Dealing with insurance companies after suffering a personal injury, such as in a car accident, can be stressful and overwhelming. There are medical bills piling up, and insurance companies are trying their best to avoid paying these amounts. Therefore, it’s crucial to learn how to challenge insurance tactics that delay/reduce settlements.
This benefits individuals handling personal injury claims and seeking a smoother claims process. Insurance companies are known for employing specific tactics designed to delay or reduce settlement amounts, often leaving injured parties struggling financially and emotionally.
This comprehensive guide outlines how you can effectively challenge these insurance tactics, secure fair compensation, and protect your rights.
Recognizing Common Tactics Insurance Companies Use
To successfully counteract insurance company strategies, understanding their common tactics is crucial:
1. Delay Tactics:
Insurance adjusters frequently use delay tactics, such as repeatedly requesting unnecessary documents or claiming they never received your paperwork. These delays can also include frequent changes of adjusters, which cause confusion and further prolong your claim.
Other common delay methods include excessive reviews of medical records or prolonged investigations. The underlying goal is to extend the claims process long enough to create significant frustration and financial hardship, pressuring you to accept a lower settlement out of desperation.
For instance, an insurer might repeatedly ask for the same documents or request irrelevant details, knowing this prolongs your financial distress.
2. Low Initial Settlement Offers:
Often, insurers hope you’ll accept quick settlement offers significantly below your claim’s actual value. These initial offers typically ignore potential future medical expenses, long-term rehabilitation costs, and lost income resulting from extended time away from work. This is one of the top red flags that indicate your health insurance claim will get rejected.
Accepting such offers early can leave you financially vulnerable in the long run, unable to cover future medical treatments or living expenses. For example, a quick offer might seem appealing at first but neglects expensive surgeries or therapy sessions you may require later.
3. Denying Liability or Partially Blaming You:
Insurance companies may attempt to dispute liability entirely or argue that you share partial responsibility for the accident. For instance, an insurer might claim you were speeding or distracted, even when evidence clearly shows the other party was at fault.
By reducing your perceived responsibility, insurers attempt to lower or deny your compensation. An example is when insurers exaggerate minor details, like incorrectly claiming your headlights weren’t on during a nighttime accident, to shift blame.
4. Misinterpreting Medical Records and History:
Adjusters often scrutinize your medical records, looking for previous injuries or conditions they can claim as pre-existing or unrelated to your current accident. They may argue that your injury symptoms existed before the incident or are exaggerated, minimizing the severity of your claim.
For example, an insurer may suggest that chronic back pain reported years prior is the true cause of your current back injury, despite clear medical evidence demonstrating new or worsened injuries directly related to the accident.
5. Recorded Statements:
Insurance adjusters often request recorded statements soon after an accident, presenting them as routine. However, these statements may be taken out of context to weaken your claim.
Adjusters hope you might unintentionally minimize your injuries or contradict yourself, thereby weakening your position. For example, casual remarks like “I feel okay” shortly after an accident could be exploited later, even if symptoms worsened significantly afterward.
6. Using Private Investigators:
Companies may hire private investigators to secretly monitor your daily activities, hoping to catch evidence that contradicts your injury claims.
For instance, an investigator might record you performing physical tasks, implying you exaggerated your injuries, even if you performed these tasks briefly or in pain. Surveillance footage could be misleadingly presented to suggest you are healthier than you actually are.
Bad Faith Insurance Practices and their Legal Remedies Available
Bad faith practices occur when insurance companies intentionally refuse or delay paying legitimate claims. Examples include wrongful denial of claims, failure to properly investigate claims, and deliberately delaying payment without justification.
Victims of bad faith practices have access to several specific legal remedies:
1. Financial Compensation Beyond Initial Claims
Victims may recover additional financial losses caused by insurer misconduct, such as extended medical expenses, increased repair costs, lost wages due to prolonged negotiations, and other financial setbacks directly linked to unjust claim delays or denials.
This compensation ensures victims are financially restored beyond the initial claim amounts, accounting for all consequences of the insurer’s misconduct.
2. Emotional and Psychological Damages
Courts acknowledge the psychological impact of bad faith insurance practices, allowing victims to claim damages for emotional distress, anxiety, depression, and reduced quality of life. These damages acknowledge the significant non-economic impact that bad faith actions can have on a claimant’s life.
3. Punitive Damages
Punitive damages are awarded when insurers’ actions demonstrate malicious intent, extreme negligence, or particularly egregious behavior. These damages serve as a financial punishment to deter insurers from repeating such harmful practices.
Punitive damages can often be substantially higher than compensatory damages, reflecting the severity of the insurer’s misconduct and aiming to send a strong message against future violations.
4. Recovery of Attorney’s Fees and Costs
Claimants prevailing in bad faith actions frequently have the right to recover their legal fees and related litigation costs. This significantly reduces the financial barrier to seeking justice, ensuring that policyholders can fully pursue their rights without facing prohibitive legal expenses.
5. Promoting Insurance Industry Accountability
Legal actions against bad faith practices reinforce industry standards, prompting insurers to act ethically, transparently, and responsibly.
Successful litigation not only compensates victims but also sets important legal precedents, improving fairness and encouraging better behavior across the insurance industry. These cases serve as warnings to insurers, fostering greater respect for policyholder rights.
Effective Steps to Challenge Insurance Company Tactics
If you are looking for ways to challenge insurance company tactics, we recommend considering the following steps.
1. Seek Medical Attention Immediately
After experiencing personal injury, immediately seek medical attention. Prompt medical treatment establishes a clear link between the accident and your injuries, documented by medical professionals. These records become essential evidence supporting the full extent of your injuries and related medical expenses.
2. Document Everything
Keep detailed records, including accident and police reports, medical records, witness statements, and receipts for medical expenses and vehicle repairs. Such comprehensive documentation minimizes insurers’ ability to dispute or delay your claim.
3. Understand Your Insurance Policy
Carefully review your insurance policy to understand your rights and obligations clearly. Familiarity with your coverage can help you effectively challenge insurers who misrepresent or undervalue the benefits you’re entitled to receive.
4. Hire an Experienced Personal Injury Attorney
Legal representation significantly improves your chances of receiving fair compensation. A skilled personal injury attorney understands the complexities of the insurance claims process and effectively counters common tactics insurance companies employ. They can also help you if the insurance company ignores your claim.
Knowledgeable personal injury lawyers offer free consultations and can clarify your claim’s actual value, ensuring you pursue maximum compensation.
5. Avoid Providing Recorded Statements Without Legal Advice
Never agree to recorded statements or sign forms without having your attorney present. Adjusters often exploit these statements, using your own words against you.
Experienced attorneys can guide you through interactions with insurers, safeguarding your claim.
6. Do Not Rush the Negotiation Process
Avoid accepting initial settlement offers hastily. These offers rarely reflect fair settlement amounts, typically neglecting potential future costs or lost wages.
Waiting until you reach maximum medical improvement ensures your settlement accurately reflects your current and future medical and financial needs.
7. Challenge Denials Based on Medical History
Insurance adjusters may unjustly deny claims, citing pre-existing conditions. A knowledgeable attorney can effectively challenge this tactic by clearly demonstrating how your current injuries differ from or were exacerbated by previous conditions.
8. Counteract Surveillance Tactics
Insurers employing private investigators aim to undermine your credibility. Maintain honesty in all activities and report unusual or suspicious surveillance activities to your attorney, who can counter misleading interpretations during negotiations.
Forcing Faster Settlements From Insurance Companies
Here’s what you can do to force faster settlement from insurance companies to keep your compensation easier.
1. Present Comprehensive and Organized Evidence
Clearly presenting detailed, accurate, and well-organized evidence to insurers significantly accelerates settlement timelines. This includes providing thorough documentation such as medical reports, treatment plans, bills, witness statements, police reports, and expert evaluations.
Organizing this evidence systematically prevents insurers from claiming incomplete information, which is a common cause of delays.
2. Leverage Legal Timeframes and Regulations
Most jurisdictions have specific laws and regulations requiring insurers to respond to claims within designated periods. For example, under California’s Fair Claims Settlement Practices Regulations (10 CCR § 2695.5), insurers are required to acknowledge the receipt of claims promptly.
This is typically within 15 days and either accept or deny the claim within a specified timeframe thereafter. Familiarity with these regulations can help policyholders pressure insurers into timely compliance.
3. Engage an Experienced Attorney Early
Involving a knowledgeable attorney early in the claims process significantly speeds up settlement negotiations. Attorneys understand insurer obligations under the law and can proactively address delays or non-compliance.
They can also effectively communicate the potential consequences insurers face for failing to adhere to regulatory standards, which can prompt insurers to act swiftly to avoid litigation and regulatory scrutiny.
When to Escalate to Litigation During the Process
1. Persistent Delays or Non-compliance
Litigation may be required if an insurance company unreasonably delays a claim, violates legal deadlines, or denies coverage without justification.
Examples of persistent non-compliance include ignoring communication, repeatedly requesting redundant information, or failing to provide timely responses.
2. Refusal to Provide Fair Compensation
When insurers offer settlements that significantly undervalue claims or deny legitimate claims without reasonable justification, litigation may become essential.
Courts consider such actions evidence of potential bad faith, thus enhancing the claimant’s position in litigation.
3. Evidence of Bad Faith Practices
Clear signs of bad faith, such as intentional misrepresentation of policy terms, unjustified denials, or prolonged delays without explanation, indicate the necessity of legal action.
Filing a lawsuit citing statutes like California Insurance Code § 790.03 (Unfair Claims Settlement Practices Act) can effectively compel insurers to act responsibly.
4. Benefits of Litigation
Initiating legal proceedings demonstrates to insurers your seriousness and readiness to pursue your rights through the courts.
The prospect of potential court judgments, significant financial penalties, and punitive damages often encourages insurers to re-evaluate their stance and present fair settlement offers before proceeding further into litigation.
Mistakes to Avoid During the Claims Process
If you’re interested in handling the claims process smoothly, here are the primary mistakes you should avoid at all costs.
1. Failing to Seek Immediate Medical Attention
Delaying medical treatment can severely weaken your claim. Insurers may argue your injuries were minor or unrelated to the accident due to delayed treatment. Always seek prompt medical care to document injuries accurately and establish a direct link to the incident.
2. Providing Inconsistent Statements
Providing inconsistent information or inadvertently admitting fault when speaking to insurance adjusters can jeopardize your claim. Always consult an attorney before giving recorded statements or discussing details extensively with insurers.
3. Overlooking Future Damages
Accepting early settlement offers without considering potential future medical expenses or ongoing care costs is a common mistake. It’s crucial to understand the full scope of your medical prognosis and long-term impacts before agreeing to any settlement.
4. Ignoring Policy Terms and Deadlines
Failing to understand your policy terms, limits, and deadlines can result in denied claims. Familiarize yourself thoroughly with your insurance coverage and deadlines to ensure compliance and protect your entitlement to benefits.
5. Settling Without Legal Advice
Attempting to handle complex negotiations independently can lead to undervalued claims and unfair settlements. Hiring an experienced personal injury attorney ensures your rights are fully protected and compensation is maximized.
6. Excessive Social Media Activity
Social media posts can be used by insurance companies to dispute injury claims. Avoid posting content that might contradict your injury claims or present your activities in a misleading manner.
7. Losing or Not Collecting Evidence
Failure to properly document or preserve evidence can severely compromise your claim. Immediately collect and securely store all related evidence, including accident scene photos, witness contact (as insurance companies can contact witnesses), information, and official reports.
Avoiding these common pitfalls will strengthen your position, facilitate smoother negotiations, and significantly enhance the likelihood of securing fair compensation.
Final Thoughts
Insurance companies aim to protect their financial stability, frequently employing tactics designed to reduce payouts. Understanding these tactics, preparing thoroughly, documenting meticulously, and hiring skilled legal representation are essential steps toward obtaining maximum settlement and fair compensation.
Fight Your Insurance Claim Settlements With BLG
If you’ve been injured, immediately seek medical attention, thoroughly document all interactions, and consult with an experienced personal injury attorney at Bourassa Law Group to ensure your rights and financial stability remain protected.
We fight against unfair insurance tactics that delay or minimize settlements, ensuring you receive the compensation you deserve. We will fight for your rightful compensation and maximize the value of your claim. Contact us today for a free consultation, and let us handle the rest.
1-800-870-8910