Strategies Insurance Companies Use to Deny or Devalue Claims

Insurance companies spend a decent amount of time and energy working to lower settlements, typically to the detriment of the person who has been injured or sustained property damage. However, understanding the strategies that the insurance carriers use to deny or devalue your claim can help alleviate your anxiety about the claims process while preparing you for any pushback you receive.

Delaying the Claims Process

One of the most common strategies insurance companies use is delaying the processing of your claim. They may request additional documentation, take an excessive amount of time to review your claim, or simply fail to respond promptly. The intention behind this delay is often to frustrate the claimant, leading them to accept a lower settlement out of desperation or to give up on the claim altogether.

• How an attorney can help: A personal injury attorney in St. Petersburg can push the insurance company to act within reasonable timeframes, ensuring that your claim does not get unfairly delayed.

Disputing Liability

Insurance companies frequently try to dispute liability by claiming that their policyholder was not at fault or that you were partially or fully responsible for the incident. This strategy can reduce or even eliminate altogether the compensation you might receive, especially in states with contributory negligence laws where any level of fault can bar recovery.

• How an attorney can help: An attorney can gather evidence, such as witness statements, accident reports, and expert testimony, to prove liability and counter the insurance company’s claims.

Offering a Low Initial Settlement

Insurance companies often present an initial settlement offer that is much lower than what your claim is actually worth. They do this in the hope that you will accept the quick payout without realizing that it does not cover all of your damages, including future medical expenses or lost wages.

• How an attorney can help: An attorney can assess the true value of your claim and negotiate with the insurance company to ensure that you receive a fair settlement that reflects the full extent of your damages.

Using Recorded Statements Against You

After an accident, an insurance adjuster may ask you to provide a recorded statement. While this may seem like a standard part of the claims process, these statements can be used against you to devalue your claim. Adjusters are trained to ask questions in a way that may lead you to admit fault or downplay your injuries.

• How an attorney can help: An attorney can advise you on whether to provide a statement and, if necessary, guide you through the process to ensure that your words are not misinterpreted or used against you.

Minimizing Your Injuries

Another tactic is to downplay the severity of your injuries. Insurance companies might argue that your injuries are pre-existing or that they are not as serious as claimed. They may also question the necessity of certain medical treatments or the length of your recovery.

• How an attorney can help: An attorney can collect and present comprehensive medical evidence, including expert opinions, to prove the extent of your injuries and the necessity of your treatments.

Questioning the Need for Medical Treatment

Insurance companies may also challenge the necessity of certain medical treatments, suggesting that they are excessive or unrelated to the accident. This tactic is used to reduce the amount they have to pay out for medical expenses.

• How an attorney can help: An attorney can work with your healthcare providers to document and justify the medical treatments you have received, ensuring that you are fully compensated for all necessary care.

Misrepresenting Policy Terms

Sometimes, insurance companies may misrepresent the terms of your policy, claiming that certain damages are not covered or that the policy limits are lower than they actually are. This strategy can lead to significant underpayment of your claim.

• How an attorney can help: An attorney can review your insurance policy in detail to ensure that the company is adhering to the terms and conditions, and to challenge any misrepresentations.

Using Pre-Existing Conditions to Deny Claims

Insurance companies may attempt to attribute your injuries to pre-existing conditions rather than the accident. By doing so, they aim to deny or reduce your claim by arguing that the accident did not cause your injuries.

• How an attorney can help: An attorney can differentiate between your pre-existing conditions and the injuries caused by the accident, often with the help of medical experts, to prove that the accident was the primary cause of your current condition. In these scenarios, the Eggshell Skull Rule will likely come into play.

Understanding these strategies can empower you to navigate the insurance claims process more effectively. However, having an experienced attorney on your side can make a significant difference in ensuring that you are treated fairly and receive the compensation you deserve.