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January 09, 2017

Differences Between a Personal Injury Claim and a Lawsuit

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Posted in Wisconsin Workers Compensation Related News

There are several major differences between a personal injury claim and a personal injury lawsuit. A personal injury claim may lead to a lawsuit but a variety of factors could prevent it from going to trial. Common deciding factors include:

  1. Did the accident result in a fatality? If yes, the victim’s family may opt for going to trial as a jury might award them more damages than they would recover in an injury claim.
  2. Is the at fault insurance company refusing to offer a fair settlement? If not, the victim may choose to pursue a lawsuit. That decision in itself may motivate the insurance company to return to the negotiating table.

Personal Injury Claims

Personal injury claims may first be filed with the at-fault insurance company or the victim’s own insurance company. This depends on state insurance laws and whether they are “at fault” or “no fault” states.

In No Fault States

In “no fault” states, the injured party will first submit a personal injury claim to their own insurance company, which then decides whether the claim is valid or not.

In At Fault States

In “at fault” states, the insurance company of the negligent party will be responsible for covering damages. Premises liability injury claims can be different in terms of how the parties are assessed in any state. However, the concept of personal contribution to the injury by the injured claimant is still a part of the process. Insurance companies have the authority to investigate a personal injury claim before paying any benefits. This can result in a claim denial or a low settlement offer with a full release of future medical coverage. This is why it is often not a good idea to handle your own personal injury claim if the injuries are serious.


Lawsuits often stem from personal injury claims that are denied by the appropriate insurance company or when the insurance company negotiated in bad faith. Experienced personal injury attorneys recognize bad faith tactics. A seasoned personal injury lawyer Charlottesville VA trust will pay close attention to how the insurance company responds to certain aspects of a personal injury claim. If the victim’s attorney opts to pursue a lawsuit, it is their burden to prove:

  1. The denied claim is actually valid. This is usually done by presenting evidence that supports the negligence claims of the injured party.
  2. The defendant directly or indirectly caused the plaintiff’s injury.
  3. The defendant owed a reasonable duty of care to the plaintiff.


Either party in a personal injury claim dispute can take a case to court. Insurance companies may do this if they think a judge will dismiss the personal injury lawsuit in court.

Plaintiff attorneys usually choose this option when they think they can prove gross negligence by an “at fault” defendant. In addition, this is common tactic in wrongful death claims because the jury might issue a substantial punitive damage award in gross negligence or intentional acts cases.

To avoid a costly lawsuit, insurance companies will often reassess a claim in the final hours and attempt to settle it. However, if their offer still falls short, the plaintiff may choose to proceed to court.

Thanks to our friends and contributors from Martin Wren, P.C. for their insight into difference between personal injury claim and lawsuit.

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