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10 Tactics Insurance Companies Use to Deny and Devalue Claims
If you’ve been injured and it was someone else’s fault, odds are good you will hear from an adjuster for the at-fault party’s insurance company. Their interests are inherently opposed to yours as a person who was injured by their insured. You want – and deserve – fair compensation under the law for your injuries. The insurance adjuster for the other side, however, is not there to help you. They solely exist to protect and promote the interests of their employer – the insurance company. The insurance company’s ultimate goal is to pay out nothing or as little as possible on every claim – that is, to deny and devalue claims.
Every insurance adjuster is trained, and trained well, by the insurance company to promote this ultimate goal. The following list goes over 10 of the most common tactics insurance companies use to deny and devalue claims.
*Note – we refer throughout this article to these tactics as used in the context of a car accident. Keep in mind, however, that these tactics are used in car collisions, slip and fall, and other cases alike. They do not solely apply to car accidents.
1. CALLING YOU VERY SOON AFTER AN INJURY
This is done for a variety of reasons – mostly to catch you off guard 1) in a vulnerable spot soon after a traumatic event like a car collision; 2) before you’ve had time to determine the full extent of your injuries; and 3) before you’ve had an opportunity to hire a lawyer.
It is extremely common for an insurance adjuster for the at-fault party’s insurance company to call you the same day of a collision or shortly thereafter and act exceedingly friendly. He will ask you how you are doing, tell you he’s so sorry, tell you not worry, and generally give you the impression you can trust him. At this point, you’re probably feeling awful – both mentally and physically – and just hearing a friendly voice can be comforting. It can also be confusing if the insurance adjuster says he’s “admitting fault for the collision,” or if he agrees with you about how the collision occurred.
While it may be tempting to want to trust and engage with him, it is important to remember the insurance adjuster for the other side is not your friend. His interests are diametrically opposed to yours. Being nice is simply a tactic the insurance adjuster employs to get injury victims to let their guard down and provide information that can be used against them later.
2. ASKING YOU TO GIVE A RECORDED STATEMENT
It may seem very reasonable for an insurance adjuster to ask for your side of the story in how the collision occurred or ask you about your injuries. Insurance adjusters frequently try to ask you to provide this information via a recorded statement. You’re probably thinking, “Well of course – once I tell them my side of things and tell them about my injuries, they’ll know it’s not my fault; they’ll fairly compensate me for my injuries; they’ll pay all of my medical bills, lost wages, etc. After all, the other guy ran a red light and hit me. That’s reasonable, right?”
While an insurance company doing all those things is reasonable, insurance adjusters do not record statements as a tool to fairly compensate injury victims. They use recorded statements as a tool to deny and devalue claims by getting the information they can use against you later. This is true not just for information about how a collision occurred, but also applies to information on injuries. For example, they will ask you if you are injured shortly after a collision and ask you to provide an accounting of exactly how you are injured at a time when you may have not even seen a doctor yet and have no idea about the full extent of your injuries. The insurance adjuster may also ask pointed questions in a recorded statement in a manner that can be used against you later. For example, he may only ask you questions about a neck injury and then say later that because you never told them your back hurt, you must not have suffered a back injury.
Remember – the insurance adjuster’s ultimate goal is to pay out nothing or as little as possible for claims. He will do whatever he can to achieve this goal, and if this means catching you off guard an hour after a collision and getting your recorded statement, he will do it. Recorded statements are always used for this purpose whether he asks you for one five minutes, two weeks, or two months after a collision.
If you are asked to give a recorded statement, you should politely decline. Generally, you should not give an insurance company a recorded or written statement unless you are instructed to do so by a personal injury attorney.
3. ASKING YOU TO SIGN A MEDICAL AUTHORIZATION
Getting an injury victim to sign a blanket medical authorization, unlimited in time and scope, is another tactic employed by insurance companies. It is a frequently-used tactic because it is a powerful tool that allows the insurance company to obtain a host of private information about you that you would never even suspect.
Common misconception: The other side’s insurance company will use the signed medical authorization as they have represented to me – to get my medical bills related to the collision so they can pay them in my claim.
Wrong. Once turned over, the insurance company will use the medical authorization to obtain your medical records from any and every medical provider you have ever seen in your entire life – both before and after the collision. It will do this to try to find any evidence of prior injuries, prior pain, prior anything to try to argue your injuries, pain, treatment, etc. after the collision were not related to the collision. The argument will then be – you had these injuries before; your issues were caused by those prior things, not our insured running a red light and hitting you. The insurance company will try to argue this even if you did have some level of pre-existing pain or injuries that were asymptomatic by the time of the collision and were reactivated or made much worse because of an accident.
If you are asked to sign a medical authorization, you should politely decline. Generally, you should not give an insurance company a signed medical authorization unless you are instructed to do so by an attorney.
4. OFFERING A QUICK SETTLEMENT IN RETURN FOR A SIGNED OR VERBAL RELEASE OF YOUR CLAIM
At a vulnerable time, it may be tempting to take money – any money – for settlement of a claim. This can be especially true if it’s very soon after a collision, before you know the full extent of your injuries or before you’ve seen a doctor or gotten any treatment.
This is the perfect time the insurance company wants you to settle. If an insurance company could get every injured victim to settle for $1,000 or less in every case a day after the collision, it would do it. After all, it would save a lot of money.
If the insurance company does employ this tactic, it will, of course, want you to sign a full release or give a full verbal release in return for the money. The insurance company does this to say your claim is over, and you cannot pursue anything for your injuries ever again in the future, even if your injuries get worse, you receive more medical treatment, etc.
5. DENYING LIABILITY, EITHER COMPLETELY OR PARTIALLY
Even if a collision is the fault of its insured, an insurance company may simply deny liability on the claim. If it does this when a collision is clearly the other side’s fault – for example, if the other party rear-ended you in a collision – it is because the insurance company is arguing you couldn’t possibly have been injured as a result of what happened. This routinely occurs when a collision involves what the insurance company deems to be minimal or minor property damage to the vehicles involved.
Another tactic is denying liability in part by saying you were partially at fault for the collision, whether this was true and whether there were other witnesses who say it was the other side’s fault. The other side is hoping those witnesses will disappear or not want to get involved later should you have to fight your case. If there is any room to argue the collision was partially your fault, insurance companies routinely do it. Minimally, they will do it to devalue the claim. Other times it is done to avoid paying altogether, such as in Kansas where an injury victim is not allowed to recover anything if he is found to be 50% or more at fault for an injury event like a car collision.
This is truly a tactic to call your bluff and see how far you’re willing to go to pursue a claim. Insurance companies know many people will give up, confused and frustrated by the situation.
6. DISPUTING A PORTION OF YOUR MEDICAL BILLS OR MEDICAL TREATMENT, OR TELLING YOU THAT YOU SHOULDN’T GET TREATMENT BEYOND A CERTAIN POINT BECAUSE IT WON’T BE COVERED
Similarly related, insurance companies routinely fight a portion of an injured person’s medical bills or treatment to devalue claims. They may say, well you may have been injured by the collision, but we don’t believe you could have been that injured. They will try to say you treated too long, you should have recovered sooner, or the treatment you did receive was unreasonable.
An insurance adjuster may also urge you or convince you to stop treatment at a certain point because the insurance company won’t pay for it for these reasons. Beyond being bad for you from a physical and treatment standpoint, this is bad for your case and is done in an effort to create a bad record in your treatment course or cut off your damages. If you do stop treatment because of such urging, but you are not better and are still in pain thereafter, the insurance company will then use that failure to seek treatment as a tool to argue you must not have really been injured, you were making it up, or you were, at least, not injured badly enough to warrant getting any recovery for it.
Keep in mind again, they are trying to save money and pay out less on a claim – however much they can get away with. The insurance companies frequently have computer systems that spit out red flag alarms to adjusters on when to fight people on these issues, such as if treatment lasts longer than a certain amount of time, costs over a certain figure, or if you had what they will argue are “delays in treatment over a certain period,” even as little as a week – no matter what the reason.
The insurance company’s computer system is not right. If you were injured because of someone else’s negligence, you should consult with an attorney about your rights and what you may be entitled to for your injuries.
7. EMPLOYING DELAY TACTICS TO GET YOU TO SETTLE FOR A LOWER AMOUNT – OR WORSE – GIVE UP ENTIRELY
Insurance companies know that many people will be facing financial difficulties after suffering an injury. You may be facing medical bills, losing time from work, losing your car because it was totaled or has to be fixed, and generally dealing with stress from all angles in your personal life, family life, and work life.
Insurance companies use this vulnerability to their advantage. They will routinely delay processing a claim until you’ve reached the point where you’re desperate enough to settle for just about anything. Even worse, many people eventually start viewing the process as so exhausting, stressful, and not worth it that they give up entirely and never receive any recovery.
Stand firm in demanding what you are rightfully owed under the law for your injuries. If you were injured because of someone else’s negligence, you should consult with an attorney about your rights and what you may be entitled to for your injuries.
8. MISREPRESENTING THE LAW ON WHAT YOU ARE LEGALLY ENTITLED TO SEEK FOR DAMAGES, OR LOW-BALLING YOU ON SETTLEMENT OFFERS
Some insurance adjusters may try to tell you that you’re not entitled to seek damages for pain and suffering for injuries, or that you can only recover a certain amount. They may also try to tell you there is no recovery for lost wages. They may try to tell you a certain low-ball amount is fair considering the law or what you could seek in your claim, knowing that is not true. Insurance companies use your unfamiliarity with the situation in order to devalue and diminish claims.
Do not accept legal advice from an insurance company for the at-fault party. You should consult a personal injury attorney to advise you of your rights in what you may seek in your injury claim under the law.
9. MISREPRESENTING THE AMOUNT OF INSURANCE COVERAGE AVAILABLE FOR YOUR CLAIM
Insurance adjusters may try to say there’s only a certain amount available to be paid on a claim when that amount may not accurately reflect what is truly available to compensate you from the at-fault party. An attorney can help you find out what insurance policy limits are available for any potentially at-fault party and advise you of the issues at play with available insurance coverage.
10. TELLING YOU THAT YOU’LL BE BETTER OFF NOT HIRING AN ATTORNEY
If all insurance companies were fair in every instance, truly on your side, and really cared about fully and fairly compensating people who are injured because of their insureds’ actions, then people might be fine with not hiring an attorney to represent them in an injury claim. Of course, this is not the case.
People do not fly across the country without a pilot, conduct surgery on themselves, or climb Mount Everest without a guide. People like pilots, doctors, guides – and yes, even lawyers – exist for a reason. Lawyers have experience and knowledge that the insurance companies don’t want you to know about. They do not want you to hire an advocate to look out for your best interests – someone who stands in the way of their goal of denying and devaluing claims.
If you’ve been injured in Kansas or Missouri due to the fault of someone else, you should consult with an experienced Kansas City personal injury lawyer to see what your rights are. It is no different than going to the doctor when you are sick, or calling a plumber when your faucet is leaking.