When people are injured in an accident, they anticipate the insurance company to cover their losses and provide financial support for repairs, medical expenses, and other related costs without unnecessary delay or dispute.
Unfortunately, this isn’t always the case, as many insurers are taught to protect their bottom line by paying out as little as they can, often engaging in tactics like disputing the claim’s validity, delaying communication, and offering low settlement amounts in the hope that claimants will settle quickly to avoid a protracted process.
In this article, we discuss common unscrupulous insurance company tactics, including denial of claims, delaying claim processing, underestimating the value of claims, offering low settlement offers, and applying pressure and intimidation tactics.
To avoid being taken advantage of and protect your rights as an accident victim, it is important to understand your insurance coverage, document everything related to the accident, and seek help from an experienced personal injury attorney who will advocate on your behalf, negotiate with insurance companies, and ensure that you receive the full compensation you deserve.
Please take a moment to watch this video by experienced Texas personal injury attorney Ty Stimpson, who discusses the value of a personal injury case and why you should never settle for less.
Why Insurance is Important in Accident Injury Claims
Insurance plays a pivotal role in accident claims by providing a safety net and financial protection for individuals involved in accidents. The importance of insurance in accident claims cannot be overstated. Here are eight reasons why it is important for everyone to carry it:
Financial Security: Insurance provides critical support to cover medical expenses, property damage, and other unforeseen costs that can arise from an accident, shielding individuals from the financial strain that could otherwise be devastating.
Legal Compliance: In many places, carrying certain types of insurance is legally required for drivers and owners of vehicles. This legal safeguard ensures that all parties have some form of financial backup in the event of an accident, thereby upholding the law and avoiding potential fines or legal actions.
Compensation for Losses: Insurance allows for the compensation of losses without the need to directly pursue the responsible party, which can be a lengthy and uncertain process. It can cover a variety of costs, from tangible losses like vehicle repairs to intangible ones like pain and suffering.
Prompt Claims Settlement: The structured process that insurance companies have in place for handling accident claims can lead to a more efficient resolution and prompt financial assistance, helping victims focus on their recovery rather than on how to afford it.
Peace of Mind: Knowing that you have insurance provides peace of mind that, should an accident occur, you have a plan in place to handle the financial repercussions, allowing for a less stressful recovery period.
Protection Against Lawsuits: If you are at fault in an accident, your insurance can cover the costs up to your policy’s limit, protecting your personal assets from being used to pay for damages in a lawsuit.
Accessibility to Healthcare: With health insurance or personal injury protection, you have better access to medical care, often receiving the necessary treatment without having to pay out of pocket at the time of service.
Prevention of Financial Ruin: Serious accidents can result in exorbitant costs that could potentially bankrupt individuals without sufficient insurance coverage, so having a comprehensive policy in place is a buffer against financial disaster.
Think of insurance as a safety net that helps people get back on their feet quickly after an accident by taking care of the costs and giving them less to worry about.
What is an Accident Claim?
An accident claim, also known as a personal injury claim, is a legal process that allows individuals to seek compensation for damages and injuries sustained in an accident. This process involves filing a formal request for financial reimbursement for the losses incurred due to the accident. Accident claims can cover various scenarios, such as car accidents, construction injuries, slips and falls, and defective products.
The primary objective of filing an accident claim is to hold the negligent or at-fault party accountable for their actions. By pursuing a claim, individuals aim to recover financial compensation to cover medical expenses, property damage, lost wages, pain and suffering, and other related costs resulting from the accident.
Accident claims are crucial in ensuring that victims receive the necessary support and resources needed to recover from full extent of their injuries and rebuild their lives. They provide a legal avenue for victims to seek justice and regain their financial stability after going through an accident through no fault of their own.
To initiate the accident claim process, individuals must gather relevant evidence, including photographs, witness statements, medical records, medical history, and any other documentation that supports their case. Adhering to legal procedures and meeting deadlines is also essential to ensure that the claim is valid and recognized by the appropriate authorities.
Consulting with a skilled legal professional or law firm specializing in personal injury law is crucial to navigate the complexities of the accident claims process effectively. An experienced attorney can offer guidance, negotiate with insurance companies on behalf of the claimant, and ensure that their rights are protected throughout the proceedings.
Common Insurance Company Tactics
Even though insurance is vital, insurance companies can be shady when it comes to processing accident claims. In this section, we’ll explain common tactics insurance companies they use to minimize the amount they pay out in injury claims.
From denying claims and delaying processing to underestimating claim values and offering low settlement offers, these practices can often leave claimants feeling unfairly treated. Insurance companies may employ pressure and intimidation tactics to push for outcomes that protect their bottom line. Here’s a look at common insurance company tactics:
Denial of Claims
Insurance companies may try and deny your claim altogether, refusing to provide compensation for damages or injuries sustained in an accident. One of the reasons they may cite for the claim denial is that the insured party was not at fault for the accident. Insurance companies may argue someone else’s negligence or that the policyholder was negligent or violated the policy’s terms. In certain cases, insurance companies may even engage in bad faith practices by wrongfully denying valid claims.
Addressing a denial of a claim requires a thorough understanding of your insurance policy. It is important to carefully review the terms and conditions to determine whether the denial is justified or if the insurance company is acting in bad faith. In order to dispute the denial or file a complaint, it is crucial to document all relevant information related to the accident, including photographs, police reports, medical records, and witness testimonies.
Obtaining legal advice is imperative in these situations. An experienced personal injury attorney can analyze your case, assess the validity of the denial, and offer guidance on how to proceed. They will handle all communications with the insurance company and advocate on your behalf to secure a fair settlement or representing you in court if necessary.
Delaying Claim Processing
Claim processing delays are a commonly employed tactic by insurance companies to delay tactics frustrate claimants and dissuade them from pursuing their rightful compensation. Here’s how and why they do it:
Insurance companies may intentionally prolong the settlement process by requesting unnecessary documentation or repeatedly soliciting additional information. This practice can extend the claim processing timeline and generate frustration for the claimant, who may get so worn down that they accept a low settlement.
Delays in processing the claim can also be caused by purposefully scheduling unnecessary meetings, inspections, or medical evaluations. These delays can impact the claimant’s ability to receive the compensation they rightfully deserve when they need it most.
Insurance companies may employ various excuses, such as a heavy workload, missing paperwork, or a shortage of staff, to justify the delay. It is important for claimants to be aware that these excuses are often used to drag out the settlement process.
If you believe the insurance company is intentionally delaying claim processing, it is importnat to keep detailed records of all correspondence, including dates and names of individuals involved, and to contact and experienced personal injury attorney who can challenge any efforts by the insurance company to prolong the process. Here’s how an attorney can help:
The attorney will be familiar with the injured party’s rights and the specific timeline within which insurance companies are legally obligated to process and settle claims. They know how to hold insurance companies accountable for any undue delays.
The attorney will proactively communicate with the insurance company and follow up on unanswered inquiries. This demonstrates to the insurance company that the claimant is serious and committed to pursuing their claim.
In certain instances, filing a complaint with the appropriate regulatory authority may be necessary to address and resolve the issue of claim processing delays. The attorney will handle this for you.
Underestimating the Value of Claims
Insurance adjusters are notorious for underestimating the value of claims. They intentionally devalue the damages and injuries suffered by the victim, in an attempt to minimize their payout. Underestimating the value of claims can have dire consequences for accident victims, resulting in insufficient compensation that fails to adequately cover medical expenses, property damage, lost wages, and other financial losses.
That’s why it is so important to let an experienced personal injury lawyer handle this process for you. The lawyer will gather solid evidence to accurately assess the true value of your claim. This may include medical records, repair estimates, and proof of lost wages. The attorney will then relentlessly negotiate with the insurance company until you are compensated for the true value of your claim. If not, they will file a lawsuit and advocate for you in court.
Offering Low Settlements
Insurance companies routinely offer low settlement offers in order to minimize their financial liability in accident claims. Here’s what you need to know:
At the beginning of the claims process, insurance companies may present low settlement offers as a means to save money and avoid paying the full entitled amount to the victim. It is important to keep in mind that these initial offers often fall significantly below the actual value of the claim.
Low settlement offers, although presented as final, can be negotiated. Accident victims have the right to reject these offers and continue the negotiation process to obtain fair compensation.
When confronted with a low settlement offer, it is crucial to gather evidence that supports your claim. This includes medical records, photographs documenting injuries or property damage, and any other pertinent documentation that demonstrates the extent of your losses.
Seeking legal advice is highly recommended if you’ve been offered a low settlement offer. Personal injury lawyers specialize in negotiating with insurance companies and can accurately calculate the appropriate compensation range based on the specific circumstances of your case.
Accepting a low settlement offer may lead to financial hardships in the future. You can’t go back and get more money once you’ve accepted it. It’s important to think long-term and consider future costs for ongoing expenses for medical treatment, rehabilitation, and lost wages.
Achieving fair compensation and resolving claims often requires persistence and patience. Let your attorney fight for full compensation.
Disputing Medical Treatment
Disagreements over medical treatment are a common tactic insurance companies and some insurance companies use to limit payouts to accident injury victims. Here’s what they do:
Questioning Treatment Validity: Insurance adjusters may challenge the necessity or appropriateness of medical procedures, arguing that they are excessive or unrelated to the accident.
Disputing Costs: Insurance providers might contest the cost of medical care, suggesting that the charges are higher than the industry standard or that certain treatments should be cheaper.
Delaying Approval: Some insurers drag their feet in approving essential treatments, which can lead to a worsening of the claimant’s condition, subsequently arguing that any deterioration is not their responsibility.
Independent Medical Exams (IMEs): Insurance companies often require claimants to undergo IMEs by doctors of their choosing, who may downplay injuries or recommend less expensive treatments.
Pre-existing Conditions: Insurers might attribute injuries to pre-existing conditions, thus claiming that the accident is not the primary cause of the victim’s need for medical treatment.
By employing these methods, insurance companies can significantly reduce their financial obligation to accident victims, often leaving them with inadequate compensation for their injuries.
Applying Pressure and Intimidation
While many insurers operate with integrity, the industry is not immune to instances of unscrupulous behavior. Some insurance agents will use pressure and intimidation to push individuals to accept unfavorable terms or abandon legitimate claims. Here are some intimidation tactics:
Quick, Lowball Offers: Initially, insurers may present an offer that’s far less than the claim’s worth, pressuring the victim to accept quickly before they can fully assess the damages or consult legal advice.
Claim Discrediting: Insurers might attempt to discredit the claim by suggesting that the victim is exaggerating their injuries or was at fault for the accident, creating doubt and fear of receiving nothing.
Fast Settlement Push: There’s often a push for a quick settlement, with insurers stressing that offers are time-limited, preying on victims’ immediate need for funds during a vulnerable time.
Surveillance Threats: Some insurers imply they will surveil claimants to catch any behavior that could invalidate the claim, instilling a sense of paranoia and invasion of privacy.
Excessive Documentation Requests: By asking for an overwhelming amount of paperwork and evidence, insurers can make the process seem daunting, hoping victims will give up or settle for less.
Legal Jargon and Complexity: The use of complicated legal terms and processes can intimidate claimants, especially those unfamiliar with legal procedures, causing them to acquiesce to lower settlements for fear of legal entanglements.
These strategies exploit the stress and trauma accident victims already face, often leading to unjust outcomes. Recognizing these tactics is the first step in advocating for fair treatment and compensation.
How to Handle Insurance Company Tactics
When it comes to dealing with insurance company tactics in accident claims, knowledge is power. In this section, we’ll show you how to handle these tactics like a pro. From understanding your policy to documenting every detail, we’ve got you covered. We’ll also discuss the importance of filing a complaint if necessary and protecting your rights as an accident victim.
Stay Calm and Composed
Staying calm and composed during insurance claim processes is crucial. Here’s why:
Clear Decision-Making: Emotional responses can cloud judgment. Remaining calm allows you to make decisions based on facts, not stress or fear.
Professional Interaction: Insurance adjusters are more likely to take your claims seriously if you engage in a composed, professional manner.
Avoiding Intimidation: Insurers may use pressure tactics, but a calm demeanor shows you’re not easily intimidated or rushed into decisions.
Accurate Information Relay: You can communicate details of the accident and your injuries more clearly if you’re composed, ensuring the insurer has the facts straight.
Stress Reduction: The process can be long and taxing; keeping your composure helps to manage stress, benefiting your overall well-being.
Legal Leverage: If negotiations stall or an insurer acts in bad faith, a calm record of all interactions can serve as an advantage if legal action becomes necessary.
Patience and composure don’t just help in communicating with insurers; they’re also vital in managing the financial difficulties of the accident’s aftermath and recovery journey.
Understand Your Policy
Understanding your insurance policy is crucial when dealing with accident claims. It helps you understand your policy, know your rights, coverage, and the steps you need to take to file a claim effectively. Here are the steps to understand your policy:
Review your policy documents: Take the time to carefully read through your insurance policy. Understand Your Policy coverage limits, deductibles, exclusions, and any other important details.
Identify the relevant sections: Identify the sections of your policy that are applicable to your accident claim. This may include sections on liability coverage, personal injury protection, or medical payments coverage.
Know the deadlines: Understand deadlines for filing a claim and submitting any required documentation. Failure to meet these deadlines may result in a denial of your claim.
Understand the coverage limits: Familiarize yourself with the coverage limits stated in your policy. This will help you determine the maximum amount you can claim for damages or injuries.
Know your responsibilities: Be aware of any responsibilities you have as the policyholder. This may include notifying the insurance company promptly after an accident or cooperating fully during the claims process.
Seek clarification: If there are any aspects of your policy that are unclear or confusing, contact your insurance provider for clarification. They can explain any terms or provisions that you find difficult to understand.
Keep your policy handy: Keep a copy of your insurance policy in a safe and easily accessible place. It will serve as a reference throughout the claims process.
Consult with professionals: If you’re unsure about any aspect of your policy or the claims process, consult with an attorney or insurance specialist who can provide guidance and ensure you are fully informed.
Stay informed: Keep yourself updated on any changes or updates to your insurance policy. Insurance companies can modify their policies, and it’s important to be aware of any changes that may affect your coverage.
Keep notes: Keep records of all interactions with the insurance company, especially when they resort to pressure and intimidation tactics. Write down dates, times, and details of conversations or any attempts at pressuring or intimidating you. This documentation can be useful if you need to file a complaint or take legal action in the future.
Know Your Rights
When it comes to dealing with insurance companies in accident claims, it is crucial to know your rights. Understanding your rights can help protect your interests and ensure you receive the compensation you deserve. Here are some important rights to be aware of:
Right to be Informed: You have the right to be informed about the claims process, your policy coverage, and any updates or changes in your case.
Right to Timely Processing: Insurance companies must handle your claim promptly and efficiently. They are required to provide a reasonable timeline for claim processing and keep you informed of any delays.
Right to Fair Evaluation: Insurance companies must fairly evaluate your claim based on the evidence and applicable laws. They cannot undervalue or underestimate your damages or offer an unreasonably low settlement.
Right to Appeal: If your claim is denied or you are unsatisfied with the settlement offer, you have the right to appeal the decision within the terms of your policy. The insurance company must provide clear guidelines for the appeals process.
Right to Legal Representation: You have the right to consult with an attorney and seek legal advice throughout the claims process. An experienced lawyer can help protect your rights and negotiate on your behalf.
Knowing your rights and taking proactive steps will help protect your interests and ensure a fair resolution to your accident claim. Remember to stay informed, keep thorough documentation, and seek professional guidance when necessary.
In the wake of an accident, one of the most critical steps for securing just compensation is to meticulously document every aspect of the incident and its aftermath. This includes:
Capturing visual evidence of the accident scene, property damage, injuries, and any other relevant details.
Recording the date, time, and location of the accident, as well as the names and contact information of any witnesses. Describe the events leading up to the accident and any statements made by the other parties involved.
Documenting your injuries, symptoms, and the impact they have on your daily life. Include details about medical treatments, appointments, prescriptions, and any changes in your condition over time.
Keeping copies of all documents related to the accident, such as police reports, medical bills, property repair costs, transportation costs, lost wages and any out-of-pocket expenses.
Maintaining a record of all written and verbal communication with insurance adjusters, including dates, times, and the content of the conversations. Note any promises made or disputes that arise.
Ensuring your documentation is consistent and accurate throughout the entire claims process. Any discrepancies or omissions could be used against you, so it’s essential to maintain a thorough and reliable record.
Making electronic copies or backing up your documents and records to prevent the loss of crucial information. Storing them securely will ensure they are accessible if needed.
Seek Legal Advice
If you’ve been injured in an accident, it’s best not to deal with insurance companies at all. Let an experienced attorney handle your claim. An attorney will:
have the knowledge and expertise to navigate through complex legal processes;
thoroughly investigate the accident and gather necessary evidence;
accurately evaluate the value of your claim by considering factors such as medical expenses, lost wages, and pain and suffering;
handle all communication with insurance companies so you can focus on recovery;
aggressively negotiate with insurance companies on your behalf;
advise you on what to expect during settlement negotiations or if your case goes to court;
file a lawsuit if necessary;
represent you in court and fight for the compensation you deserve.
File a Complaint if Necessary
If you believe that your insurance claims adjuster has engaged in unscrupulous tactics, it may be necessary to file a complaint. Here are the steps to follow if you need to file a complaint against an insurance company:
Gather all your documentation and evidence related to the claim. This includes your policy details, communication with the insurance company, and any supporting documents.
Review your insurance policy to understand your rights and the terms and conditions that apply to your claim.
Contact the insurance company’s customer service department and explain your complaint clearly and concisely. Provide them with all the necessary information and details about your claim.
If necessary, file a formal complaint with the insurance company’s customer service department. If the customer service representative is unable to resolve your complaint satisfactorily, ask to speak to a supervisor or escalate the complaint to a higher level within the company.
If the insurance company still does not address your complaint or provide a satisfactory resolution, you can file a formal complaint with the appropriate regulatory authority. Research and find the relevant regulatory body for insurance complaints in your country or state.
Prepare a written complaint to the regulatory authority, clearly explaining the issues you have encountered with the insurance company. Include any supporting documents and evidence.
Submit your complaint to the regulatory authority either electronically or through mail, following their specific instructions for filing complaints.
Keep a record of all communication and correspondence with the regulatory authority regarding your complaint.
Cooperate with the regulatory authority and provide any additional information or documentation they request to investigate your complaint.
Continue to follow up with the regulatory authority on the progress of your complaint and any updates regarding its resolution.
Why Hiring a PI Lawyer Is Crucial for Legal Guidance and Support
When dealing with accident claims, hiring a lawyer for legal guidance and support is an essential step. Lawyers play a vital role in helping accident victims navigate the complex legal process and ensure their rights are protected. Here are some reasons why hiring a lawyer is crucial:
Knowledge and Expertise: Lawyers specializing in accident claims have in-depth knowledge and expertise in personal injury law. They understand the complexities of the legal system and can guide you through each step of the process.
Maximizing Compensation: An experienced lawyer will fight for your rights and work to maximize your compensation. They will assess the damages you have suffered, including medical expenses, lost wages, and pain and suffering, to determine the fair amount of compensation you deserve.
Building a Strong Case: Lawyers know how to gather evidence, interview witnesses, and obtain expert opinions to build a strong case on your behalf. They will ensure all necessary documentation is gathered and presented properly in court.
Negotiating with Insurance Companies: Insurance companies often try to settle claims for as little as possible. A skilled lawyer will negotiate with the insurance company on your behalf, ensuring your interests are protected and that you receive a fair settlement.
Litigation Support: If a fair settlement cannot be reached through negotiation, a lawyer will file a lawsuit and represent you in court. They will present your case effectively, argue for your rights, and advocate for the compensation you deserve.
Peace of Mind: Dealing with the aftermath of an accident can be overwhelming. Hiring a lawyer allows you to focus on your recovery while knowing that you have a legal professional handling your case.
It is important to choose a lawyer with experience in accident claims and a track record of success. Consultations are often offered free of charge, allowing you to discuss your case and determine if the lawyer is the right fit for you. Hiring a lawyer for legal guidance and support is a crucial step towards obtaining fair compensation and ensuring your rights are protected throughout the accident claims process.
Injured in an Accident? Contact Varghese Summersett.
If an accident has disrupted your life, it’s time to bring in the heavyweights. At Varghese Summersett Injury Law Group, we’re not intimidated by big insurance companies and their tactics. We’ve seen it all, and we know how to push back, ensuring they don’t push you around. We will stand up for you and fight to secure the compensation you rightfully deserve. Reach out to us now – let us take on the legal battle while you focus on healing. Call 817-207-4878 (HURT) for a free consultation. Best of all, you don’t pay anything unless we win.