Claim vs. Lawsuit: What’s the Difference in florida?

Short answer: A claim is a demand for payment you make to an insurance company outside of court. A lawsuit is a case you file in civil court when a claim does not produce a fair result. In Florida, most injury lawsuits must be filed within two years of the accident, and negotiating a claim does not stop that deadline.

It is common to see the terms ‘claim’ and ‘lawsuit’ used interchangeably in personal injury cases. However, these are two different forms of legal action to recover compensation after an accident. 

If you’re wondering whether to file a claim or a lawsuit after your injury, make sure you speak to an experienced attorney at Perenich Caulfield, Avril & Noyes: (727) 591-3354.

What Are Claims?

The first thing most people do after an accident is file a claim. A claim is a demand to an insurance company to cover the costs of an accident, usually because someone it insures is responsible for the accident. Claims are made outside of court, and a variety of people can be involved in the claims process. 

Examples of claims include:

• Automobile insurance claim after a car accident
• Property insurance claim for house damage after a storm or hurricane 
• Business liability insurance claim after a slip and fall
• Medical malpractice insurance claim after a medical error

An insurance company can assign an adjuster, an attorney, and other negotiators to deal with a claim. 

The adjuster will examine the reasons and basis for a claim and determine the appropriate compensation level for the claimant, if any. The final decision to accept, deny, or negotiate a claim belongs to the insurance company, not the claimant.

How Florida’s No-Fault Law Affects Car Accident Claims

After a Florida car accident, your first claim is usually with your own insurer. Florida still requires Personal Injury Protection (PIP) coverage, which pays part of your medical bills and lost wages no matter who caused the crash. To bring a claim or lawsuit against the at-fault driver for pain and suffering, your injury generally has to meet Florida’s serious injury threshold, such as a permanent injury or significant scarring [ATTORNEY TO CONFIRM WORDING UNDER F.S. §627.737]. Read more about PIP and no-fault vs. at-fault insurance.

Why You Should or Shouldn’t File a Claim

If the cause of your accident is obvious, it might be more beneficial to file a claim as opposed to a lawsuit. You can often recover fair compensation for your injuries and damages through an insurance claim.

It can be beneficial to file a claim to:

• Save potential court fees and costs
• Save potential attorney fees
• Recover compensation more quickly

It can be beneficial to file a lawsuit instead of a claim to:

• Force an insurance company into settlement negotiations
• Collect more evidence about the cause and circumstances of your accident
• Have your case decided by a judge or jury instead of an insurance company
• Protect your rights when the two-year filing deadline is approaching

Each case has its own strengths and weaknesses. Some legal actions may fare better as an insurance claim. Others will find more success in a lawsuit. A personal injury lawyer can help you evaluate your case to determine your best chances of recovering compensation after your accident.

If a claim doesn’t result in fair compensation, the next step is usually a lawsuit. A lawsuit is a legal action to resolve a dispute between a plaintiff and a defendant. To win your personal injury lawsuit, you will have to prove to the court that the defendant injured you through negligence or carelessness.

Lawsuits can take a long time, often more than a year, before they are completed. They involve discovery, motions, hearings, trials, and possible appeals. These processes can be extremely time-intensive and expensive.

Florida Rules That Affect When You Should File Suit

• Two-year deadline. For accidents on or after March 24, 2023, most Florida negligence lawsuits must be filed within two years. Ongoing settlement talks with an insurer do not pause that deadline, so waiting on a slow claim can cost you the right to sue. How long do I have to file?
• Modified comparative negligence. If a judge or jury finds you more than 50% at fault, you recover nothing. Insurers use this rule during claim negotiations to push fault onto you, which is one reason cases end up in court. Learn about contributory fault in Florida

Why You Should or Shouldn’t File a Lawsuit

Often, injury victims will file a lawsuit after an unsuccessful insurance claim. Sometimes, an insurance company won’t accept responsibility for a victim’s damages. Or it may undervalue the victim’s claim. Lawsuits arise after negotiations break down in these and other ways.

Some advantages you have when filing a lawsuit instead of a claim include:

• The case is given to a third-party judge or jury and is taken away from the insurance company
• The potential damages are higher in lawsuits
• Non-economic and punitive damages are more common in lawsuits

Some advantages you have when filing a claim instead of a lawsuit include:

• Your claim expenses are typically lower than they would be for a lawsuit
• You know the exact outcome before you agree to it
• A claim will take less time to complete

Insurance claims are limited to policy limits and terms. For example, after a car accident, you may be able to recover some (but not all) of your medical expenses and lost wages related to your injuries. A lawsuit may allow you to recover all your damages, both economic and non-economic, if you can prove your case.

Moreover, insurance companies don’t have to work with you if they don’t believe your claim is legitimate. If you file a lawsuit, then an insurance company has to respond, or else they will lose the case by default.

Filing a lawsuit does not mean your case will go to trial. Most lawsuits still settle, and filing often moves negotiations forward. Our attorneys prepare every case as if it will go to trial, which strengthens our position when we negotiate.

How An Attorney Can Help Your Claim or Lawsuit

Although you can represent yourself in a claim or lawsuit, an experienced personal injury attorney can be a great asset in both legal actions. 

Your attorney can:

• Evaluate the strength of your case
• Investigate to gather evidence and identify liable parties
• Calculate how much your case is worth
• Discuss a general strategy to get your maximum compensation

Insurance companies will likely take your claim more seriously if you have an attorney. Your attorney will negotiate with the insurance adjuster for a settlement that compensates you for your damages fully. If negotiations break down, your attorney can file a lawsuit to recover the compensation you deserve after your accident. Two of our attorneys, Bryan D. Caulfield and Lorraine E. Robinson, are Board Certified in Civil Trial Law by The Florida Bar.

If you’ve been injured, contact our law office at (727) 591-3354 to discuss your case.