Hiring an Attorney for Insurance Claim: A Complete Guide
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When to Hire an Attorney for an Insurance Claim

An attorney hired for an insurance claim reviews documents at a desk with scales of justice.

After an accident, you quickly realize you’re not just dealing with a simple claim; you’re up against a massive corporation. Insurance companies have teams of adjusters and lawyers whose main job is to protect the company’s profits, not your well-being. This creates a huge power imbalance, leaving you feeling overwhelmed and at a serious disadvantage. They know the rules of the game because they wrote them. This is precisely why the decision of hiring an attorney for an insurance claim is so critical. It’s not about starting a fight; it’s about leveling the playing field and ensuring your voice is heard and your rights are protected.

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Key Takeaways

  • Know when to call for backup: While you can manage a simple claim yourself, it’s time to hire an attorney if the insurer denies your claim, makes a lowball offer, or you’ve sustained serious injuries. A lawyer steps in to protect your rights when the stakes get high.
  • An attorney’s value goes beyond legal knowledge: They act as your dedicated negotiator, shielding you from the insurance company’s tactics. By handling the complex legal work and communication, they allow you to focus on your recovery while they fight to maximize your compensation.
  • Hiring an expert is more accessible than you think: Don’t let cost be a barrier; most personal injury lawyers work on a contingency fee, meaning you pay nothing unless you win. Use free consultations to interview several attorneys and find a specialist you feel confident and comfortable with.

When Should You Hire an Attorney for an Insurance Claim?

After an accident, dealing with an insurance claim can feel like a full-time job you never asked for. While you might handle a minor fender-bender on your own, certain situations are clear signals that it’s time to get professional legal help. Insurance companies are businesses focused on their bottom line, which often means paying out as little as possible. If you find yourself in any of the following scenarios, having an experienced attorney on your side can make all the difference in protecting your rights and securing the compensation you deserve.

The Insurance Company Denied or Delayed Your Claim

It’s incredibly frustrating when an insurance company you’ve paid premiums to suddenly denies your claim or drags its feet without a clear explanation. These delays and denials are often tactics used to discourage you until you give up. If your insurer isn’t honoring your policy or is giving you the runaround, it’s a major red flag. An attorney can step in to demand answers, challenge an unfair denial, and hold the company accountable. They understand the laws surrounding insurance bad faith and can pressure the insurer to process your claim fairly and promptly. You shouldn’t have to fight this battle alone.

You Received a Lowball Settlement Offer

The first settlement offer from an insurance adjuster is almost never their best one. It’s typically a lowball amount meant to close your case quickly and cheaply. Adjusters know that you’re likely stressed about medical bills and lost wages, and they hope you’ll take the fast cash without realizing what your claim is truly worth. Research has shown that accident victims who work with an attorney often recover significantly more compensation. A skilled lawyer knows how to accurately calculate the value of your claim, including future medical costs and pain and suffering, and will negotiate aggressively for a fair settlement.

The Policy Language is Confusing

Insurance policies are dense legal documents filled with complex jargon, exclusions, and conditions. They are written by lawyers to protect the insurance company’s interests, not to be easily understood by the average person. Trying to decipher the “Declarations Page,” “Endorsements,” and other sections on your own can be overwhelming and may lead you to mistakenly believe you aren’t covered. An attorney can review your policy, interpret the complicated language, and explain your rights in plain English. This ensures you don’t leave money on the table simply because you didn’t understand the fine print.

You Suffered a Serious Injury or Major Property Damage

If your accident resulted in serious injuries like broken bones, a traumatic brain injury, or spinal cord damage, the stakes are incredibly high. Your claim will involve extensive medical records, future treatment costs, lost earning capacity, and significant pain and suffering. These complex, high-value claims are the ones insurance companies fight the hardest to minimize. Hiring an experienced personal injury lawyer is crucial in these situations. They can manage the entire legal process, gather the necessary evidence, and build a powerful case while you focus on your physical and emotional recovery.

You Suspect the Insurer is Acting in Bad Faith

Insurance companies have a legal duty to act in “good faith,” meaning they must treat you fairly and honestly. If you feel the adjuster is misrepresenting the policy, refusing to conduct a proper investigation, or using threatening tactics, they may be acting in bad faith. These unfair practices are illegal, but they can be difficult to prove without legal expertise. If your gut tells you something is wrong with how the insurance company is handling your claim, it’s time to speak with an attorney. They can identify bad faith practices and take legal action to protect you from being taken advantage of.

How an Attorney Can Help With Your Insurance Claim

After an accident, the last thing you want is a battle with an insurance company. But their goal is to protect their bottom line, not necessarily to give you the full amount you deserve. Bringing in a personal injury attorney changes the dynamic entirely. They become your advocate, handling the complexities of your claim so you can focus on your recovery. A lawyer works to ensure your rights are protected and that you are treated fairly throughout the entire process. From negotiating on your behalf to managing deadlines, their support can be invaluable when you need it most.

They Handle Negotiations with the Insurance Company

Insurance adjusters are trained negotiators whose job is to settle claims for the lowest possible amount. Going up against them alone can feel intimidating and overwhelming. An experienced attorney levels the playing field. They take over all communication with the insurance company, presenting your case in the strongest possible terms. Having a lawyer shows the insurer you are serious about your claim and won’t be pushed into accepting an unfair offer. An attorney can help you get the respect and claim results you deserve, managing the back-and-forth so you don’t have to.

They Understand Complex Insurance Laws

Insurance policies are dense, complicated contracts filled with legal jargon and confusing clauses. On top of that, California has specific laws that govern how insurance claims must be handled. A personal injury attorney is an expert in this area. They can interpret your policy, identify all potential sources of coverage, and make sure the insurance company is following the law. A lawyer will present your best case and make sense of the complexities of insurance law on your behalf, ensuring your claim is built on a solid legal foundation and that no detail is overlooked.

They Fight to Maximize Your Settlement

One of the most significant ways an attorney can help is by fighting for the maximum compensation you are owed. They know how to accurately calculate the full value of your claim, including medical bills, lost wages, future expenses, and pain and suffering. Research from the Insurance Research Council found that, on average, personal injury victims who hired a lawyer received settlements that were 3.5 times larger than those who handled their claims alone. Your attorney will gather the evidence needed to justify a higher settlement and won’t back down until a fair offer is on the table.

They Manage All Paperwork and Deadlines

An insurance claim involves a mountain of paperwork, from initial reports and medical records to formal demand letters. Missing a single deadline or filling out a form incorrectly can jeopardize your entire claim. When you hire an attorney, they take this burden off your shoulders. They will handle all the necessary paperwork, gather evidence, and ensure that every deadline is met, which is absolutely crucial for a successful outcome. This frees you up to concentrate on what matters most: your health and your family.

They Protect You from Unfair Practices

Insurance companies sometimes use tactics to delay, devalue, or deny valid claims. They might ask for a recorded statement to use your words against you, misrepresent the terms of your policy, or pressure you into a quick, lowball settlement. An experienced personal injury lawyer knows how to spot and counter these strategies. They act as a shield, protecting you from unfair practices and ensuring the insurer acts in good faith. This support alleviates the burden of dealing with the insurance company directly and gives you peace of mind knowing a professional is safeguarding your interests.

What Types of Insurance Claims Do Attorneys Handle?

Personal injury attorneys are equipped to handle a wide variety of disputes with insurance companies. While car accidents are the most common, a skilled lawyer can step in whenever an insurer isn’t treating you fairly, regardless of the policy type. If you’re facing a denied claim, a low settlement offer, or confusing policy terms, legal support can make all the difference. An attorney acts as your advocate, ensuring your rights are protected and that you are positioned to receive the compensation you’re owed. They understand the tactics insurers use to minimize payouts and can build a strong case on your behalf. Here are some of the key types of insurance claims an attorney can help you with.

Auto Accident Claims

This is one of the most frequent reasons people seek legal help. After a crash, insurance adjusters often try to settle claims quickly and for the lowest amount possible. They might pressure you into accepting an offer before you even know the full extent of your injuries or vehicle damage. An experienced accident lawyer understands these tactics. They can take over all communication with the insurer, gather the necessary evidence to build a strong case, and negotiate for the compensation you truly deserve for medical bills, lost wages, and pain and suffering.

Homeowners and Property Damage Claims

When your home sustains damage from a fire, flood, or other disaster, the last thing you want is a fight with your insurance company. Unfortunately, insurers sometimes deny valid claims or undervalue the cost of repairs, leaving you in a difficult position. If your claim has been denied or you feel the settlement offer is inadequate, an attorney specializing in property insurance claims can be a powerful ally. They can review your policy, document the full extent of your losses, and challenge the insurer’s decision to help you get the funds needed to rebuild.

Health Insurance Disputes

Navigating health insurance can be frustrating on its own, but it becomes even more complex when your medical care is tied to an accident. If you were injured in a car crash or a slip and fall, you might find your health insurer is reluctant to cover certain treatments or therapies. An attorney can help you get the respect and claim results you deserve. They can coordinate between different insurance policies—like auto and health—to ensure your medical bills are paid and that you aren’t left with unexpected out-of-pocket costs for necessary care.

Life Insurance Claims

Losing a loved one is devastating, and a denied life insurance claim can add immense financial and emotional stress. Insurers may deny a claim for various reasons, such as alleged misrepresentations on the application or a lapse in premium payments. If you are a beneficiary and the insurance company is not honoring the policy, it’s time to speak with a lawyer. An attorney can investigate the denial, determine if the insurer is acting in bad faith, and fight to secure the benefits your loved one intended for you to have.

Workers’ Compensation Claims

If you get hurt on the job, the workers’ compensation system is supposed to provide benefits for medical treatment and lost wages. However, the process can be complicated, and employers or their insurance carriers often dispute the severity of injuries or deny claims altogether. Hiring a personal injury lawyer can significantly impact your case. An attorney can guide you through the legal process, ensure all paperwork is filed correctly, and represent you in hearings to fight for the full range of workers’ compensation benefits you are entitled to under the law.

How to Find the Right Attorney for Your Claim

After an accident, the thought of finding a lawyer can feel like another mountain to climb. But you don’t have to do it alone, and finding the right legal partner is one of the most important steps you can take. The right attorney acts as your advocate, your guide, and your champion, fighting to get you the compensation you deserve. Think of this process as building your team. By taking a few deliberate steps, you can find a lawyer who not only has the right skills but also makes you feel supported and confident throughout your case.

Look for Relevant Experience and Specialization

When you’re dealing with an injury claim, you don’t want a jack-of-all-trades; you need a specialist. Look for an attorney whose practice focuses specifically on personal injury law. A lawyer who handles car accidents, slip and falls, and wrongful death cases every day will have a deep understanding of the tactics insurance companies use and the evidence needed to build a strong case. A general practice attorney might be great for writing a will or handling a contract dispute, but they likely won’t have the specific experience to effectively negotiate with insurance adjusters who are trained to minimize payouts. Choosing a specialist ensures your case is in the hands of someone who knows this area of law inside and out.

Ask for Referrals from People You Trust

One of the best ways to find a trustworthy attorney is to ask for recommendations from your personal network. Talk to friends, family members, or colleagues who may have been in a similar situation. Hearing about their firsthand experiences—good or bad—can provide invaluable insight that you won’t find online. If you know an attorney who practices in a different area of law, ask them for a referral. Lawyers often know the reputation of other attorneys in their community and can point you toward a respected personal injury specialist. A personal recommendation can give you a great starting point and a little extra peace of mind.

Verify Their Credentials and Good Standing

Once you have a few names, it’s time to do a little homework. Before you schedule a consultation, take a few minutes to verify that the attorney is licensed and in good standing. You can easily do this by visiting The State Bar of California’s website and searching for the attorney’s name. This search will confirm that they are eligible to practice law and will show any public records of disciplinary action. While you’re online, look for client testimonials and reviews on their website or other independent review sites. This step helps ensure you’re considering qualified professionals with a history of client satisfaction.

Interview More Than One Attorney

You wouldn’t hire the first person you interview for a job, and you shouldn’t feel pressured to hire the first attorney you speak with. Most personal injury lawyers offer a free initial consultation, so take advantage of this opportunity to meet with at least two or three different candidates. This is your chance to ask questions, share the details of your case, and get a feel for their communication style and personality. Do they listen to you? Do they explain things clearly? You need to feel comfortable with the person who will be representing you during a vulnerable time. Use these meetings to find someone you trust to handle your claim.

Check Reputable Legal Directories

If you don’t get any personal referrals, online legal directories are a solid place to start your search. Websites like Avvo, FindLaw, and Martindale-Hubbell provide comprehensive profiles of attorneys in your area, often including their practice specialties, years of experience, and reviews from past clients and fellow lawyers. These directories allow you to filter your search to find attorneys who specialize in personal injury law right here in California. You can use these resources to create a shortlist of potential lawyers to research further and schedule consultations with. It’s an effective way to identify experienced and well-regarded attorneys near you.

Key Questions to Ask During a Consultation

Your initial consultation with a personal injury attorney is a two-way interview. While they’re evaluating your case, you should be evaluating them to see if they’re the right fit for you. Walking in with a prepared list of questions can help you make a confident, informed decision during a stressful time. It shows you’re serious about your claim and helps you compare different lawyers effectively. Think of this meeting as your chance to find a true partner who will fight for you. Here are the essential questions to ask to ensure you find the best representation for your insurance claim.

What is Your Experience with Cases Like Mine?

Not all personal injury cases are the same. A lawyer who primarily handles slip-and-fall accidents might not have the specific knowledge needed for a complex commercial truck accident claim. You want an attorney who has a deep understanding of the specific challenges and nuances of your situation. Ask them directly about their experience with cases that mirror yours. A confident lawyer will be able to discuss past scenarios, strategies they’ve used, and the types of outcomes they’ve achieved. This kind of specialized experience can make a significant difference in how effectively they can build your case and anticipate the insurance company’s tactics.

How Does Your Fee Structure Work?

Don’t let worries about cost stop you from getting the help you need. Most personal injury lawyers, including our team at James McKiernan Lawyers, work on a contingency fee basis. This is a crucial point to clarify. A contingency fee arrangement means you don’t pay any attorney fees unless they win your case, either through a settlement or a court verdict. The fee is then taken as a percentage of your total recovery. Be sure to ask what that percentage is and if it changes depending on whether the case goes to trial. You should also ask about other costs, like expert witness fees or court filing fees, and how those are handled. A trustworthy attorney will be completely transparent about their fee structure.

What is the Expected Timeline and Communication Plan?

Personal injury claims take time, and it’s helpful to have a realistic idea of the road ahead. Ask the attorney to walk you through the general stages of the legal process and provide a rough timeline for your case. While they can’t give you an exact date, they can explain the factors that might speed up or slow down the process. Just as important is understanding how you’ll be kept in the loop. Ask about their communication policy. How often can you expect updates? Will you be speaking with the attorney directly or a paralegal? Establishing clear communication expectations from the start helps build a strong, trusting relationship and ensures you never feel left in the dark about your own case.

What is Your Track Record with Similar Cases?

Experience is one thing, but a history of success is another. It’s perfectly reasonable to ask about an attorney’s track record. While every case is unique and past results don’t guarantee a future outcome, this question helps you gauge their effectiveness. You can ask about their success rate in securing favorable settlements or winning verdicts for cases like yours. An attorney who is proud of their work will be prepared to discuss their past achievements. Remember, studies have shown that claimants who hire an attorney often recover significantly more compensation than those who go it alone. This question helps you find a lawyer who has a proven ability to deliver results for their clients.

Understanding the Cost of Hiring an Attorney

When you’re already dealing with medical bills and lost income, the last thing you need is another financial worry. The cost of hiring an attorney is a valid concern, but it shouldn’t stop you from getting the help you need. The good news is that for personal injury cases, legal representation is often more accessible than you might think. Most personal injury law firms, including ours, are structured to help you fight for your rights without adding to your financial strain.

Understanding how lawyers charge for their services can give you peace of mind and help you make an informed decision. The most common arrangement in personal injury law is the contingency fee, which means you don’t pay any attorney fees unless you win your case. However, it’s helpful to be aware of other potential costs and fee structures so you can ask the right questions and know exactly what to expect from the start.

Contingency Fees: No Win, No Fee

For most personal injury claims, attorneys work on a contingency fee basis. This is a straightforward, risk-free arrangement for you. In simple terms: if we don’t win your case and secure a settlement or verdict for you, you don’t owe us any attorney fees. Our fee is a pre-agreed-upon percentage of the total compensation we recover on your behalf. This structure ensures our goals are perfectly aligned with yours—we are both motivated to achieve the best possible outcome for your claim. It allows you to access high-quality legal representation without paying anything out of pocket.

Hourly Rates and Retainer Fees

While less common in personal injury law, some attorneys charge by the hour. It’s useful to know how this works in case you encounter it. An attorney’s hourly rates can vary widely based on their experience and location, with partners at a firm often charging more than associate lawyers. In this model, you might also be asked to pay a retainer fee upfront. A retainer is essentially a down payment that the lawyer holds in a trust account and bills their hourly work against. Any unused portion of the retainer is returned to you at the end of the case.

Other Potential Costs and Expenses

Beyond attorney fees, every legal case involves certain expenses. These are the direct costs of moving your claim forward and are separate from what you pay your lawyer for their time and expertise. These can include things like court filing fees, the cost of obtaining medical records and police reports, and fees for expert witnesses who may need to testify on your behalf. It’s crucial to ask a potential attorney how these costs are handled. Often, they are deducted from your final settlement, but you should always clarify this upfront so there are no surprises down the road.

Why You Should Always Start with a Free Consultation

Nearly all personal injury law firms offer free consultations, and you should absolutely take advantage of this. This initial meeting is a no-pressure, no-obligation opportunity to tell your story, get a professional opinion on your case, and understand your legal options. It’s also your chance to interview the attorney and see if they’re the right fit for you. Use this time to ask specific questions about their experience, their process, and their fee structure. A reputable attorney will be transparent about all potential costs and will make sure you feel comfortable before moving forward.

What to Expect After You Hire an Attorney

Deciding to hire an attorney is a big step, and it’s natural to wonder what happens next. The good news is that you’ve just put a dedicated advocate in your corner. From this point forward, your lawyer and their team will manage the legal heavy lifting, allowing you to focus on your recovery. The process is methodical and designed to build the strongest possible case on your behalf. It generally unfolds in a few key stages, each one building on the last.

Your attorney’s first goal is to get a complete picture of your situation. They will then move into a thorough investigation, gathering all the facts and evidence needed to support your claim. With a solid case built, they will handle all communications and negotiations with the insurance company, fighting for the full compensation you deserve. While most personal injury cases are settled out of court, your attorney will be prepared to take your case to trial if the insurance company refuses to offer a fair settlement. This entire process is about protecting your rights and securing your future, ensuring you aren’t left to face a complex system alone.

Your Initial Case Evaluation

Once you’ve officially hired your attorney, the first step is a comprehensive case evaluation. This is much more detailed than your initial consultation. You’ll sit down with your legal team to go over every aspect of your accident and its aftermath. Be prepared to share all documents you have, including police reports, medical bills, and any correspondence from the insurance company. Your attorney will ask specific questions to understand the full extent of your injuries, the impact on your daily life and work, and the sequence of events that led to the incident. This deep dive is essential for developing a strong legal strategy tailored to the unique facts of your case.

Investigating Your Claim and Gathering Evidence

After the initial evaluation, your attorney’s team will launch a full investigation into your claim. This is a critical phase where they work to gather all the evidence needed to prove liability and document your damages. This process often involves collecting police and accident reports, obtaining all of your medical records, interviewing witnesses, and hiring experts like accident reconstructionists or medical specialists if needed. They will also gather proof of your financial losses, such as pay stubs to show lost wages and receipts for out-of-pocket expenses. Every piece of evidence collected helps build a powerful and persuasive case to present to the insurance company.

Negotiating with the Insurance Company

With a strong case built on solid evidence, your attorney will take over all communication with the insurance company. They will start by sending a demand letter that outlines the facts of the case, establishes the other party’s liability, and details the full extent of your damages, demanding a specific settlement amount. The insurance adjuster will respond, and the negotiation process begins. Your lawyer will handle all the back-and-forth, countering lowball offers and using their experience to argue for the maximum compensation you deserve. Having a skilled negotiator on your side prevents you from falling for the insurance company’s tactics and ensures your claim is taken seriously.

Filing a Lawsuit if a Fair Settlement Isn’t Reached

While the goal is always to reach a fair settlement without going to court, sometimes insurance companies refuse to be reasonable. If negotiations stall and the insurer won’t offer an amount that fairly covers your losses, your attorney will be prepared to file a lawsuit. This formally begins the litigation process. It’s important to know that filing a lawsuit doesn’t automatically mean you’re headed for a trial. Negotiations often continue even after a suit is filed, and many cases still settle before reaching a courtroom. However, your attorney’s willingness to take your case to court shows the insurance company you are serious about getting the justice you deserve.

Common Myths About Hiring an Attorney for Insurance Claims

Deciding to hire an attorney can feel like a big step, and it’s easy to get bogged down by misinformation. When you’re already dealing with the stress of an injury and an insurance claim, the last thing you need is confusion about your legal options. Let’s clear up some of the most common myths so you can make a decision that feels right for you.

Myth: You Need a Lawyer for Every Single Claim

This is simply not true. For a minor fender-bender with no injuries and a straightforward claim, you probably don’t need to hire an attorney. However, the situation changes quickly when things get complicated. If your claim is denied, the settlement offer is too low, or you’ve suffered significant injuries, getting professional help is often the only way to get a fair outcome. An experienced lawyer can step in when the insurance company isn’t treating you fairly, ensuring your rights are protected when the stakes are high.

Myth: An Attorney Guarantees a Higher Payout

No ethical attorney can ever guarantee a specific result. However, having a legal expert on your side can dramatically improve your chances of receiving a fair settlement. Insurance companies are businesses, and their goal is to pay out as little as possible. An attorney levels the playing field. In fact, a study by the Insurance Research Council found that insurance payouts average 3.5 times more for people who have an attorney compared to those who don’t. While there are no guarantees, the data shows that legal representation often leads to better financial outcomes.

Myth: All Insurance Attorneys Have the Same Skills

Just as you wouldn’t see a foot doctor for a heart problem, you shouldn’t hire just any lawyer for a personal injury claim. Law is a vast field with many specializations. When you’re going up against a powerful insurance company, you need someone with extensive experience handling cases just like yours. A dedicated personal injury attorney understands the specific laws, tactics, and medical evidence relevant to your claim. They know how to build a strong case and anticipate the insurance adjuster’s moves, which is a skill set a general practice lawyer may not have.

Myth: You’re Stuck with the First Lawyer You Hire

Your relationship with your attorney is important, and you need to feel confident in their ability to represent you. If you’re not satisfied with their work or communication, you have the right to fire your attorney at any time. It’s your case, and you are in control. Keep in mind that you may still be responsible for paying for the work they have already completed, which is usually outlined in your initial agreement. Don’t feel trapped in a bad fit; finding the right legal partner is essential for your peace of mind and the success of your claim.

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Frequently Asked Questions

What if the accident was partially my fault? Can I still get compensation? This is a very common concern, and the short answer in California is yes, you often can. California follows a “comparative fault” rule, which means you can still recover damages even if you were partially to blame for the accident. Your final compensation would simply be reduced by your percentage of fault. An experienced attorney can help protect you from the insurance company trying to place an unfair amount of blame on you to reduce their payout.

Is it too late to hire a lawyer if I’ve already been talking to the insurance company? It’s almost never too late to get legal help, even if you’ve already started the claims process or given a statement to an adjuster. In fact, this is a common point where people realize they’re in over their heads. Bringing an attorney in can shift the dynamic in your favor, stop the insurer from taking advantage of you, and ensure your claim is handled correctly from that point forward.

Will I have to go to court if I hire an attorney? Most people worry about this, but the reality is that the vast majority of personal injury cases are settled out of court. The goal of hiring an attorney is to build such a strong and well-documented case that the insurance company is compelled to offer a fair settlement to avoid the time and expense of a trial. While we are always prepared to go to court if needed, our primary goal is to resolve your claim efficiently and effectively through negotiation.

How much is my insurance claim actually worth? There’s no simple formula, as every case is unique. The value of your claim depends on several factors, including the cost of your medical treatment (both past and future), any wages you’ve lost from being unable to work, property damage, and the extent of your pain and suffering. A skilled attorney will carefully analyze all of these elements to calculate the full and fair value of your claim, ensuring no damages are overlooked.

What does a “contingency fee” really mean for my settlement? A contingency fee means you don’t pay us anything upfront. We cover all the costs of building and pursuing your case. When we win a settlement for you, our fee is taken as a pre-agreed-upon percentage of the total amount. Any case-related costs are also reimbursed from the settlement. This ensures you have access to expert legal help without any financial risk, and it means our goals are perfectly aligned with yours: to get you the best possible result.

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