do anything that can harm your claim. They will negotiate on your behalf, pushing back against lowball settlement offers and tactics designed to minimize your compensation.
By having an attorney handle these negotiations, you can focus on your recovery instead of the stress of dealing with the insurance company. Your attorney will fight to ensure that any settlement fully accounts for your medical bills, lost income, pain and suffering, and other damages.
Calculating the Full Extent of Your Damages
One of the critical roles of a personal injury lawyer is to calculate the full extent of your damages, including economic and non-economic losses. In TBI cases, this can be an involved process, as the long-term costs of the injury may not be immediately clear. Your attorney will work with medical professionals to estimate the costs of future medical care, rehabilitation, therapy, and any necessary lifestyle adjustments, such as home modifications or special equipment.
Non-economic damages, such as pain and suffering, emotional distress, and loss of enjoyment of life, are often more challenging to quantify. However, an experienced attorney knows how to present these damages in a way that demonstrates their real impact on your life and ensures that they are taken into account during settlement negotiations.
Filing a Lawsuit (if Necessary)
Your attorney can file a lawsuit if the insurance company refuses to offer a fair settlement. Litigation can be a powerful tool for holding the insurance company accountable, especially in cases where the insurer has acted in bad faith by delaying your claim or offering an unfairly low settlement.
A personal injury attorney with trial experience can prepare your case for court, gathering all necessary evidence, filing legal motions, and representing you in front of a judge and jury. While most personal injury cases are settled before going to trial, the threat of litigation can often push insurance companies to offer a more reasonable settlement.
Dealing with Bad Faith Tactics
In some cases, insurance companies may act in bad faith by intentionally delaying your claim, denying a valid claim without cause, or failing to conduct a thorough investigation. When this happens, your attorney can take legal action against the insurance company for bad faith practices. In some states, bad faith claims can result in additional compensation for the policyholder on top of the original damages sought in the personal injury claim.
What to Expect in Terms of Compensation for a TBI
If you’ve suffered a TBI due to someone else’s negligence, you may be entitled to significant compensation. The amount you can recover will depend on your injury’s severity, impact on your life, and the strength of your legal case. In general, you can recover:
- Medical Expenses: This includes immediate medical bills and the costs of ongoing care, rehabilitation, and therapy. In severe cases, it may also cover the costs of long-term care or home modifications needed to accommodate a disability.
- Lost Income: If your TBI has caused you to miss work, you can recover compensation for your lost income. If the injury has diminished your ability to earn a living in the future, you may also be entitled to compensation for reduced earning capacity.
- Pain and Suffering: TBIs can cause significant physical pain, emotional distress, and a loss of enjoyment of life. These non-economic damages can be difficult to quantify but are essential to your compensation.
- Loss of Consortium: If your TBI has affected your relationships with your spouse or family members, you may be entitled to compensation for loss of consortium.
Did You Suffer a TBI? Contact a Personal Injury Attorney Today for Professional Legal Help
Fighting the insurance company after a traumatic brain injury can be a long and difficult process. Insurance companies often use tactics designed to minimize the compensation you receive, but with the help of an experienced personal injury attorney, you can fight back. An attorney will advocate for your rights, negotiate with the insurance company, and ensure you receive the compensation you need to recover and move forward with your life.
If you or a loved one has suffered a TBI due to someone else’s negligence, don’t try to navigate the claims process on your own. Contact a personal injury attorney today to learn more about your legal options and how to pursue fair compensation for your injury. Most personal injury attorneys offer free injury consultations, and many also work on contingency fees—which means you owe nothing until they secure compensation on your behalf. You have nothing to lose by reaching out to an attorney to discuss your TBI claim today.