Insurance companies are businesses, and they have an interest in keeping claim costs under control. After an accident or injury, an insurer may closely review your claim, ask for detailed documentation, take longer than expected to respond, or make an early settlement offer that falls short of covering your losses.
Knowing what to expect during the claims process and understanding more about dealing with insurance companies can help you spot potential problems and take steps to protect your rights.
Common Tactics Used by Insurance Companies
Insurance adjusters might use one or more common tactics to minimize, delay, or deny an injured person’s claim. From disputing fault to making a lowball offer, or even causing a deliberate delay, their tactics can interfere with your right to recover damages.
Disputing Fault
One of the most common tactics that insurers will use to undermine a claim is to dispute fault. They may push fault onto you by claiming you were partially or fully responsible for your own injuries in the accident. In some states, depending on liability laws, being assigned fault can greatly harm your case and the ability to secure compensation.
Challenging Medical Evidence
Having solid medical documentation is essential for your claim. Insurers often look to medical evidence to minimize compensation. Any gaps in treatment can be used against you to make it appear as though your injuries were not as serious as you claim.
If you had a pre-existing condition before the accident, an insurer may try to argue that your current injuries are related to that condition rather than the accident. Gaps in your medical records can make that argument easier. Keeping up with your medical appointments and following your treatment plan will provide a clear and consistent record of your injuries and recovery.
Lowball Offers
Personal injuries often stem from traumatic and stressful experiences. Whether you were in a car accident or fell at a grocery store, it is understandable that you want to put the incident behind you and move forward with recovery.
Insurers know this, and will often pressure you to accept the first settlement offer they present. However, this offer is usually a lowball amount that does not fully compensate you for your damages. By waiting until you can calculate the full extent of your losses, you are more likely to receive adequate compensation.
Deliberate Delays
Insurance companies sometimes deliberately take a long time to resolve a claim. This can make the process frustrating and leave you feeling pressured to accept a lower settlement. Delayed responses, repeated requests for documents, and other obstacles can increase stress and make it harder to move your claim forward.
Recorded Statements
Insurance companies often use recorded statements to twist your words and try to place greater blame on you.
When speaking with insurers, stick to the facts and never make assumptions about what took place or who may be at fault. Do not provide more information than legally required.
You can also allow your attorney to communicate with insurance adjusters on your behalf to avoid accidental admissions of fault.
Social Media Posts
When it comes to social media, like Facebook or Instagram, the other party or the claims adjuster will likely be monitoring your posts. Even if you think your settings are private, anything you say could be used against you to minimize compensation. Keep any and all information you share about the accident to a minimum.
How Do Insurance Adjusters Evaluate a Claim?
Insurance adjusters consider several factors when determining whether a claim is covered and how much compensation is appropriate. The process can vary depending on the type of claim and the terms of the policy. However, adjusters often consider:
- Incident details: When and how the accident, injury, or damage occurred
- Coverage: Policy terms, limits, exclusions, and deductibles for covered losses
- Evidence: Photos, medical records, witness statements, and other documents
- Damages: Extent of medical costs, property damage, and lost income
- Liability: Who was responsible and whether others contributed
- Consistency: Gaps in statements, records, and evidence
Knowing what an adjuster considers when reviewing a claim can help you gather the records and evidence needed to support it.
How To Tell if a Settlement Offer Is Too Low
There are several warning signs of a lowball settlement offer. If an insurance adjuster has made you an offer to settle your claims, consider the following:
- Your treatment is ongoing: If you are still being treated, you likely don’t know the full extent of your injuries, expenses, or recovery needs.
- Pressure to settle quickly: Immediate offers or short deadlines prevent careful evaluation.
- Future costs are missing: The offer might omit anticipated treatment, rehabilitation, ongoing care, and related expenses.
- The injury’s full impact is overlooked: The settlement may not cover lost earning capacity, pain and suffering, or effects on daily life.
- The injury is minimized: If the insurer describes your injuries as minor or says you have recovered when your medical records show otherwise, take a close look at the settlement offer before accepting it.
Once you accept a settlement offer, you cannot go back and ask for more money. Before accepting, make sure it accounts for both current and anticipated losses. Seeking legal guidance is the best way to know if your settlement offer is adequate.
Protecting Your Insurance Claim
After an accident, keep track of what happened and save records related to your medical treatment, bills, lost wages, and communications with the insurance company. It is also a good idea to keep photos from the scene and any other evidence that may help support your claim.
When dealing with the insurance company, stick to the facts and provide accurate information. Avoid guessing about who was at fault, downplaying your injuries, or agreeing to a settlement before you understand what it covers and whether it fully accounts for your losses.
If liability is disputed, the insurer refuses to pay, or you are unsure whether a settlement covers your losses, consider consulting an attorney. They can handle negotiations with insurers and help you avoid costly mistakes.
Steps To Take After Receiving a Settlement Offer
There are key steps you should take after receiving a settlement offer. Before accepting the amount, compare the damages with your documented medical bills, lost wages, property damage, and other losses. Consider whether the offer accounts for future medical expenses or other ongoing costs.
Also, pay close attention to any language that could prevent you from seeking additional compensation later if new damages or expenses arise. If you are not sure whether the settlement covers all of your losses, consider having an attorney review the offer before you sign it.
Reach Out for Legal Support With Your Insurance Claim
Understanding how insurance companies handle claims can help you recognize when an offer, delay, or request for information could affect the value of your claim. If your claim has been denied or delayed, you have received a low settlement offer, or you are unsure what to do next, an attorney can review your situation and explain your options.
Cordisco & Saile, LLC is committed to protecting clients’ rights and pursuing the compensation they are entitled to receive. We offer free initial consultations. Contact us today at 215-642-2335 to discuss your insurance claim and learn how our legal team can help.
