insurance company tactics

 

You may not realize it, but at the time of your accident or malpractice you waged a battle between you and your insurance company.

Insurance companies exist to protect their policy holders from claims and to pay proven claims. But in reality, insurance companies make their money by not paying claims-or by paying as little as possible. Think about it in this way. For every day the insurance company doesn't pay on your claim, it can invest that money and earn interest for its own profit. Every dollar the insurance company doesn't pay in claims increases its bottom line profit at the end of the year.

Every personal injury case is a series of battles with the insurance company. Your lawyer's job is to win and secure the best possible settlement or judgement. The insurance company and its lawyers have two goals: delay the settlement and make the settlement as small as possible.

Listed below are insurance tactics commonly used in the personal injury world.

Making Nice. Insurance representatives (often called adjusters) are trained to be nice to injury victims who don't have attorneys. Insurance company studies show that people treated in a friendly way are more likely not to hire lawyers. Studies show that injury victims without lawyers settle their claims for much smaller amounts. So if you don't have a lawyer, don't be surprised that your insurance adjuster calls frequently to ask about your medical treatment. Don't be surprised if they seem kind and deeply concerned about your welfare. But don't believe they have your best interests in mind. And remember, during every conversation your insurance adjuster will be taking notes, and what you say may be used against you later.

Requesting Unnecessary Information. Insurance companies have many excuses not to settle meritorious cases. One excuse is that their file isn't "complete." In other words, they want every record, every bill, every piece of paper concerning your case before they will evaluate it for settlement. Often they want documents having nothing to do with your injury, including old medical records from long ago. They are looking for information to deny your claim or reduce the amount of the settlement.

Deliberate Delay. By holding onto your settlement money, the insurance company earns interest on that money. So delay is to its advantage. Early in the case, the insurance company may claim it doesn't have all the medical records. In the middle of the case, the insurance company will insist that you be evaluated by a doctor they choose. At the end of the case, if it goes to court, the insurance company will refuse to settle until the case is scheduled for trial. Delay is usually in their interests.

Disputing Medical Treatment. The other side's insurance company will contest the amount of treatment you had. Sometimes they will claim you received "too much" treatment for your injuries, or that the treatment was "unnecessary." Many insurance companies use computer programs to "prove" that you over-treated or that you should have recovered more completely than you have. On the other hand, if you don't pursue regular treatment, the insurance company will argue this pattern proves you weren't seriously injured in the first place.

Hiding the Coverage. Until a lawsuit is filed, many insurance companies refuse to disclose the amounts of their policies. And if they finally reveal the amount of the policy, they'll neglect to disclose an excess or "umbrella" policy with additional coverage.

False Defenses. Because they make money from delay, insurance companies will use any excuse to postpone a fair settlement. Sometimes their insured will claim that the police report was wrong and that you caused the collision. In such cases, even where the insured's version is contradicted by eye-witnesses, the insurance company will refuse to settle because they have a defense, however questionable it may be.

Invading Your Privacy. Insurance companies routinely hire investigators to follow and photograph accident victims. No law prohibits an investigator from talking to your neighbors about your activity level, or conducting video surveillance without your knowledge. The insurance company may not have to disclose their surveillance information until the case is almost ready for trial.

Uncovering Your Injury History. Insurance companies all contribute to a computerized data bank which keeps track of all claims filed in the United States. Within minutes of receiving notice of your claim, the insurance company can run a search listing all prior accidents and injuries. So by withholding information about prior injuries from your doctor or lawyer, you won't prevent the insurance companies from uncovering your previous claims. In fact, they will know when and where you were injured, the type of injury, and the settlement you received. The companies wait for injury victims to lie under oath about prior injuries, and then confront them with the truth. Such a lie is far more damaging to your case than admitting the prior injuries honestly and up-front.