Is the Insurance Company Playing Games With Your Accident Claim?

Awarded$17.72 Million
In Baylor Stadium Construction Death

After suffering from a serious injury in an accident, you could find yourself fighting a new battle as you struggle to get the insurance company to give you a fair settlement. Insurance companies are notorious for doing everything they can to avoid paying out large settlements to accident victims. While you're busy going to the doctor and trying to recover from your injuries, the other driver’s insurance company is going to have an adjuster contact you. This person is probably going to start out being pretty friendly with you, acting concerned about your injuries and seeming like they want to help. However, don't trust the insurance company. We say it over and over again—the insurance company is not on your side.

Why Injured Accident Victims Should NOT Trust the Insurance Company

Why can’t you trust the insurance companies or their adjusters? Here’s the deal: insurance companies are for-profit businesses. There is nothing wrong with making money—it is something we all need to do—but many of these auto insurance companies are in the business of maximizing their value to their shareholders. They need to make a big profit to keep their shareholders happy. This means that they are motivated to limit how much they pay out for claims.

After an accident, the insurance adjusters will be very nice and sympathetic, but they aren’t doing this for your benefit. They are hoping to find little details that they can then use against you to deny, delay, or minimize your claim. If you have been hurt, here are just some of the many ways that insurance companies may try to maximize profits at your expense:

  • They contact you as soon as possible. Insurance adjusters are trained to contact you as soon as possible after you are injured. They try to get to you before you have stabilized from your injuries, and sometimes while you are even still in the hospital. They hope to catch you at a time when you don't yet have an attorney and don’t know your rights.
  • They try to get you to give a recorded statement. Insurance adjusters are trained to take your statement in a way to hurt your legal claim, usually asking you one-sided questions about your accident in hopes that you say something to incriminate yourself or undercut your personal injury claim. Most adjusters have taken hundreds of such statements, but you have probably never given such a statement. If you give a recorded statement, odds are you will significantly weaken your injury claim. Even though the insurance adjuster might bully you or say that refusing to give a recorded statement will hurt your claim, it won't.
  • They try to get you to sign away your rights. You may be asked to "sign some forms" almost immediately after you file your claim. The forms are usually long and full of complicated legalese. The adjuster may tell you, verbally, what the forms mean, but they never really tell you the truth. Don't sign any forms the adjuster presents to you. You could accidentally release your case forever, meaning you could never file a lawsuit. You could sign away your privacy rights and authorize the insurance company to delve into your personal background, even though they only need to have the information that absolutely relates to your injuries.
  • They make a “lowball” initial offer. Another favorite tactic of insurance adjusters is to give you a "lowball" settlement offer shortly after you file your claim. They hope you will jump at any monetary offer they give you. However, it is a bad idea to accept an offer from an insurance company if you have not had an attorney review your claim. It's probably also too early in your claim to even think about accepting any offer because you probably don't yet know how severe your injuries are or how much medical treatment you need.
  • They try to get you to accept a small settlement. Ultimately, all insurance company tricks come down to their bottom line. How little can they give you to make you go away? Even after a low initial offer, the insurance company is likely to continue to offer less than your case is truly worth.
  • They drag your case out as long as possible. Insurance companies know that time is of the essence, especially if you are struggling to make ends meet after the accident. The longer they drag it out, the more desperate they hope you’ll become.
  • They unfairly deny claims. Considering their profit motive, it should come as no surprise that insurance companies try to outright avoid paying claims whenever they can.
  • They hire cheap, inexperienced claims adjusters. Insurance companies save money by hiring cheap, inexperienced adjusters. If you are dealing with one of these adjusters, it’s likely that all you’ll get from them is a flat-out denial or a paltry payout that is pre-determined by a computer program, regardless of your personal situation.
  • They use standardized claims adjustment software. Standardized software allows insurance companies to decide how much they will pay out on each type of injury claim so they can keep costs down. What this means for you is that your compensation is based on a software algorithm, not what you really deserve.
  • They keep a law firm on retainer. This is one of the “dirty little secrets” of the insurance industry. They use lawyers to fight even small claims because most people don’t want to enter into a long, drawn-out legal battle just to get paid fairly after an accident.
  • They scare you away from hiring a lawyer. Insurance companies don’t like lawyers. Personal injury attorneys know from experience that accident victims usually get stiffed by insurance companies, and attorneys are usually able to get victims more money than they could get on their own.

I know it sounds like we are over-dramatizing what happens, but we have seen this time and time again in serious accident cases. We wish we could tell every car crash victim to be careful what they say or do for the insurance company after a bad car crash, but the sad truth is that a lot of victims are in the dark about their rights and how the insurance industry works.

Example: How Insurance Company Adjusters Use Medical Bills to Deny Injury Claims

As an example of a common insurance company trick, let’s take a look at some of the insurance companies' tactics on the issue of medical bills. The insurance companies want their adjusters to say your doctors overcharged you for medical care so they don’t have to pay the bill. Do they offer to pay the part of the bill that they consider reasonable? Of course not. Even if the insurance companies did offer to pay the part of the bill they consider to be "reasonable," here's the problem: insurance adjusters typically don't have the required qualifications to determine the reasonableness and correctness of medical bills. In order to make this determination, someone needs to have a background in the medical profession, at a minimum. 

In addition, the insurance companies train their adjusters to question "causation, duration, and frequency of treatment" in accident cases:

  • "Causation" means this: did the accident in question cause the need for the medical services that generated the bill in question?
  • "Duration" means this: did you see doctors for too long after you were hurt?
  • "Frequency of treatment" means: did you go see your doctors too often?

The answers to all these questions require medical expertise, which most insurance adjusters don’t have. Please don’t fall for these kinds of tricks. You deserve more after suffering a serious injury that wasn’t your fault.

Should I Talk to the Insurance Adjuster After I’ve Been Hurt in an Accident?

Insurance Agent Phone Call on a CellphoneYou are probably getting visits or calls from not one, but two or more insurance adjusters. Whether or not you should speak with the insurance adjuster after an accident will depend on which insurance adjuster you’re talking about. Each insurance company involved has an adjuster on your claim, and some insurance companies may have more than one adjuster on your claim. In every case that involves personal injuries and damage to a vehicle, each insurance company opens two separate claims with an adjuster on each. You may be asked to speak to several different insurance adjusters about:

  • Property damage. When dealing with the property damage portion of your claim, speaking with the adjuster will generally help get your property claim settled more quickly. The adjuster for your property claim will inspect your vehicle, determine the damages, and make you an offer based on values generally determined by leading car-pricing guides, such as Kelley Blue Book.
  • Your injuries. When speaking with the insurance adjusters for the person who hit you, you need to realize that these adjusters are not on your side and are not trying to help you. In fact, they are trying to pay you as little as possible. If at all possible, you should speak with a lawyer before you speak with these adjusters.
  • Other vehicles involved in a crash. If there were multiple vehicles involved in the accident, you will be hearing from adjusters for the insurance for all of these people. Again, they will each have a property damage adjuster and an injury adjuster.
  • Your own insurance coverage. If you have auto insurance, you may have coverage on it that you could claim. So, your own insurance company will assign an adjuster for your accident. Usually, the adjuster for your own insurance will be on your side.

If you are unsure if you should be speaking with an insurance adjuster, don't hesitate to call our experienced injury lawyers. We will help you determine your legal rights and how you can best protect yourself in your situation.

The Insurance Company Says I Don't Need a Lawyer. Is This True?

In their initial visit with you, insurance adjusters will try to talk you out of contacting a personal injury attorney. They may even bad-mouth lawyers in general. What they won't tell you is that, while you hang around without an attorney, the insurance company has literally hundreds of attorneys on retainer working around the clock, examining your claim for ways to minimize or even eliminate it. Some insurance companies will send letters to people involved in accidents that tell the injured person that they do not need an attorney. Since 1995, for example, Allstate has been sending a letter entitled "Do I Need an Attorney?" which makes the following misleading claims, among others:

  • Claims are settled faster when a lawyer is not involved.
  • Lawyers charge a percentage of recovery but, if you settle directly with Allstate, you get to keep the entire amount.
  • Injury victims can hire a lawyer later if they don't like the settlement offer.

The letter includes many other statements that are misleading, half-true, or not true at all. In fact, the insurance company's own statistics prove that it costs the insurance industry an average of $9000 more per claim when the injured person has a lawyer. The reason the insurance companies try to convince people not to hire an experienced lawyer is because they know they can settle the case more cheaply if the injured person doesn't have a lawyer.

The real truth is that talking to a personal injury attorney—sooner rather than later—can only help your claim. A lawyer who is experienced in handling personal injury claims can walk you through your claim and give you a sense of the compensation you deserve after being hurt. Even if you don't wind up hiring an attorney, that initial discussion will help you be able to better navigate the claims system and obtain a better settlement. If the insurance company is trying to convince you not to hire a lawyer, you should know right away that they are trying to trick you into settling your case for pennies on the dollar. Talking to an attorney will only strengthen your claim.

How Can I Avoid Falling for Insurance Company Tricks?

Insurance companies play a game with you when you try to make your injury claim. You will never win at their game, because they made up all the rules to benefit themselves. However, there is a lot you can do to protect yourself and avoid falling for their tricks:

  • Don’t delay getting medical care.
  • Write down everything you remember about the accident, including information about the exact accident location, weather, time of day, the presence of witnesses—anything and everything you recall.
  • Get a copy of the police report
  • Don’t sign anything from the insurance company until you talk to a lawyer. 
  • Don’t give the insurance company a recorded statement. 
  • Don’t sign a blanket medical release form. 
  • Don’t settle quickly
  • Don’t mess around with your future and your family’s well-being—get advice and guidance from an experienced attorney before making any decisions about your case.

If you have any question about whether or not the insurance adjuster is on your side, try asking them these pointed questions:

  • Can I talk to your client alone?
  • How much insurance does your client have?
  • Can I take a recorded statement of your client?
  • Will your client sign this form that says they were 100% at fault in causing my accident?
  • Will you pay my doctor's bills right now?
  • Will you pay me for my lost wages?

Listen to the adjusters’ reactions when you request these items. Their demeanor will reveal to you right away whose side they are really on.

It isn’t about accident victims getting rich. It is about victims having enough money to pay for the months, years, or even lifetime of medical care they’ll need after a bad accident. For most serious injuries and accidents, you absolutely must consult with an experienced personal injury lawyer if you want to fight for the full worth of your claim. Once your case is in the hands of a qualified injury attorney, the insurance company can no longer play by its own made-up rules, but must abide by the rules of our legal system.

Fortunately, for the most part the rules of our civil justice system are fair to injury victims, and they are certainly much fairer than the insurance company's rules. If you believe the insurance company is using any of these tactics against you, call us now at 1-877-724-7800 or start a Live Chat now.