10 Common Insurance Tactics to Devalue or Deny a Personal Injury Claim

 

An insurance company is in the business of making money. When someone is injured and files a claim, they are expecting fair compensation. But that’s not always what happens. If an insurance company settles a claim, that means their overall profits will be reduced. So how do they avoid that? The insurance company will employ a series of tactics to try to limit or even deny its liability. Here’s a look at some of their most common tactics and how personal injury attorneys can avoid them.

1. Calling a Plaintiff Shortly After Their Accident

It is very common for the at-fault party’s insurance company to reach out shortly after the incident and try to speak to the plaintiff. The agent will typically act very friendly – but don’t let their behavior fool you. They do not have your client’s bests interests at heart. These calls are designed to catch the injured person off guard when they are still injured and vulnerable, and perhaps haven’t had time to get a full medical consult or meet at-length with their attorney. The insurance agent is looking for information that can be used against the plaintiff. The easiest way to avoid this tactic is to avoid their calls. The plaintiff does not have to engage with the at-fault party’s insurance company.

2. Asking the Plaintiff for a Formal Statement

Insurance adjusters will frequently contact the plaintiff, asking them for a formal statement (verbal or written) to “verify the facts” or “to help process the claim.” But an insurance adjuster doesn’t need a formal statement in order to handle the claim. What they are actually looking for is information that can be used later in the case, whether it’s about the incident itself or the plaintiff’s injuries. They want information that will help them devalue or deny the claim. The plaintiff does not need to speak with the at-fault insurance company at this point, and they should not be providing a verbal or written statement. Instead, the plaintiff should be consulting with their personal injury attorney before they speak with the insurance adjuster.

 

3. Creating Insurance Company Name Confusion

Sometimes, the plaintiff and the at-fault party both have insurance policies through the same company. When this happens, the insurance adjuster might deliberately create confusion by contacting the plaintiff and not specifying that they represent the other party. In other words, the plaintiff believes they are speaking with their own insurance agent or representative when they’re actually speaking with the at-fault party’s insurance team. In this confusion, the plaintiff may reveal details that the adjuster can use to try and devalue or deny the claim. To avoid this situation, it’s a good idea for the plaintiff to take specific notes about who they are talking to and when – and to specifically ask the insurance agent whether they represent the plaintiff or the other party.

4. Asking the Plaintiff for a Medical Authorization

Asking the plaintiff to sign a medical authorization is another common insurance tactic. The insurance adjuster may contact the plaintiff, saying they need to see the medical bills in order to issue payment, or that they need medical records in order to verify the plaintiff’s injuries. They then send the plaintiff a blanket medical authorization (no time limits, no specific doctors). If the plaintiff signs this broad authorization, the insurance company will have access to the plaintiff’s entire medical history. With this tactic, the insurance company is looking for any previous injuries or medical conditions – relevant or not – that they can use to devalue or deny the claim. To avoid this tactic, the plaintiff should decline any requests for medical authorizations. Their personal injury attorney will provide the at-fault insurance company with the medical records needed to process the claim.

5. Downplaying the Plaintiff’s Injuries

When someone is injured in an accident, it’s natural to downplay any injuries. People are quick to insist that they’re fine or that they do not need to go to the emergency room. But, if a plaintiff delays treatment, the insurance company may try to devalue the claim, arguing that any injuries weren’t serious because the plaintiff didn’t seek medical care. If a plaintiff does seek treatment, insurance adjusters may also try to argue that the treatments were unnecessary or that the recovery process took longer than needed. To avoid this tactic, the plaintiff should seek the appropriate medical treatment and be consistent with their treatment/recovery plan. Insurance adjusters are not medical professionals, and they are not qualified to make observations about a plaintiff’s treatment or the recovery process.

6. Leveraging Personal or Medical Information Against the Plaintiff

Some insurance adjusters will use any information that they can against the plaintiff in order to get them to settle or reveal information that can damage their claim. It’s a common, aggressive tactic. For example, let’s say an insurance adjuster knows that the plaintiff is suffering from severe anxiety or that the plaintiff takes medication for anxiety issues. The adjuster may try to trigger that plaintiff’s anxiety by contacting them multiple times or speaking to them in a confrontational manner. The goal, in this situation, would be to get the plaintiff in such an anxious state that they inadvertently reveal information or agree to settle the case prematurely.

7. Delaying the Plaintiff’s Claim

Insurance adjusters know that the plaintiff wants to get paid. While plaintiffs are recovering from their injuries, many of them are out of work and have medical bills and other household expenses piling up. Another insurance tactic is to unnecessarily delay the claim, in order to frustrate the plaintiff. The insurance company is hoping that the plaintiff will become desperate for money and willing to accept a low-ball settlement. Or, the insurance company wants the plaintiff to become so annoyed by the process that they’ll desert their claim or accept any offer, just to be done with it. Some insurance companies will even go so far to delay the case in order to run out the statute of limitations on the personal injury case. A personal injury attorney can help communicate with the insurance company and prevent unfair settlements. Attorneys are also knowledgeable about their state’s statute of limitations and can help resolve the personal injury case before the statute of limitation clock runs out.

 

8. Denying Any Liability

To recover compensation on a personal injury claim, the plaintiff must prove that the other party caused the accident. The insurance company might try to deny liability by arguing that the plaintiff was partially at-fault (whether or not this is true). The insurance company might outright deny the claim, without sufficient reasoning. This is a very common insurance tactic. The company knows that many people will be confused or frustrated by the denial, and they will give up on the claim. With a personal injury attorney supporting them, the plaintiff can continue to pursue the claim and seek the compensation they deserve.

9. Misrepresenting the Insurance Policy’s Coverage

Insurance adjusters can be deceptive about the amount of insurance available for a claim. They may say that the coverage is much lower than what is actually available. Or, insurance adjusters might lead the plaintiff to believe that they are not entitled to seek damages for pain and suffering or for lost ages. A personal injury attorney can help the plaintiff find out what the insurance policy limits actually are, and can advise on the possible compensation available.

10. Insisting that the Plaintiff Doesn’t Need a Lawyer

Insurance companies want the plaintiff to settle their claim before they realize the full extent of their injuries, or before they understand how much their claim is worth. Once the release is signed, the plaintiff cannot seek additional money. If a plaintiff mentions wanting to hire an attorney, it is a common tactic for the insurance company to insist “you don’t need a lawyer” or “having an attorney won’t increase your settlement.” Personal injury attorneys have the knowledge and experience to make sure that the plaintiff will be fairly compensated for their injuries. Unlike the insurance company, an attorney will advocate for the plaintiff, protect their claim, and look out for their best interests.

With USClaims, pre-settlement funding can help your clients pay those unexpected expenses in anticipation of a court judgment or settlement. Call 1-877-USCLAIMS today for the information you and your clients need and deserve.

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