After a car accident, one of the first steps most people take is to file a claim with the insurance company. Many assume the insurer will fairly compensate them for their losses. In reality, the process is much more complex.
Insurance companies use detailed evaluation systems that often result in lower payments than victims expect. Understanding how these evaluations work helps protect your rights and increases your chances of receiving full and fair compensation.
1. The Real Goal of the Insurance Company
Insurance companies are businesses that focus on profits. Their objective is not to ensure your recovery but to reduce payouts whenever possible.
Even if an adjuster sounds friendly, their main task is to protect the company’s financial interests. At Phillips Law Offices, we have seen every possible strategy insurers use to minimize payments, from questioning medical treatment to denying that injuries are connected to the accident. Knowing these tactics is the first step in defending your claim.
2. Opening the Claim and Gathering Information
Once a claim is reported, the insurance company opens a file and assigns an adjuster. The adjuster begins collecting documents and evidence such as:
- The police report and any witness statements
- Photographs of the accident scene and vehicle damage
- Statements from the drivers involved
- Medical records and billing information
At this stage, the adjuster also reviews liability to determine who caused the accident and whether both parties share any responsibility. In Illinois, this involves examining comparative fault, where each party’s percentage of responsibility affects the outcome.
From the very beginning, the insurer looks for inconsistencies between your statements and the available evidence. Any differences may be used later to question your credibility or to reduce your claim.
3. Deciding Who Is at Fault
Before the insurer pays a claim, it must determine who was responsible for the collision. Adjusters analyze the police report, photographs, and witness accounts to assign fault.
In Illinois, fault is shared under a system known as comparative negligence. If the adjuster believes you contributed to the accident, they will assign a percentage of blame to you. The higher your percentage, the less you recover. If the insurer claims you were 51 percent at fault or more, you could receive nothing.
For this reason, you should avoid making recorded statements to the insurance company without legal guidance. What seems like a harmless explanation could later be used to argue that you were responsible for part of the crash.
4. Reviewing Medical Records and Bills
Once fault is addressed, the adjuster turns attention to the value of your claim. They review the type and seriousness of your injuries, the duration of treatment, and whether the care you received appears reasonable.
Insurance companies often use computer software to compare your treatment costs with internal data. If your bills appear higher than average or if you missed appointments, they may try to deny part of your claim.
Adjusters sometimes send your medical records to doctors who work for the insurance company for review. Those doctors may attempt to limit or question your injuries. Keeping detailed records and following your physician’s advice helps prevent these arguments.
5. Evaluating Economic Losses
Economic losses include measurable financial damages such as:
- Medical expenses
- Lost wages or reduced earning ability
- Vehicle repair or replacement costs
- Other out-of-pocket expenses related to your recovery
The adjuster will review each of these categories and may challenge certain expenses or suggest they were not related to the accident. Accurate documentation, including receipts and pay stubs, strengthens your position.
6. Estimating Pain and Suffering
The most difficult part of the claim to measure is pain and suffering. Because there is no set formula in law, insurance companies often use a mathematical approach called the multiplier method.
They total your medical bills and multiply that figure by a number between 1.5 and 5, depending on how serious your injuries appear. For example, if you had $25,000 in medical bills and the insurer applies a multiplier of 2, they may value your pain and suffering at $50,000.
Insurance companies usually apply the lowest multiplier they can justify. Experienced lawyers present detailed medical reports, testimony, and daily-life impacts to show that a higher multiplier is appropriate.
7. Verifying Lost Income
If your injuries caused you to miss work, the insurer will require verification from your employer showing your pay rate and the time you were absent. They may also review whether you can return to work sooner than your doctor recommends.
When injuries limit future employment or earning potential, the insurer often minimizes these losses. Attorneys use evidence from medical experts and vocational professionals to show how injuries affect your ability to work long term.
8. Reviewing Future or Long-Term Costs
If ongoing medical care, rehabilitation, or surgery is expected, insurers often resist paying those costs upfront. They prefer to settle early, before the full financial impact is clear.
Your attorney’s role is to ensure that future damages are properly included. This may involve medical experts or life-care planners who project future costs and document them thoroughly before any settlement discussion takes place.
9. How Settlement Offers Are Calculated
After the insurer finishes its evaluation, they usually make a low initial settlement offer. This is often a fraction of the claim’s true value. The offer tests whether the injured person understands the process or has legal representation.
Once a settlement is accepted, you cannot reopen the case later. That is why consulting a lawyer before signing anything is essential.
At Phillips Law Offices, we evaluate every offer against actual verdicts and settlements from similar cases. We present evidence to demonstrate the true cost of your injuries and negotiate from a position of strength.
10. How Attorneys Change the Outcome
Insurance companies maintain detailed records of the law firms they deal with. When they know a firm like Phillips Law Offices is involved, they take the case seriously.
Firms with proven trial success are more likely to secure fair settlements because insurers want to avoid the uncertainty and cost of court. Our reputation for careful preparation and aggressive advocacy often leads to stronger results for clients without the need for trial.
11. How to Protect Your Claim During Evaluation
While your claim is being reviewed, several actions can help preserve its strength:
- Seek prompt medical attention and follow all doctor recommendations.
- Keep copies of all bills, receipts, and records.
- Do not post details about your accident or injuries on social media.
- Avoid recorded statements or casual phone conversations with adjusters.
- Speak to a lawyer as soon as possible.
Every step you take after an accident can affect how much compensation you ultimately receive.
12. When Insurance Companies Act in Bad Faith
Some insurers cross the line and engage in unfair or deceptive practices. This behavior is called insurance bad faith. Examples include:
- Failing to investigate the claim properly
- Making misleading statements about coverage
- Unreasonable delay in processing payment
- Denying a valid claim without cause
In certain situations, Illinois law allows victims to pursue additional damages when an insurer acts in bad faith. A lawyer can identify whether this applies to your case and help you take the right steps.
13. Why Handling a Claim Alone Is Risky
It is possible to handle a claim without an attorney, but doing so often results in much smaller settlements. Insurance companies have trained negotiators and attorneys working for them from the moment you file.
Without experienced representation, it is difficult to recognize when an offer is far below the claim’s value. At Phillips Law Offices, our team handles every stage of the process so that clients can focus on recovery, not paperwork and negotiations. We only collect a fee if we win your case.
The Bottom Line
Insurance companies use a detailed and calculated approach to evaluate car accident injury claims. Their process focuses on reducing what they pay, not on what you need to recover.
Having an experienced lawyer ensures that your evidence is complete, your medical needs are fully documented, and your rights are protected. The legal team at Phillips Law Offices understands how insurers think and how to build a case that commands attention and results.
Contact Phillips Law Offices
If you were injured in a car accident anywhere in Illinois, do not let the insurance company undervalue your claim. Our Chicago-based car accident attorneys are ready to help you understand your rights and pursue the full compensation you deserve.
Call (312) 346-4262
161 N Clark St, Suite 4925, Chicago, IL
Free Consultation | No Fee Unless You Win
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