Traumatic brain injury (TBI) injuries often result in long-term or permanent impacts on physical and cognitive function, and recovery may require extensive medical care, rehabilitation and lifestyle changes. As a result, they can be very costly to treat. When individuals are harmed in this way as a result of another’s negligence or intentional wrongdoing, they may be hopeful that their costs will be covered by insurance. Unfortunately, the process of seeking an insurance payout for a TBI can be a particularly complex and energy-intensive process.
If you or a loved one has suffered a TBI in California due to an accident, understanding how to file a strong insurance claim—and what pitfalls to avoid when doing so—can be consequential when it comes to securing the compensation you need. Know that you don’t have to navigate this process alone. After reviewing the basics below, know that seeking experienced legal guidance to better ensure that you’re making truly informed decisions about your situation is always an option.
The basics
A TBI claim typically begins with identifying all available insurance coverage. This may include auto insurance (for car accidents), premises liability coverage (for falls or unsafe property conditions) or workers’ compensation (for job-related injuries). Filing promptly is important. Most insurance policies require a timely notice of the injury and any intention to seek benefits. Failure to honor this requirement can lead to claims being rejected before they’ve even been considered on their merits.
The next step is to thoroughly document the injury and its impact. Insurance companies require detailed medical records to evaluate a TBI claim. These records should include emergency treatment, diagnostic imaging (such as CT scans or MRIs), specialist evaluations (neurologists, neuropsychologists) and ongoing treatment plans. Because TBI symptoms—like memory loss, difficulty concentrating and personality changes—are not always immediately visible, continued documentation of symptoms over time may be required as well.
One of the most common pitfalls that can compromise the strength of TBI claims is underestimating the severity or long-term effects of the injury. Insurance adjusters often attempt to minimize claims by arguing that the injury is mild or unrelated to the incident in question. They may also rely on the fact that TBI symptoms can be subtle or delayed. To counter this, consistent medical treatment and expert evaluations are often powerful resources. To this end, victims should avoid gaps in treatment, as insurers may use them to argue that their condition has improved or was not serious to begin with.
Another major issue is providing recorded statements to insurance adjusters too early. These statements can be used to downplay symptoms or create inconsistencies in a claim. As a result, victims should always consult with a personal injury attorney before making any formal statements or signing any documents related to their concerns.
Traumatic brain injuries are life-altering. Filing an insurance claim may seem daunting, but with the right support and preparation, victims can avoid common mistakes and pursue the full compensation that they deserve.
