How Insurance Companies Evaluate Wrongful Death Claims in South Carolina

The loss of a loved one is an immeasurably painful experience. When that loss occurs due to the negligence or wrongful act of another, the grief can be compounded by the complexities of seeking justice and financial stability for the surviving family members. Navigating a wrongful death claim in South Carolina involves interaction with insurance companies, entities that have their own specific procedures for evaluating such sensitive matters.

The Framework of Wrongful Death Claims in South Carolina

Before an insurance company can evaluate a wrongful death claim, the claim itself must fit within the legal framework established by South Carolina law. A wrongful death occurs when a person’s death is caused by the “wrongful act, neglect, or default” of another. Essentially, if the deceased person could have filed a personal injury lawsuit had they survived, their surviving family members may pursue a wrongful death action.

In South Carolina, the wrongful death claim is brought by or on behalf of the deceased’s spouse and children. If there is no spouse or children, the claim can be brought for the benefit of the deceased’s parents. If there are no parents, then it falls to the heirs of the deceased as defined by statute. The action must typically be filed by the executor or administrator of the deceased’s estate.

A key element is the statute of limitations. In South Carolina, a wrongful death lawsuit must generally be filed within three years from the date of the person’s death. Missing this deadline can mean a complete loss of the right to seek compensation.

The Insurance Company’s Initial Assessment

Once a wrongful death claim is initiated, the relevant insurance company begins its evaluation process. This usually starts with a review of the applicable insurance policy. The adjuster will verify coverage for the incident in question and take note of the policy limits, which is the maximum amount the insurer may pay out for the claim.

Simultaneously, the insurer will conduct an initial investigation into the circumstances surrounding the death. This involves gathering facts from various sources, which may include:

• Police reports or incident reports
• Witness statements
• Photographs or videos of the scene (if applicable, such as in a car accident)
• Preliminary medical information

A significant part of this initial phase is determining liability. The insurance adjuster will try to assess whether their insured party was indeed at fault and to what extent. This determination heavily influences how they proceed with the claim.

Key Factors Influencing the Evaluation

Several critical factors shape an insurance company’s evaluation of a wrongful death claim. These elements help the insurer gauge the potential value of the claim and their likely exposure.

Evidence of Negligence: The strength and clarity of the evidence proving the insured’s fault is paramount. Clear-cut liability will often lead to a different evaluation approach than a case where fault is disputed or shared.

The Deceased’s Profile: Insurers consider various aspects of the deceased’s life, including:

• Age and health status prior to the fatal incident.
• Earning capacity, employment history, and income.
• The number of dependents relying on the deceased for financial and emotional support.

Nature of Dependents: The relationship of the statutory beneficiaries to the deceased and the level of their dependency are important. For example, the financial and emotional losses experienced by a young child who has lost a parent will be viewed differently from those of an adult child who was financially independent.

Comparative Negligence: South Carolina follows a modified comparative negligence rule. This means that if the deceased person was partially at fault for the incident that led to their death, any compensation awarded can be reduced by their percentage of fault. If the deceased is found to be 51% or more at fault, they are barred from recovery. Insurance companies will meticulously investigate any potential fault on the part of the deceased to reduce their payout.

Calculating Damages in Wrongful Death Cases

A substantial part of the insurer’s evaluation involves calculating the potential damages. In South Carolina, damages in a wrongful death claim are intended to compensate the statutory beneficiaries for the losses they have suffered due to the death. These can be broken down into several categories:

Economic Damages: These are tangible financial losses that can be calculated with a degree of certainty. They include:

• Loss of financial support, income, and wages that the deceased would have provided.
• Loss of benefits such as health insurance, retirement contributions, or pensions.
• Medical expenses incurred by the deceased as a result of the injury prior to their death.
• Reasonable funeral and burial expenses.

Non-Economic Damages: These are intangible losses that are more subjective but equally significant. They include:

• Loss of the deceased’s companionship, care, guidance, and protection.
• The mental anguish, grief, and sorrow experienced by the surviving family members.

Survival Action Component: In some instances, a survival action may be brought in conjunction with the wrongful death claim. This allows for recovery of damages the deceased person would have been entitled to, including compensation for their pain and suffering endured from the time of injury until their death. Insurance companies will scrutinize medical records to assess the level and duration of any conscious pain and suffering.

Punitive Damages: In cases where the wrongful conduct was reckless, willful, or wanton, punitive damages may be awarded. These are not intended to compensate for losses but rather to punish the wrongdoer and deter similar conduct in the future. Insurance policies often have exclusions for punitive damages, or there may be statutory caps. Insurers are typically very resistant to paying punitive damages and will evaluate the likelihood of such an award very carefully.

The calculation of future economic losses, such as lost income over what would have been the deceased’s working life, often involves projections and may require the input of economic professionals. Insurance companies will have their own methods and experts to arrive at these figures, which may differ significantly from those calculated by the claimant’s representatives.

The Role of Documentation and Evidence

Thorough documentation and compelling evidence are vital when presenting a wrongful death claim to an insurance company. The insurer will meticulously review all submitted materials to support its evaluation. Families should be prepared to gather and provide:

• The deceased’s death certificate.
• Medical records related to the fatal injury and any prior conditions.
• Proof of income, such as tax returns, pay stubs, and employment records.
• Documentation of funeral and burial expenses.
• Records of other financial losses, like lost benefits.
• Personal testimonies or impact statements from family members detailing the emotional and personal losses.

A knowledgeable attorney plays a key part in assembling a comprehensive claim package. They can identify the necessary documentation, present it in a clear and organized manner, and anticipate the information the insurer will require to properly assess the claim.

Common Tactics and Challenges in Dealing with Insurers

It is important to remember that insurance companies, while providing a valuable service, are also businesses. Their aim is often to resolve claims for the lowest amount reasonably possible. Families may encounter various tactics and challenges:

• Attempts to Minimize Payouts: Insurers may dispute the extent of the economic losses or downplay the severity of the non-economic damages. They might use their own experts to produce lower estimates for future lost income or the value of lost services.
• Requests for Recorded Statements: Adjusters often request recorded statements from surviving family members soon after the loss. While seeming routine, these statements can be used to find inconsistencies or admissions that could harm the claim. It is generally advisable to consult with an attorney before providing any recorded statement.
• Disputing Liability or Damages: Even in cases where fault seems clear, an insurer might still contest liability or argue that the death was due to pre-existing conditions rather than the insured’s actions. They may also vigorously dispute the monetary value placed on the various components of the damages.
• Dealing with Multiple Insurers: Sometimes, more than one insurance policy or insurer may be involved (e.g., different policies for different defendants, or different types of coverage like auto versus an umbrella policy). Coordinating these claims can be complex.

The Negotiation Process

After the insurance company has completed its initial evaluation and the claimant has presented their demand, a period of negotiation typically ensues. The insurer will usually make an initial settlement offer. This first offer is often lower than the full value of the claim.

The claimant’s legal representative will then respond, often with a counter-demand and further evidence or arguments to support the valuation of the claim. This back-and-forth process can continue for some time. Effective negotiation requires a thorough preparation of the case, a realistic assessment of its strengths and weaknesses, and strong advocacy skills.

In some cases, mediation may be used. Mediation is a process where a neutral third party helps facilitate discussions between the claimant and the insurer to try and reach a mutually agreeable settlement. It is a voluntary process but can be very effective in resolving complex claims without resorting to a full trial.

When a Lawsuit Becomes Necessary

If a fair settlement cannot be reached through negotiation or mediation, the next step is often to file a wrongful death lawsuit. The prospect of litigation can sometimes prompt an insurer to re-evaluate its position and make a more reasonable offer, as trials are costly and outcomes can be uncertain.

Once a lawsuit is filed, the case enters the discovery phase, where both sides formally exchange information, documents, and witness testimony (depositions). This can uncover additional evidence that may strengthen or weaken the claim, further influencing the insurer’s evaluation. Many cases are still settled before reaching a trial, even after a lawsuit has been initiated.

South Carolina Specific Considerations

There are a few specific aspects of South Carolina law that influence how insurance companies and the legal system handle wrongful death settlements:

• Court Approval for Settlements: If any of the statutory beneficiaries are minors or are legally incapacitated, any settlement reached in a wrongful death claim must be approved by the court. The court will review the settlement to ensure it is in the best interests of the minor or incapacitated person. This often involves appointing a guardian ad litem to represent the interests of these beneficiaries.
• Role of the Probate Court: Once a settlement is finalized and approved (if necessary), the funds are typically paid to the deceased’s estate. The Probate Court in South Carolina then oversees the distribution of these funds to the statutory beneficiaries according to the wrongful death statute or an approved allocation.

These procedural safeguards are in place to protect all beneficiaries, particularly the most vulnerable.

Take the First Step with Peake & Fowler

Dealing with the aftermath of a loved one’s death is incredibly challenging. When that loss is coupled with a wrongful death claim, the legal and financial complexities can feel overwhelming. An experienced attorney can be an invaluable ally, helping you navigate the insurance evaluation process and advocating for the full and fair compensation your family deserves.

If your family is facing this difficult situation, we invite you to reach out to Peake & Fowler. Our team is committed to providing compassionate and effective legal representation for wrongful death claims in South Carolina. Contact us online or call us at 803-788-4370 to schedule a consultation and learn how we can assist you.