Insurance claim
- Starts with a call or form to the insurer
- An adjuster reviews records and makes offers
- Informal, with no court fees
- Can end in payment, denial or settlement
Claims process
Insurance claim vs lawsuit
Almost every injury case starts as an insurance claim. A lawsuit comes in when the insurer won't pay fairly, won't accept fault, or a filing deadline is getting close.
The short answer
Start with an insurance claim. It is quicker and cheaper, and most injury claims settle there. File a lawsuit when the insurer denies liability, makes an offer that ignores your evidence, or your limitation period is running out. Filing doesn't mean you'll end up in a courtroom: most lawsuits still settle, but filing protects your right to recover and gives you tools like discovery.
At a glance
Lawsuit
- Starts with a formal court filing against the at-fault person
- Uses pleadings, discovery, motions and possibly trial
- Strict court deadlines and evidence rules
- Can still settle at any point
| What differs | Insurance claim | Lawsuit |
|---|---|---|
| When it fits | Clear fault and modest, well-documented losses | Disputed fault, low offers, serious injury or a looming deadline |
| Who you deal with | An insurance adjuster | The insurer's lawyers, and ultimately a judge or jury |
| Getting information | Only what the insurer chooses to share | Discovery forces both sides to disclose evidence |
| Cost and effort | Low at the start | Higher: filing fees, experts, more of your time |
| Deadlines | Policy notice rules; negotiating doesn't stop the limitation clock | Must be filed before the limitation period ends |
| Outcome | Payment, denial or negotiated settlement | Settlement, judgment or dismissal |
Signs it may be time to file
- Your deadline is close. Most US states give two or three years for injury claims. In England and Wales it is usually three years from the accident or from when you knew about the injury. Many Canadian provinces, including Ontario and British Columbia, allow two years. Talking to the insurer does not pause any of these.
- Fault is denied. If the insurer says its driver wasn't responsible, negotiation often stalls until a lawsuit puts evidence in front of a court.
- The offer ignores your evidence. A figure that leaves out future treatment or lost earning capacity may only move when the insurer faces trial costs.
- You need evidence the other side holds. Vehicle data, company records or phone records often only come out through discovery.
- Your losses may exceed the policy limits. You may need to pursue the at-fault person or other parties directly.
What changes once you sue
In the US, your lawyer files a complaint and the defendant's insurer appoints lawyers to defend it. The adjuster is still involved, but the process now runs on court deadlines. Expect written questions, a deposition where you answer questions under oath, and possibly an independent medical examination. Many courts also require mediation before trial.
In England and Wales, you must first follow the Pre-Action Protocol for Personal Injury Claims. You send a letter of claim, the defendant usually has 21 days to acknowledge it and three months to investigate and say whether it accepts liability. Court proceedings generally come after that, unless a deadline forces you to issue sooner. Canadian provinces have their own court rules, with similar stages of pleadings, document exchange and examinations for discovery.
Example
A delivery driver injured in a junction crash negotiates with the other driver's insurer for 20 months. The insurer keeps asking for more records and hasn't made an offer. With the limitation period four months away, her lawyer files suit to protect the claim. Within weeks, defence lawyers are appointed and a first offer arrives.
Common questions
Should I sue or just file an insurance claim?
Start with the claim. Most injury cases settle through the insurer. A lawsuit makes sense when the insurer disputes fault, stalls, makes an unreasonable offer or your filing deadline is approaching.
Does negotiating with the insurer stop the statute of limitations?
No. The limitation clock usually keeps running while you negotiate. If the deadline passes before you file, you normally lose the right to sue, however strong your case.
Can I sue if the insurance company denies my claim?
Usually yes, but in a claim against another driver you normally sue the driver, not their insurer. The insurer then defends the case. If your own insurer unfairly denies a claim under your policy, you may have a separate claim against it, including for bad faith in some places.
Does filing a lawsuit mean my case will go to trial?
No. Most lawsuits settle before trial, often after discovery or mediation. Filing mainly protects your deadline and puts pressure on the other side.
Last reviewed September 2026. General information, not legal advice.