Key Takeaways
- A Texas personal injury claim requires proving negligence by showing duty, breach, causation, and damages.
- Texas splits fault by percentage, and a claimant found more than 50% responsible recovers nothing.
- Most claims are resolved through a demand letter and negotiation rather than a trial.
- Most claims must be filed within two years of the injury, though claims against government entities have much shorter notice deadlines.
- How well a claim is documented in the early weeks often determines what an insurer is eventually willing to pay.
Nearly everyone who ends up dealing with an insurance claim after a car accident, a fall, or a workplace injury is doing it for the first time, and the process tends to unfold the same way regardless of what caused the injury. The León Law Firm’s guide to the personal injury claim process in Texas breaks that process down into six stages. What follows is a closer look at each one, along with places where people commonly lose value in a claim without realizing it at the time.
Stage One: Building the Medical Record
When an insurance adjuster first reviews a claim, one of the first things they look at is the amount of time between the accident and the injured person’s first medical visit. If someone waits several days to see a doctor because the pain seemed manageable at first, that delay often becomes the basis for an argument that something else caused the injury, or that it wasn’t serious to begin with.
This matters because soft-tissue injuries, concussions, and other common injuries don’t always present symptoms immediately. Alongside prompt medical treatment, documenting the scene helps: photographs of any hazards, vehicle damage, or visible injuries, plus the names and contact information of anyone who witnessed the incident. A police or incident report should be requested where applicable, and if a business is involved, a written request to preserve any surveillance footage should go out quickly, since many systems automatically overwrite older recordings.
Stage Two: Establishing Negligence
Texas personal injury claims are built around negligence, which generally requires showing four things: that the other party owed a duty of care, that they breached that duty, that the breach caused the injury, and that the injury resulted in real, measurable damages. If any one of those elements can’t be established, there typically isn’t a viable claim, regardless of how serious the injury turned out to be.
Texas is also a modified comparative-fault state, and this is where Chapter 33 of the Civil Practice and Remedies Code comes into play. A jury assigns a percentage of fault to everyone involved in an incident, including the injured person. If that percentage is above 50%, the injured person recovers nothing. At 50% or below, the total award is reduced by that percentage. In a hypothetical case involving $100,000 in damages, a jury finding the injured person 20% at fault would reduce the recovery to $80,000. This is part of why insurance adjusters spend so much time and effort trying to find something, however small, to attribute to the injured party.
Stage Three: Navigating the Insurance Company
Once a claim has been reported, the at-fault party’s insurer typically reaches out fairly quickly, sometimes within a day or two of the incident. The caller is often friendly and easy to talk to, which can put people at ease, even though the adjuster’s underlying role is to limit what the insurance company ultimately has to pay.
A few things commonly happen during that early contact. The adjuster may ask for a recorded statement, which an injured person is not required to provide, and answering questions before the full scope of an injury is understood can create problems later if the actual injuries turn out to be more serious than initially described. The adjuster may also request a broad medical records authorization, which can allow the insurer to look through years of unrelated medical history in search of a pre-existing condition to blame. And an early settlement offer is often floated before medical treatment is even complete, at a point when it’s genuinely difficult to know what the claim might actually be worth.
Stage Four: Understanding What Damages Are Involved
Texas law generally recognizes a few different categories of damages in a personal injury case. Economic damages cover concrete, provable losses such as medical bills, lost wages, and property damage. Non-economic damages compensate for harder-to-quantify harm, including physical pain, mental anguish, and physical impairment. In more limited situations involving fraud or gross negligence, a court may also award exemplary damages, which are intended to punish rather than to compensate and are subject to statutory caps.
Of these categories, future medical expenses and lost earning capacity tend to be the largest components in a serious injury claim, and both usually require expert testimony to establish with any real credibility, rather than being estimated. This is also often when the difference between a minor injury requiring a few weeks of treatment and a catastrophic injury requiring lifelong care becomes clear in terms of overall claim value.
Stage Five: The Demand Letter and Negotiation
Once medical treatment has progressed to the point where a doctor can speak to the injured person’s future needs, an attorney will typically prepare and send a demand letter to the insurance company. The letter lays out the basis for liability, itemizes the damages involved, attaches supporting documentation, and states a specific dollar amount being demanded.
What follows is usually a negotiation process rather than an immediate resolution. The insurer typically responds with a lower counteroffer. The back-and-forth that follows often resembles an exchange of evidence more than an argument: a questioned medical bill is answered with the underlying record, a disputed fault allocation with photographs or a witness statement, and so on until the two sides either reach an agreement or determine they can’t. How this process plays out depends heavily on how well-documented the claim is and whether the insurance company believes the injured person’s attorney is prepared to take the case to trial if necessary. The León Law Firm, which has operated out of Sugar Land since 1995, generally approaches every case as though it may eventually go to trial, and that posture helps produce settlements that don’t require one.
Stage Six: Filing a Lawsuit, and the Deadline Behind It
When a fair settlement can’t be reached through negotiation, the next step is filing a lawsuit, which puts the case on a formal court schedule rather than ending the process. That typically involves filing a petition and receiving a response from the defendant, followed by a discovery period in which both sides exchange documents and take depositions, mediation (which most Texas courts require and which resolves a significant portion of cases that reach this stage), and, if the case still hasn’t been resolved, a trial in which a judge or jury ultimately decides the outcome.
However, once the applicable deadline has passed, none of these later stages are available. For most personal injury claims in Texas, that deadline is two years from the date of the injury, under Section 16.003 of the Texas Civil Practice and Remedies Code, and it generally applies regardless of how strong the underlying claim might otherwise be. Claims involving a city, county, or state agency are subject to a much shorter notice requirement, often measured in months rather than years, and a wrongful death claim’s deadline typically runs from the date of death rather than the date of the original injury. Anyone unsure where their situation falls, or how much time is left, is generally better off having a lawyer review it sooner rather than later, since missing the deadline is hard to undo. The León Law Firm offers personal injury representation across Houston, Harris County, Fort Bend County, and the rest of Texas, in English or Spanish, and handles cases on a contingency-fee basis.
Why the Stages Build on Each Other
Each stage tends to depend on the one before it. Thorough medical documentation makes it easier to establish fault. Clearly established fault gives a demand letter more weight. A demand letter backed by solid documentation and a credible willingness to go to trial is usually what produces a fair settlement without one. When documentation is missing or incomplete at any point, every later stage becomes correspondingly harder to argue.
A Few Questions People Often Have
Whether a lawyer is actually necessary depends a great deal on the specifics of the situation. A minor collision that doesn’t result in any real injury may not require legal representation at all. Once the situation involves surgery, ongoing physical limitations, significant lost income, or a genuine dispute over fault, an attorney’s involvement can change how the insurance company treats the claim, and the difference in the outcome can be substantial.
Cost is also a common concern. Firms that work on a contingency-fee basis, including The León Law Firm, don’t require upfront payment. Instead, the fee is calculated as a percentage of whatever is ultimately recovered, and nothing is owed if nothing is recovered. That percentage, along with what counts as a reimbursable case expense, should be spelled out in writing before any agreement is signed, since the specifics can vary from one firm to another.
Missing the applicable filing deadline is one of the more serious mistakes in this process, since it generally bars the claim entirely, regardless of how strong the underlying facts might have been. Texas law allows a narrow set of exceptions, most commonly involving claims brought on behalf of a minor. Still, no one should count on it applying to their own situation. Anyone with a deadline that seems close, or who isn’t sure how much time is left, is better off getting an answer promptly.
The León Law Firm, P.C.
1 Sugar Creek Center Boulevard
Sugar Land
TX
77478
United States
