Fighting the Insurance Company After a TBI (2023)

Fighting the Insurance Company After a TBI

Traumatic brain injuries (TBIs) are highly unpredictable and challenging injuries. Depending on the part of your brain that suffers damage, you can experience various symptoms, effects, and impairments in the days, weeks, months, or years following your injury.

Many people with TBIs also have the right to compensation for their injuries and losses. This happens when someone else’s conduct is the cause of the injury. While compensation can help you cover expenses and face the future with a TBI, it can be difficult to obtain what you deserve.

Often, TBI victims are in for a fight with one or more insurance companies, which is the last thing they should deal with. If you suffered a brain injury, seek help from an experienced Chicago TBI attorney immediately. You do not have to fight insurance companies alone, nor should you ever try.

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Accidents That Lead to Brain Injury Claims

Some brain injuries happen, and no one is to blame. However, many TBIs result from accidents due to another party’s negligence, recklessness, or intentional conduct. When you have evidence to prove that someone else should be responsible for your injuries, you can seek compensation for your losses. This is critical to your overall physical, mental, and financial recovery.

Some incidents that commonly result in TBIs include:

  • Car accidents - The impact of a crash can cause head trauma or a sharp jolt of the head, which is often enough to cause a TBI.
  • Bicycle accidents - Even with a helmet, cyclists can suffer severe head injuries if they fall from their bikes in a collision.
  • Motorcycle accidents - Motorcyclists travel much faster than bicyclists, and even the best helmets cannot protect from brain injuries 100 percent of the time.
  • Slips, trips, and falls - While a slip and fall might not seem like a serious accident, many people hit their heads and suffer TBIs when they fall.
  • Truck accidents - Large commercial trucks cause such extensive damage to smaller cars that victims often suffer head trauma.
  • Bus accidents - Bus passengers often have no restraints, so they might fall over if a bus crashes and hit their heads.
  • Pedestrian accidents - Pedestrians have the least protection of any traffic accident victims, as they do not even have a helmet like cyclists. Pedestrian traumatic brain injuries are common.

If you suffered a traumatic brain injury in one of these accidents and believe someone else was to blame, you likely have the right to compensation. Allow an injury attorney to evaluate what happened and advise of your legal options.

(Video) How Do Insurance Companies Value Traumatic Brain Injuries After a Car Accident?

Why is the Insurance Company Involved at All?

Why must you deal with insurance companies if another driver or business is responsible for your injuries? Insurance policies often cover injuries when a policyholder causes them.

This is true with:

  • Auto insurance companies covering the injuries a damage an insured driver causes
  • Property insurance companies covering injuries resulting from property-related accidents, such as slip and falls
  • Commercial insurance covering injuries due to employees who are negligent on the job, such as a commercial truck or bus driver

Many drivers do not have the assets to cover your medical bills and other losses out of their pockets. Similarly, businesses do not want to take your compensation from their bottom lines. This is why parties have insurance; the insurer should step in and cover any accident-related losses.

Never expect insurance companies to provide compensation automatically, however. This is not how the process works. Instead, you need to proactively file a claim and demand payment with the proper insurance companies, and you might file claims with more than one.

Always seek help from an injury attorney when preparing and filing your brain injury claim. They will protect your interests and fight for you throughout the claim process.

How Do You Determine What a TBI is Worth?

To ensure you receive the full compensation you need for a TBI, you must determine the value of your past and future losses. This is more complex than most people imagine, as TBIs can have wide-ranging and costly effects on your life. These effects can be economic and non-economic, and you can seek financial recovery for both types of damages.

Many TBI victims grossly underestimate the value of their losses, and insurance companies are more than happy to pay less than you deserve if you don’t put up a fight. To protect yourself and ensure you never accept less than you need, always have an injury lawyer calculate the value of your claim.

Some losses your attorney will evaluate include:

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  • Medical expenses - Anyone with head trauma or signs of a TBI should immediately get medical attention. Treatment for a brain injury will depend on its severity and might include emergency treatment, diagnostic imaging tests, hospitalization, surgeries, rehabilitative therapy, medications, and more. If your injury persists beyond your claim, you must seek compensation for your expected future medical bills.
  • Lost income - Many people with brain injuries must take time off work. Those with long-term TBI symptoms might not return to work for months, years, or ever again. Children with brain injuries might experience extreme setbacks in their education and career goals, which can decrease their lifetime income. Your lawyer can assess past and future lost earnings.
  • Pain and suffering - Brain injuries are difficult for many reasons. They can cause serious physical effects, such as headaches, seizures, sleep disorders, and more. They can also take a huge mental toll on victims, especially since they are invisible injuries many misunderstand. Losing cognitive or physical abilities can also affect a victim’s mentality, and the injury itself can result in depression, anxiety, and other types of pain and suffering. Though these are intangible losses, they are certainly compensable.
  • Permanent injuries - Some people never fully recover from a TBI and feel the cognitive, physical, and behavioral effects for the rest of their lives. They might never again work at a job they enjoyed, participate in activities they loved, or even care for themselves or remember things on a daily basis. You deserve compensation for the permanent effects of a TBI.

Because many damages from TBIs are intangible or estimated future losses, it can be quite complicated to determine how much you deserve. Leave these calculations to legal professionals who regularly represent victims of serious brain injuries.

However, just because you have accurate calculations does not mean the insurance process will go smoothly. Insurers regularly ignore the losses you claim and take steps to minimize your settlement payment for a TBI.

Insurance Companies Regularly Minimize TBI Compensation

As someone who has suffered a TBI, you should know that insurance companies regularly attempt to minimize the compensation they pay victims. In fact, TBIs often provide an opportunity for insurers to pay out much less than victims deserve because many of the effects of TBIs are invisible.

In many cases, TBI victims do not look injured, so the insurance companies do not believe they will make particularly sympathetic plaintiffs in court. As a result, they often feel more comfortable offering them much less than their cases are actually worth.

Thankfully, there are steps that you can take to ensure that you obtain the compensation you deserve after suffering a TBI. The most important of these is to retain a lawyer as soon as possible after an accident. In the meantime, you should:

Avoid Speaking With Insurance Adjusters:

Fighting the Insurance Company After a TBI (1)

Insurance adjusters work to deny claims whenever they can. If they cannot find a legitimate way to deny a claim, they will do everything possible to settle it for as little as possible.

In many cases, their tactics to minimize settlement offers take advantage of victims’ unfamiliarity with the personal injury process. For example, if the adjuster asks you how you are doing, and you reply, “fine, thanks,” they can potentially use your response to argue that you are not injured. In addition, they may even lie to you about your legal rights and wrongfully tell you that the law does not entitle you to compensation for your pain and suffering or future losses. Do not believe this.

Never Accept a First Settlement Offer Without Legal Counsel:

You should never accept a settlement offer without first talking to a lawyer about your case. Insurance companies almost always make initial lowball offers and may never offer you what your case is worth if you do not retain an attorney. Remember, the insurance company is under no obligation to make you a fair offer, and if they do not think you will file a lawsuit, they have little incentive to do so.

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A lawyer who regularly handles traumatic brain injury cases can review the facts of your case and determine how much compensation the law entitles you to. As a victim, you should keep in mind that you should recover not only compensation for your current medical expenses and lost income but also losses that occur in the future. Similarly, your non-economic losses, like your pain and suffering or lost quality of life, entitle you to compensation.

Determining the value of a traumatic brain injury claim is extraordinarily complicated. Without the assistance of a lawyer who can determine how much the at-fault party owes you, you may accept a settlement far below the actual value of your claim.

Once you accept a settlement offer, obtaining more compensation for the same injury is extremely difficult - if not impossible. As a result, it is critically important that you work with a lawyer who can get you the compensation the law entitles you after a TBI.

Hire a Brain Injury Attorney Right Away

The best thing you can do to put up a strong fight for your compensation is to have a lawyer on your side as soon as possible following your injury. You can focus on your physical healing, rest, and medical treatment. Your hired attorney can provide the legal representation you need to go up against difficult insurance companies.

Negotiations With the Insurance Company

An experienced brain injury lawyer knows how insurance companies work and what they might do to minimize your compensation. They expect a low offer at first and have the negotiation skills to fight for the higher amount you need to cover your losses.

Your lawyer can present additional evidence when necessary to support the damages you seek. They can also identify when the insurer is mishandling your claim, such as by unreasonably delaying the process or wrongfully denying your claim. They will know how to fight for you - even when the first few settlement offers seem tragically low.

What Happens if the Insurer Does Not Make a Fair Offer?

In some cases, an insurance company will never make a fair offer on a brain injury claim. This situation often calls for personal injury litigation. Your attorney can help you decide whether taking your case to court is the best path forward.

Just because you file a lawsuit does not mean your fight is over. It will continue through the various stages of litigation. Your lawyer can demonstrate that you have a strong case against the insurance company, which will be defending against your lawsuit. In many situations, the insurance company will see the evidence your attorney plans to present in court and might decide to settle. They might offer a favorable amount during pretrial litigation, which can resolve the matter without going to trial.

(Video) What Should I Do if the Insurance Company Doesn't Believe I have a Traumatic Brain Injury?

If the insurance company still does not make a fair offer, you will need to fight for your compensation in front of a judge or jury. Fortunately, the right injury attorney will have the litigation experience and skills to persuasively present your case in court.

Never Wait to Seek Legal Help from a Brain Injury Lawyer

Fighting the Insurance Company After a TBI (2)

Whether you are fighting directly with the insurance adjuster or in civil litigation, one thing is for certain. You need the right legal team to lead your battle. The insurer has an arsenal of tactics to use against you, so you need the right attorney to give you the upper hand. Consult a top rated personal injury law firm in Chicago about your case today.

Schedule a Free Initial Consultation Today!

Abels & Annes, P.C.

Address: 100 N LaSalle St #1710,
Chicago, IL 60602

Phone: (855) 529-2442

(Video) Combat the Games Insurers Play After a Kentucky Brain Injury


How much compensation do you get for TBI? ›

Your claim might be worth more or less. On average, a traumatic brain injury settlement case will exceed $100,000. Some cases can be worth significantly more. Multi-million-dollar verdicts are not unheard of in traumatic brain injury cases.

What are red flags after TBI? ›

A headache that gets worse and does not go away. Slurred speech, weakness, numbness, or decreased coordination. Repeated vomiting or nausea, convulsions or seizures (shaking or twitching). Unusual behavior, increased confusion, restlessness, or agitation.

What is the average recovery time for TBI? ›

Symptoms of Mild TBI/Concussion

The majority of patients with mild TBI have these symptoms and recover completely in a week to three months. If you are older than 40, it may take a bit longer to return to normal. Symptoms often disappear without any special treatment.

How do you get 70 percent for a TBI? ›

A Veteran whose highest rating is a 3 in the neurobehavioral effects category because they have one or more behaviors that interfere with workplace or social interaction will receive a 70% disability rating for their TBI.

Is TBI a permanent disability? ›

Suffering a TBI can lead to physical and/or cognitive difficulties requiring intense rehabilitative care. Even with intensive treatment, a traumatic brain injury may cause residual symptoms severe enough to cause a permanent disability.

Does traumatic brain injury show up on MRI? ›

Diagnosing brain injuries, however, can be complicated. About 80 percent of TBIs cannot be seen on an MRI or CT scan. The only other way to discover a TBI used to be neuropsychological or psychological testing - a fancy way of saying doctors ask patients questions or give them tasks to complete.

What are 3 signs of traumatic brain injury? ›

Symptoms of Moderate or Severe TBI
  • Headache that gets worse or will not go away.
  • Loss of vision in one or both eyes.
  • Repeated vomiting or continued nausea.
  • Slurred speech.
  • Convulsions or seizures.
  • An inability to wake up from sleep.
  • Enlargement of the pupil (dark center) of one or both eyes.
Nov 24, 2020

What are the four criteria to diagnose TBI? ›

mTBI diagnostic criteria range from observations relating to one or more of the common four factors (neuroimaging, loss of consciousness, posttraumatic amnesia, and the Glascow Coma Scale score) to the use of symptom checklists or some combination of these.

Does TBI get worse with age? ›

The short answer is: yes, it can. Every brain injury is different and even though many secondary effects of a brain injury improve with time, others may linger and interfere with rehabilitation.

What organ fails after TBI? ›

Acute kidney injury (AKI) is a common organ injury after multiple critical illness paradigms, including TBI. The incidence of AKI after TBI has been reported between 8% and 14%. In addition, the development of AKI has consistently been associated with worse clinical and functional outcomes after TBI.

Does brain fully heal after TBI? ›

And the answer is yes. The brain is incredibly resilient and possesses the ability to repair itself through the process of neuroplasticity. This phenomenon is the reason why many brain injury survivors can make astounding recoveries.

Do people with TBI go back to normal? ›

The prognosis for mild TBI is usually better than for a moderate TBI, and the prognosis for moderate TBI is usually better than for a severe TBI. With a concussion (mild TBI), most people recover most or all of their brain function within 3 months following injury, with most recovering sooner.

Can you be normal again after a TBI? ›

Therefore, a full and functional TBI recovery is almost always possible, even though it might take several years of dedication. But in order to make this type of progress, you must take initiative. In fact, without consistent work, brain injury recovery can stall and even regress.

Can you go back to normal after TBI? ›

Many people (but not all with a disorder of consciousness related to a TBI) will eventually regain consciousness. The following are some important facts to keep in mind about recovery from a disorder of consciousness caused by a severe TBI. Recovery usually follows a step-by-step path.

What score would give a severe TBI? ›

The Glasgow Coma Scale (GCS) classifies Traumatic Brain Injuries (TBI) as Mild (14–15); Moderate (9–13) or Severe (3–8).

How does a TBI limit your ability to work? ›

Limitations for Specific Jobs

Your limitations from a traumatic brain injury can be extensive. If you suffer memory loss or have difficulty concentrating, you may find that being able to work in an office setting, maintain records, or work in customer service would be impossible.

Is it hard to get disability for a TBI? ›

An applicant with mild TBI usually does not qualify for SSDI benefits, but people who have suffered mild TBIs may be approved for disability under a medical-vocational allowance.

Does a TBI reduce life expectancy? ›

They also found that on average, TBI appears to reduce life expectancy by about 8 years.

What are long-term outcomes after TBI? ›

“Trauma to the left side of your brain can cause problems with logic, speech difficulties, trouble understanding others or talking, versus right side injury, which can cause problems processing visual information, neglect, or apraxia - the ability to perform regular or familiar tasks.

What is the lifetime cost of TBI? ›

Lifetime Cost of Brain Injury

While costs vary according to the extent of the injury and its specific long-term effects, it is estimated that the cost of caring for a survivor of severe traumatic brain injury is between $600,000 and $1,875,000 over a lifetime.

Can TBI affect you years later? ›

One thing we know for sure: people with moderate or severe TBI have multiple physical problems that can last for years. In fact, at least one-fifth of those with more severe injuries have reported difficulties with their physical health—in some cases decades later.

What is the difference between brain injury and traumatic brain injury? ›

You may wonder what the difference between brain damage and traumatic brain injury is. Brain damage usually is non-traumatic, while traumatic brain injury (TBI) is the result of a blow to the head, often in an accident with negligence.

Does traumatic brain injury affect memory? ›

Memory impairment is a common complaint following traumatic brain injury (TBI)2,25,37) and is frequently associated with medial temporal or diencephalic pathology. Damage to these structures usually leads to anterograde amnesia and characteristic impairments in recall and recognition1).

What part of the brain are affected most in a TBI? ›

Cerebral Cortex TBI

As the outermost portion of the brain, the cerebral cortex is one of the most common parts of the brain impacted by TBI. The cerebral cortex is essential for more advanced functions, including thought processes, reasoning, language, emotions, behaviors, movements and sensations.

What are the five cognitive problems of TBI? ›

After a TBI it is common for people to have problems with attention, con- centration, speech and language, learning and memory, reasoning, planning and problem-solving.

What are the four main types of mental health problems after a TBI? ›

There is a well-documented association between TBI and behavioral health comorbidities, including depression, anxiety, suicide, and substance use disorders.

What is the gold standard for diagnosing TBI? ›

Brain CT is the gold standard in the diagnosis of traumatic brain injury. This is an easy technique to perform, which can help accurately diagnose intracranial bleeding (epidural hematoma, subdural hematoma, subarachnoid hemorrhage, cerebral hemorrhage), brain parenchymal contusion and cubital fracture.

What is the best test for TBI? ›

Diagnosis of TBI

Assessment usually includes a neurological exam. This exam evaluates thinking, motor function (movement), sensory function, coordination, eye movement, and reflexes. Imaging tests, including CT scans and MRI scans, cannot detect all TBIs.

What is considered a mild TBI? ›

Most TBIs that occur each year are mild TBIs or concussions. A mild TBI or concussion is caused by: A bump, blow, or jolt to the head, or. By a hit to the body that causes the head and brain to move quickly back and forth.

What are the facial changes after brain injury? ›

Some people with a brain injury acquire a condition known as prosopagnosia (pronounced pro-so-pag-no-sia), or 'face blindness'. People with the condition cannot tell the difference between faces, an ability most of us take for granted.

What is the most common and long lasting effect of TBI? ›

Anxiety and depression are common. Personality (mood) changes, mood swings, and difficulty controlling impulses can also be an issue. The challenges associated with life after a TBI and the emotional and personality changes that sometimes go along with it can also contribute to relationship difficulties.

How can I improve my brain function after TBI? ›

Focus on one task at a time. Break large or complex tasks into smaller tasks. Practice attention skills on simple but practical activities (such as reading a paragraph or adding numbers) in a quiet room. Gradually make tasks harder.

What makes the TBI symptoms worse? ›

Some examples of detrimental changes that can aggravate the initial TBI include reduced blood flow and coagulopathy problems. Additionally, delayed and improper medical treatment can also contribute to the worsening of a TBI.

What is the most common cause of death after TBI? ›

Falls lead to nearly half of the TBI-related hospitalizations. Firearm-related suicide is the most common cause of TBI-related deaths in the United States.

What is the fastest recovery from TBI? ›

3-6 Months Post-TBI: Fastest Recovery Occurs

During the first six months after a TBI, the brain is in a heightened state of plasticity, or healing. This explains why the greatest gains in TBI recovery will usually occur within the first 3-6 months of therapy.

Can you live a full life after a TBI? ›

These changes may affect a person's ability to function in their everyday life. Despite initial hospitalization and inpatient rehabilitation services, about 50% of people with TBI will experience further decline in their daily lives or die within 5 years of their injury.

How long does it take brain to rewire after a brain injury? ›

The first six months is generally when you will see the most improvement after an injury, and then patients continue to progress for another several years. After this, progress tends to slow. This is because the damage remains, but the severe symptoms (like bleeding and swelling) have receeded.

How does TBI affect relationships? ›

Couples may feel they no longer understand what their partner is thinking or feeling. Difficulty communicating can sometimes cause people to pull away from their relationship, choosing instead to handle challenges with friends or other family members.

What is the average TBI recovery time? ›

Symptoms of Mild TBI/Concussion

The majority of patients with mild TBI have these symptoms and recover completely in a week to three months. If you are older than 40, it may take a bit longer to return to normal. Symptoms often disappear without any special treatment.

How long does it take to fully recover from a severe TBI? ›

In fact, depending on the severity of the injury, recovery time for a TBI may vary from a few weeks to six or more months. Each person reacts differently to injury and illness. Thus, recovery time will vary between individuals. However, the length of recovery time for TBI depends on how long a patient is unconscious.

Is a TBI a permanent injury? ›

Some types of TBI can cause temporary or short-term problems with normal brain function, including problems with how the person thinks, understands, moves, communicates, and acts. More serious TBI can lead to severe and permanent disability, and even death.

What is good for TBI recovery? ›

Get plenty of sleep at night, and rest during the day. Avoid activities that are physically demanding (e.g., heavy houscleaning, weightlifting/working-out) or require a lot of concentration (e.g., balancing your checkbook).

Are personality changes after a TBI permanent? ›

People with a severe TBI are more likely to have behavior changes that last for a while. The good news is that behavior changes can get better as time passes.

Can you get compensation for TBI and PTSD? ›

Veterans with TBI and PTSD caused by military services are eligible for disability payments from the VA if the conditions are service-connected. They may also be eligible for special monthly compensation in addition. Learn more about how the VA addresses paying benefits to veterans with multiple diagnoses.

What is the disability rating for mild TBI? ›

Under each of these categories, the VA rates the severity of impairment caused by the TBI residual on a scale of 0 to 3. Each rating corresponds to a disability percentage rating: 0 = 0% (normal functioning) 1 = 10% (mild)

Can people with a TBI make a full recovery? ›

Therefore, a full and functional TBI recovery is almost always possible, even though it might take several years of dedication. But in order to make this type of progress, you must take initiative. In fact, without consistent work, brain injury recovery can stall and even regress.

What is the most common impairment in TBI? ›

Attention and memory deficits are the most common cognitive difficulties reported by patients and their families after the TBI. This could be due to primary brain damage or due to secondary factors such as sleep disturbance.

What are TBI residuals? ›

TBI residuals are the resulting disabling effects beyond those that follow immediately from the TBI event. VA will assess your injury based on the residual symptoms that you currently have as the result of the trauma.

Are mild TBI permanent? ›

Over 80 percent of patients with mild traumatic brain injury will recover quickly and fully with no long-term effects. Less than 20 percent of patients may have some longer lasting, or even permanent, symptoms. Persistent headaches, memory loss, anxiety, and depression are the most common lasting problems.

Does mild TBI affect life expectancy? ›

They also found that on average, TBI appears to reduce life expectancy by about 8 years.

Is TBI a physical or mental disability? ›

Most TBI patients have emotional or behavioral problems that fit under the broad category of psychiatric health. Family members of TBI patients often find that personality changes and behavioral problems are the most difficult disabilities to handle.

What should I avoid after TBI? ›

Avoid activities that are physically demanding (e.g., heavy houscleaning, weightlifting/working-out) or require a lot of concentration (e.g., balancing your checkbook). They can make your symptoms worse and slow your recovery.

Can MRI show old brain injury? ›

An MRI can see subarachnoids hemorrhages, bleeding in the brain, old parts of brain damage that where parts of the brain have basically form scarring. That will show up on an MRI often.


1. Warning: What NOT to Say To The Insurance Company After a Car Accident
(NOVA Injury Law)
2. CASE SPOTLIGHT: Settlement of a Mild Brain Injury Case
(Jim Higgins)
3. Traumatic Brain Injury - Bek's Battle
(Mary Free Bed Rehabilitation Hospital)
4. She Didn't Make Any Sense After Traumatic Brain Injury
5. How Much Is a Traumatic Brain Injury Worth in a Personal Injury Case?
(RSH Legal)
6. Suing For A TBI? Know These Facts!
(The Ernst Law Group)


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