Recovering from a traumatic brain injury (TBI) often presents unexpected hurdles, particularly when an insurance company challenges your claim. Unfortunately, many individuals who suffer from TBIs find that insurance companies are usually more concerned with safeguarding their profits than helping claimants obtain the compensation they deserve.
This article explains what you need to know about traumatic brain injuries and the insurance process. It explores the causes of TBIs, their effects, and reasons insurers often push back on claims. It also examines how tactics insurers use are countered by collaborating with a qualified TBI lawyer. When insurance companies play hardball, a skilled attorney improves your chances of securing appropriate compensation for your injuries.
Who Fights for You After a TBI Insurance Denial?
- Insurance companies often dispute TBI claims due to invisible symptoms and high costs.
- Common causes of TBIs include car crashes, falls, assaults, and medical negligence.
- Insurers use delay tactics, deny coverage, or lowball victims to minimize payouts.
- A TBI lawyer can collect evidence, negotiate with insurers, and build a case for full compensation.
- Hiring a lawyer on contingency means you pay nothing upfront—legal help is accessible.
What Causes Traumatic Brain Injuries?
Traumatic brain injuries occur due to a sudden blow or jolt to the head that disrupts normal brain functions. The force impacting the brain often results in bruising, bleeding, or swelling.
Motor vehicle accidents account for a significant number of TBIs. Collisions between cars, motorcycles, trucks, and pedestrians may lead to severe head trauma. Slips and falls are another common cause of TBI, particularly among elderly individuals or those working in hazardous environments. Some TBIs result from violent assaults, where objects or fists strike a person’s head. Sports-related incidents, such as rough tackles or falls, frequently lead to concussions and other brain injuries.
Workplace accidents, such as falls from ladders or head injuries resulting from falling objects, also contribute to TBI. Regardless of how they happen, the effects are often life-altering. Even with safety precautions in place, TBIs occur daily across the country.
Understanding the Spectrum of TBIs
Not all TBIs are alike. Injuries differ based on the severity of the impact, the force exerted, and the region of the brain affected.
A concussion is among the most common and least severe types of TBI. It occurs when a sudden movement causes the brain to bounce or twist inside the skull. Concussions may lead to symptoms such as dizziness, headaches, and confusion, although these symptoms are often temporary.
Contusions are bruises on brain tissue, usually caused by a direct impact, such as hitting your head on a steering wheel or the ground. When bleeding occurs within the brain, it is called an intracranial hematoma. This complication may create pressure inside the skull, requiring immediate medical attention.
More severe TBIs include diffuse axonal injuries, where the brain shifts rapidly within the skull, damaging the connections between brain cells. Penetrating injuries, in contrast, occur when an object, such as debris from an accident, directly penetrates the skull and brain tissue.
Doctors use various tools, including imaging scans, to assess the extent of a TBI. While some injuries recover over time, others lead to lasting complications that affect work, relationships, and daily activities.
How a TBI Disrupts Everyday Life
A traumatic brain injury may disrupt a person’s everyday routines and lifestyle. The effects range from physical difficulties to emotional stress, often affecting not only the injured individual but also their family members.
Memory problems are a common complaint among TBI survivors. Forgetting appointments, losing track of time, and failing to recall conversations are some of the challenges they face. Simple tasks like focusing on a book or following instructions at work may feel impossible. For those with more severe injuries, the ability to walk, speak, or even sit upright without assistance might be affected.
Behavioral and emotional shifts are also common. Loved ones may notice someone becoming more irritable, withdrawn, or confused following a brain injury. Since the brain regulates emotions, TBIs may cause personality changes. Additionally, lingering fatigue and chronic pain create further challenges.
The financial strain exacerbates the situation. Medical bills accumulate rapidly due to hospital stays, medications, or therapy sessions. For individuals compelled to take extended time off work or leave their jobs permanently, the loss of income increases these challenges even more.
Every TBI is unique, but regardless of the specific symptoms, they frequently disrupt stability in ways that affect all areas of life.
Why Insurance Companies Push Back on TBI Claims
Insurance companies often undervalue the costs of TBIs, even when medical records clearly indicate the severity of the injury. The reasoning behind this is simple: insurance firms aim to pay as little as possible to settle claims. Large claims, in particular, pose a financial risk to these companies, prompting them to seek ways to reduce payouts.
TBIs are particularly costly as they typically necessitate extended recovery periods and more specialized care. Medical appointments, rehabilitation, and lost wages often lead to higher dollar claims. When an insurance provider encounters a claim involving a traumatic brain injury, it may quickly start seeking ways to question its validity.
The invisible nature of many brain injuries works against the injured person. Unlike broken bones or cuts, the effects of a TBI don’t always manifest on the surface. Insurers may argue that the injury isn’t as serious as it seems, even if further testing proves otherwise. They may even attempt to claim that symptoms are exaggerated, pre-existing, or entirely unrelated to the incident in question.
This aggressive approach frustrates claimants, leaving many exhausted and uncertain about how to gather evidence to prove their case.
Tricks Used by Insurers to Undermine Your TBI Claim
Insurance companies do not hesitate to employ various tactics to create obstacles for TBI claimants. Their objective is straightforward—to make the claims resolution process as slow, difficult, or unfavorable as possible.
One common tactic is to delay responses to communications. Insurance companies may take weeks or months to acknowledge paperwork or provide updates. The intention is that the claimant will eventually give up out of frustration.
Insurers frequently request extensive documentation. While this may seem reasonable initially, they sometimes insist on unnecessary or repetitive medical records, further prolonging the process.
Another tactic involves misrepresenting policy language. For instance, an adjuster may assert that a type of care is not covered when, in reality, the policy does allow for that coverage.
One of their common strategies is lowballing settlements. By presenting an amount significantly lower than medical expenses or long-term needs demand, insurers take advantage of individuals who fear they won’t receive anything if they decline. Ultimately, these tactics place individuals at a disadvantage unless they engage a lawyer who understands how to challenge them.
Scenarios in Which a TBI Lawyer Offers Support
Lawyers managing TBI claims are experienced in the various circumstances that result in these injuries. They support clients by assessing whether negligence was a factor and constructing cases to maximize compensation.
Car accidents are a prime example. Whether a distracted driver causes a collision or a trucking company neglects vehicle maintenance, these incidents often result in head trauma. Lawyers also handle workplace accidents, such as falls on unsafe job sites or injuries from an employer’s failure to provide adequate safety equipment.
Some cases arise from premises liability issues. If a property owner’s negligence- such as failing to fix a hazard or properly illuminate a walking path- causes someone to fall and suffer a traumatic brain injury, they may be held responsible. Additionally, violent assaults leading to head injuries may warrant legal action if evidence shows the responsible party acted without provocation or malice.
Medical malpractice, although less common, is another area where TBIs occur. If improper care during surgery or birth injuries harms the brain, the provider may be held responsible. Lawyers help by evaluating the facts and collecting evidence to demonstrate how someone else’s negligence caused the injury.
The Advantages of Legal Assistance in Insurance Disputes
When someone experiences a TBI, the odds may seem stacked against them, particularly regarding the claims process. Insurance companies have resources, strategies, and even attorneys at their disposal. Collaborating with a lawyer is often the only way to level the playing field.
Insurance providers often take claims more seriously when a lawyer is involved. They understand that claimants have support from someone who comprehends legal strategies, knows compensation structures, and won’t succumb to high-pressure tactics. Lawyers identify lowball offers, reveal overlooked damages, and pursue higher settlements to address the complete scope of someone’s injury and losses.
With a lawyer managing the negotiation process, injured individuals may concentrate on their recovery rather than facing an uphill battle alone. They also benefit from having an advocate who gathers evidence, such as medical records, accident reports, or expert opinions, to support their claims. Complex cases, like TBIs requiring lifelong care, are easier to handle with legal assistance. Ultimately, strong legal support improves the likelihood of achieving a financially supportive resolution.
Steps a Lawyer Takes to Strengthen Your TBI Claims
Working with a TBI attorney involves several steps aimed at investigating the injury, calculating damages, and negotiating a settlement. First, the legal team collects as much evidence as possible. This usually includes police accident reports, medical records, witness statements, and any photos or videos from the scene.
Next, they will identify all responsible parties. For instance, in a trucking accident, the liable parties may include the driver, the trucking company, or even the vehicle’s manufacturer if faulty parts contributed to the crash. A lawyer examines these details to pinpoint all potential sources of compensation.
After building a strong case, lawyers enter negotiations with the involved insurance company or companies. They seek fair compensation for medical expenses, lost income, therapy costs, and other damages. If insurers decline to provide a reasonable amount, attorneys may suggest pursuing the claim through legal channels, such as arbitration or filing a lawsuit in court.
Throughout the process, communication remains a priority. Clients receive updates on progress, and lawyers respond to questions or concerns. This step-by-step guidance reduces stress while establishing a foundation for resolution.
What is the Cost of Hiring a TBI Lawyer?
The cost of hiring a lawyer is one of the primary concerns many individuals have after a traumatic brain injury. However, most TBI lawyers operate on a contingency fee basis, meaning clients do not need to pay any upfront fees. This structure alleviates financial stress, enabling individuals to concentrate on their recovery rather than worrying about legal expenses.
In a contingency fee arrangement, a lawyer only receives payment if they successfully helps the client secure compensation through a settlement or court award. Once the case is resolved, the lawyer usually receives a percentage of the amount recovered. This percentage is established at the beginning of the attorney-client relationship, so there are no surprises later.
This approach benefits clients by eliminating the need for hourly rates or large retainers. It also incentivizes lawyers to work diligently toward achieving the best possible results since their payment is directly tied to the case outcome. Clients generally do not owe the lawyer for legal services if no settlement or award is recovered.
Additional costs, such as filing fees or expenses related to gathering evidence, may be deducted from the settlement or award before the lawyer’s percentage is applied. Lawyers typically outline these terms in a clear, written agreement, so clients understand the process from start to finish.
This arrangement makes legal representation more accessible for individuals and families facing the high costs often associated with a TBI.
Your Journey to Legal Support
Fighting an insurance company after a traumatic brain injury might seem like a frightening task, but claimants don’t have to face it alone. The proper legal support makes a significant difference. TopDog Law Personal Injury Lawyers connects individuals with experienced local attorneys who focus on holding insurance companies accountable and pursuing the compensation that injured individuals deserve.
If you or a loved one is facing a TBI and having difficulty with an insurance claim, contact TopDog Law today. They will connect you with a qualified local lawyer who will evaluate your case and guide you through the next steps in seeking the justice and support you deserve. Don’t hesitate to act. Reach out now to turn a frustrating struggle into a path forward. Call TopDog Law today at (888) 778-1197.
