How an injury claim after a car crash works: who pays first, how fault is decided, which insurance policies apply, and what a settlement has to account for.
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A car accident claim is usually a negligence claim against the at-fault driver, paid in practice by that driver's liability insurer. To recover, the injured person generally has to show the other driver was careless, for example by speeding, following too closely, running a signal or driving while distracted, and that the carelessness caused the injuries. A driver who broke a traffic law designed to prevent this kind of crash may be treated as negligent for that reason alone in many states (see negligence per se). Fault is often shared, and each state has its own rule for what happens to a claim when the injured person was partly at fault.
Several layers of insurance can be involved, and the order matters. In the roughly a dozen no-fault states, the injured person's own personal injury protection pays medical bills and some lost wages first, regardless of fault, and a suit against the other driver is allowed only for injuries above a threshold set by state law. Elsewhere, medical payments coverage, health insurance and the at-fault driver's liability policy are the usual sources. The at-fault driver's policy limit caps what that insurer will pay, which is why a person's own uninsured and underinsured motorist coverage often matters in a serious crash. Vehicle damage is a separate property claim, including whether the car is a total loss.
A settlement has to deal with what others have already paid. Health insurers, Medicare, Medicaid and some hospitals can have liens or reimbursement rights against the recovery (see subrogation and medical liens), and a release normally ends the claim permanently, including injuries that show up later. Objective evidence, such as the police report, photographs, witness statements, dash-cam and nearby video, and the vehicles' event data recorders, usually decides disputes about how the crash happened.
Get medical care and keep every record, photograph the vehicles, the scene and your injuries, get the other driver's insurance details and the police report number, and notify your own insurer. Be careful with recorded statements to the other driver's insurer and do not sign a release before you know the full extent of your injuries. Many car accident lawyers work on a contingency fee and will review a claim without charge, and advice is most useful when injuries are significant, fault is disputed, or the other driver's insurance looks too small.
Worried about the cost? A lawyer can be hired for one part of a case only (limited-scope representation), may be paid from what a claim recovers (contingency fee), or may be free through a pro bono program or legal aid; a court can also waive its own filing fees.
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