After an accident, many injured people hear two terms repeatedly: claim and lawsuit. Although these words are sometimes used interchangeably, they describe very different stages of the personal injury process. Understanding how each works—and how Missouri law affects both—is essential for anyone navigating medical bills, lost wages, or property damage after an injury.
Whether your accident occurred in St. Louis, Kansas City, Springfield, or anywhere else in Missouri, knowing the distinction between a claim and a lawsuit can help you make informed decisions about your legal options and next steps.
What Is a Personal Injury Claim?
A personal injury claim is the informal process of seeking compensation from the at-fault party’s insurance company. This step occurs before filing anything in court. Most injury cases in Missouri begin as claims rather than lawsuits, because insurance coverage is typically the first avenue for recovering damages.
During a personal injury claim, the injured party (or their representative) presents evidence showing:
- How the accident occurred
- Who caused the accident
- The nature and severity of the injuries
- Medical expenses and other financial losses
- Pain and suffering and other non-economic damages
The insurance company then reviews the evidence, investigates the incident, and may request medical records, police reports, or witness statements. The goal is to negotiate a settlement that compensates the injured person for their losses.
Common Situations Where Claims Are Filed
Personal injury claims arise in scenarios such as:
- Car accidents
- Slip-and-fall injuries
- Dog bites
- Truck collisions
- Workplace incidents involving third-party negligence
- Bicycle or pedestrian crashes
A claim is typically the fastest way to resolve a personal injury matter, although the process is not always simple.
Advantages of Filing a Claim First
Many cases settle during the claim stage because:
- It avoids court litigation, which is costly and time-consuming.
- The injured person can receive compensation sooner, particularly in straightforward cases.
- Negotiations allow flexibility, enabling both sides to reach a mutually acceptable resolution.
- Most insurance policies require filing a claim before a lawsuit is even possible.
However, while claims are efficient, insurance companies do not always offer fair settlements. When negotiations stall, a lawsuit may become necessary.
What Is a Personal Injury Lawsuit?
A personal injury lawsuit is a formal legal action filed in court when the parties cannot settle the claim through negotiation. A lawsuit begins when a petition is filed with the court, outlining the allegations against the defendant and detailing how the defendant’s actions caused the injury.
Missouri law provides guidance on how personal injury lawsuits proceed. Most personal injury actions must be filed within five years of the date of the injury. Missing this deadline usually bars the injured person from pursuing compensation through the court system.
Once the lawsuit is filed, both sides begin the litigation process, which includes:
- Discovery, such as depositions, interrogatories, and document requests
- Expert evaluations
- Motions and hearings
- Negotiations or mediation
- Trial, if the parties cannot reach an agreement
Lawsuits take much longer to resolve than claims and may last months or even years, depending on complexity.
Why a Case May Move From a Claim to a Lawsuit
Not all claims progress smoothly.
Situations that cause a claim to turn into a lawsuit include:
1. Disputes Over Liability
If the insurance company denies fault or argues that the injured person contributed to the accident, negotiations may come to a standstill. Missouri follows a pure comparative fault rule, which means an injured person’s recovery is reduced by their percentage of fault.
2. Inadequate Settlement Offers
If the insurer offers an amount far below what would reasonably compensate the injured party for medical costs, lost wages, and pain and suffering, filing a lawsuit may be the next step.
3. Severe or Long-Term Injuries
Cases involving permanent disability, disfigurement, or lifelong medical care often require formal evidence and expert testimony to determine the full value of damages.
4. Disputes Over Medical Treatment
Insurance companies may challenge whether certain treatments were necessary, creating disputes that cannot be resolved outside of court.
5. Approaching the Statute of Limitations
If the deadline for filing a lawsuit is nearing, litigation may be necessary simply to preserve the injured person’s legal rights.
Disagreements about fault often trigger litigation.
Key Differences Between Claims and Lawsuits
Understanding how claims and lawsuits differ helps clarify why each process exists.
1. Formality
A claim is informal and handled outside of court. A lawsuit is a formal legal action governed by court rules and procedures.
2. Timeline
Claims may resolve within weeks or a few months. Lawsuits are typically far more time-consuming.
3. Level of Evidence Required
Claims rely heavily on negotiations and documentation. Lawsuits require litigation-level evidence, expert testimony, and procedural compliance.
4. Who Makes the Final Decision
In a claim, the insurance adjuster decides whether and how much to pay. In a lawsuit, the decision may rest with a judge or jury.
5. Potential for Appeal
Settlements reached during a claim are final and cannot be appealed. Lawsuits may result in appellate review.
Each case has unique elements and factors that may affect your claim, and each of these steps may or may not apply.
Which Option Is Right for Your Situation?
Most personal injury cases in Missouri begin as claims because the process is faster, more flexible, and allows for informal resolution.
However, a lawsuit may be appropriate when:
- The insurance company denies liability
- The settlement offered is too low to cover medical bills and other damages
- The injuries are serious or permanent
- Fault is heavily disputed
- Litigation is the only way to compel full compensation
Many cases involve both stages—starting as a claim and evolving into a lawsuit if negotiations fail. Understanding this progression helps injured individuals prepare for what to expect.
Contact Eason Car Accident and Personal Injury Lawyers for a Free Consultation
Understanding the difference between a personal injury claim and a lawsuit helps you know what to expect after an accident and how your case may progress under Missouri law. While many cases resolve through insurance claims, some require formal litigation to achieve fair compensation.
An experienced personal injury attorney can evaluate your situation, handle negotiations, and determine when filing a lawsuit is necessary to protect your rights and pursue the full recovery you deserve. Contact Eason Car Accident and Personal Injury Lawyers for a free consultation.