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After an accident, one of the first questions you may have is whether you should file an insurance claim or pursue a personal injury lawsuit. While these terms are often used interchangeably, they are two different legal processes. Understanding the difference can help you make informed decisions, avoid costly mistakes, and protect your right to recover the compensation you deserve.
In Illinois, most personal injury cases begin with an insurance claim. However, when the insurance company refuses to offer fair compensation, filing a lawsuit may become necessary to protect your rights.
At Conboy Law, we help injury victims throughout Illinois understand their legal options and pursue the best path forward. Whether your case can be resolved through an insurance settlement or requires filing a lawsuit, our experienced attorneys are prepared to fight for the maximum compensation available.
What Is an Insurance Claim?
An insurance claim is a formal request for compensation after an accident or injury. In a personal injury case, it asks the at-fault party's insurance company to pay for losses such as medical expenses, lost wages, property damage, and pain and suffering.
For most injury victims, filing an insurance claim is the first step toward recovering compensation. It allows the insurance company to investigate the accident, determine liability, and negotiate a settlement before a lawsuit becomes necessary.
While many claims are resolved through settlement, others are denied, delayed, or undervalued, making further legal action the best option.
How Does an Insurance Claim Work?
Most personal injury claims follow a similar process, although the exact timeline varies depending on the facts of the case.
In general, the process includes the following steps:
- Report the Accident: Notify the appropriate insurance company as soon as possible after the accident and provide basic details about what happened.
- File the Insurance Claim: Submit your claim along with any supporting documentation, such as medical records, accident reports, photographs, and witness information.
- Insurance Company Investigation: An insurance adjuster reviews the evidence, investigates liability, and evaluates the extent of your injuries and damages.
- Settlement Negotiations: If the insurer accepts liability, it may make a settlement offer. Your attorney can negotiate for compensation that fully reflects your medical expenses, lost wages, pain and suffering, and other losses.
- Claim Resolution or Lawsuit: If a fair settlement is reached, your claim is resolved. If the insurance company denies your claim or refuses to offer reasonable compensation, filing a personal injury lawsuit may be the next step.
What Types of Compensation Can an Insurance Claim Cover?
Depending on the circumstances of your case, an insurance claim may provide compensation for:
- Medical expenses
- Future medical treatment
- Lost wages
- Loss of future earning capacity
- Property damage
- Pain and suffering
- Other accident-related losses
Every case is different. The value of your claim depends on the severity of your injuries, available insurance coverage, and the evidence supporting your losses.
Why Do Insurance Companies Deny or Undervalue Claims?
Insurance companies are businesses, and their goal is often to limit how much they pay on claims.
Some of the most common reasons claims are denied or undervalued include:
- Disputing who caused the accident
- Arguing that your injuries were pre-existing
- Claiming there is insufficient evidence
- Questioning the necessity of your medical treatment
- Offering a settlement before the full extent of your injuries is known
An experienced personal injury lawyer can challenge these tactics and negotiate for the compensation you deserve.
What Is a Personal Injury Lawsuit?
A personal injury lawsuit is a civil action filed against the person, business, or other party responsible for causing your injuries.
Unlike an insurance claim, which is handled through negotiations with an insurance company, a lawsuit asks the court to resolve the dispute when a fair settlement cannot be reached.
Filing a lawsuit does not necessarily mean your case will go to trial. In fact, many lawsuits settle before reaching a courtroom. However, filing suit often strengthens your position because it demonstrates that you are prepared to pursue your claim through the legal system if necessary.
When Should You File a Personal Injury Lawsuit?
A lawsuit may be appropriate when:
- The insurance company denies your claim.
- Liability is disputed.
- The settlement offer does not fully compensate you for your losses.
- Negotiations have reached a standstill.
- The statute of limitations is approaching.
What Happens After a Lawsuit Is Filed?
Once a lawsuit is filed, both sides begin gathering evidence through a process known as discovery. This stage may include exchanging documents, answering written questions, taking depositions, consulting expert witnesses, and continuing settlement negotiations.
If the parties still cannot reach an agreement, the case proceeds to trial, where a judge or jury determines liability and damages.
Does Every Personal Injury Lawsuit Go to Trial?
No. Most personal injury lawsuits are resolved before trial through negotiated settlements.
According to the Bureau of Justice Statistics, only about 3% of general civil cases filed in state courts are resolved through a bench or jury trial. Most cases are resolved before trial through settlement, dismissal, or other means. This means that even after a lawsuit is filed, there is still a strong possibility that the parties will reach an agreement before the case is heard in court.
Even after a lawsuit is filed, the parties can continue discussing settlement until a final decision is reached. If the insurance company refuses to offer fair compensation, however, going to trial may be the best way to protect your rights.
Claim vs. Lawsuit: Key Differences
The main difference between an insurance claim and a lawsuit is where compensation is sought. An insurance claim is handled through the insurance company and may result in a negotiated settlement. A lawsuit is filed in court when a fair settlement cannot be reached and asks a judge or jury to decide the case.
| Feature | Insurance Claim | Personal Injury Lawsuit |
| Purpose | Seek compensation from an insurance company. | Ask the court to award compensation when a claim cannot be resolved. |
| Who Handles It? | Insurance adjusters and claims representatives. | A judge or jury if the case goes to trial. |
| Where It Happens | Outside of court through settlement negotiations. | In Illinois civil court. |
| Timeline | Often resolved in weeks or months. | May take several months or longer depending on the case. |
| Cost | Usually handled on a contingency fee with no upfront attorney's fees. | Also commonly handled on a contingency fee basis. |
| Outcome | Settlement or claim denial. | Settlement or a court judgment. |
Can You File a Lawsuit Without Filing an Insurance Claim First?
In many personal injury cases, filing an insurance claim is the first step because it gives the insurance company an opportunity to investigate the accident and resolve the matter through settlement.
However, there are situations where filing a lawsuit may be appropriate without waiting for the insurance claims process to conclude. For example, legal action may be necessary if liability is clearly disputed, the insurance company refuses to communicate in good faith, or the statute of limitations is approaching.
An experienced personal injury attorney can evaluate your case and recommend the strategy that best protects your rights.
What Evidence Do You Need for a Claim or Lawsuit?
Whether you are pursuing an insurance claim or a personal injury lawsuit, strong evidence is essential to proving liability and recovering fair compensation. The stronger your evidence, the stronger your insurance claim or lawsuit becomes.
Medical Records
Medical records document the nature and extent of your injuries, the treatment you received, and your expected recovery. They also help establish a connection between the accident and your damages.
Accident Reports
Police reports, workplace incident reports, or other official records often provide important details about how the accident occurred and who may have been at fault.
Photographs and Videos
Pictures of the accident scene, vehicle damage, hazardous conditions, and visible injuries can help preserve important evidence before it disappears.
Witness Statements
Independent witnesses may provide valuable testimony about how the accident happened and support your version of events.
Expert Testimony
Medical professionals, accident reconstruction specialists, vocational experts, and economists may provide opinions regarding liability, future medical care, lost earning capacity, and other important issues.
How Long Do You Have to File a Personal Injury Lawsuit in Illinois?
Illinois law generally gives injured victims two years from the date of the injury to file most personal injury lawsuits under 735 ILCS 5/13-202. Missing this deadline may prevent you from recovering compensation, regardless of the strength of your case.
Although insurance companies often require claims to be reported much sooner than the legal filing deadline, submitting an insurance claim does not extend the statute of limitations. If negotiations continue for too long, you could lose your right to file a lawsuit.
Waiting too long can make it harder to collect evidence and locate witnesses, even if you are still within the legal deadline.
Should You Accept an Insurance Settlement or File a Lawsuit?
Every case is unique, and the right decision depends on the circumstances surrounding your accident, the severity of your injuries, and the compensation being offered.
Never accept a settlement until you understand the full extent of your injuries and how accepting an offer may affect your right to seek additional compensation.
When Accepting a Settlement May Make Sense
A settlement may be appropriate when the insurance company accepts liability and offers compensation that fairly covers your medical expenses, lost income, pain and suffering, and other damages. Settlements can often resolve cases more quickly while avoiding the uncertainty of litigation.
When Filing a Lawsuit May Be the Better Option
A lawsuit may be necessary if the insurance company denies liability, disputes your injuries, refuses to negotiate fairly, or offers substantially less than your claim is worth. Filing a lawsuit allows you to pursue compensation through the court system while continuing settlement discussions.
How a Personal Injury Lawyer Can Help
Choosing between accepting a settlement and filing a lawsuit is an important decision. An experienced attorney can evaluate the value of your claim, negotiate with the insurance company, explain your legal options, and recommend the strategy that best protects your interests.
Contact Our Personal Injury Lawyers at Conboy Law for a Free Consultation
Dealing with an insurance company after an accident isn't always straightforward. While some cases can be resolved through a fair settlement, others require filing a lawsuit to recover the compensation you deserve. Knowing which path is right for your situation can make a significant difference in the outcome of your case.
At Conboy Law, we don't let insurance companies dictate the value of our clients' claims. Whether you're filing an insurance claim for the first time or considering a personal injury lawsuit, our experienced attorneys are ready to protect your rights and fight for the maximum compensation available.
Call (312) 376-4291 today for a free consultation.
