How Do Insurance Companies Work to Reduce and Deny Claims?

If you’ve been injured in an accident, you may want to believe that you can save money by negotiating your own settlement instead of seeking legal help. In probably 99 cases out of a hundred, people who seek the help of an experienced attorney wind up with several times the money they would receive without legal help, even after paying the reasonable costs of representation. But maybe you are in that one percent. Before you try to negotiate your own settlement, you should understand something about how insurance companies work to reduce or deny claims.

Unless you’ve been getting in frequent accidents all your life, you probably don’t have much experience dealing with insurance people. Here are some pointers to help you to deal with the at-fault driver’s insurance company if that’s what you want to do. Before you deal with them, you need to consider that the insurance company is in business to make the biggest profit possible.

How Insurance Companies Make Big Profits

Do you know how your Insurance Agency might reduce your claim?
Side view of writing on clipboard while insurance agent examining car after accident

Insurance company employees undergo extensive training to establish trust with injured parties. Not just insurance adjusters, but everybody from the sales people on up is coached on how to make you believe that they are acting in your best interest. Most folks will lower their guard if somebody seems friendly, helpful and concerned. The first thing the negligent party’s insurance company will do in their communication with you regarding your personal injury claim is to act like they are your friend and want to help you.

Whether you speak to a receptionist, a claims adjuster or an insurance defense attorney, the phone call will be recorded. The company can and will use anything you say to try and reduce their liability or deny your claim completely. You must keep this in mind when somebody asks you a question regarding:

  • Your injury,
  • The accident or injury that caused your injury,
  • Your past medical history, or
  • Anything else

These people are not making friendly conversation. Insurance companies work hard to lower the amount of settlement money they will have to pay you or deny the validity of your claim altogether (depending on the law in your state) by digging for information they could use as proof.

A few of the things the insurance company could try to prove in order to lessen the amount of money they pay you or to avoid paying you any compensation at all are:

  • You contributed to your own accident,
  • You did not seek medical help right away,
  • You are not hurt that badly,
  • You did not follow the doctor’s advice, or
  • You did not submit enough evidence to substantiate your claim.

A Personal Injury Lawyer Would Advise You Not to Talk to Insurance Company Employees

Insurance ClaimWhen you speak to an insurance company employee, that person could try to trick you into saying things during your recorded conversation that the insurance company could use to limit your claim settlement amount. The receptionist who takes your call could ask, “How are you doing today?”

You may give a response like, “I’m fine, thanks.” Or you could say something like, “I was hurting so bad this morning I couldn’t get out of bed.” The safest thing you could do is to not answer the question. You have no obligation to.

The insurance company does not care how you’re doing, they care about money they have to pay out for claims. Any innocent remark you make to insurance company reps could help them toward reducing your claim. An experienced attorney knows how to talk with the insurance company and how to prove that you suffered serious injuries as an accident victim.

How Insurance Could Claim You Contributed to Your Own Accident

The worse you are injured, the harder the insurance company will work against you. This is because they don’t want to pay a fair settlement for:

  • Disability,
  • Multiple Surgeries, or
  • Extended medical care.

The above are just a few of the many damages that could be included in a settlement negotiation.

In order to claim that you were partially responsible for your accident, the insurance company will send a team of accident scene investigators out as soon as they learn that the accident caused major injuries. The investigators will be looking for physical evidence from the accident scene that could prove that you were also responsible for the accident. The more proof they gather, the greater they can reduce the amount of money they have to pay you.

How Can I Protect Myself From Insurance Company Investigators?

The best way to protect yourself is to call an experienced personal injury attorney as soon as you possibly can. You could gather your own evidence at an accident scene. But if you are seriously injured, you may not be able to do so. And even if you can manage to collect evidence, the insurance company could say that your injury was not that serious if you were able to take photos, talk to the other driver and witnesses and so on.

In most states, your claim settlement amount will be reduced by the percentage of responsibility for the accident which can be attributed to you. In some states, if insurance can prove you were 51-percent or more responsible for your accident, they can deny you any compensation. In a few states, if the insurance people can prove that you were one-percent responsible for the accident, they can refuse your claim altogether.

A Qualified Personal Injury Law Firm Can Help You to Get a Fair Settlement

At Isaacs & Isaacs, we do all we can to make sure our clients receive a fair deal. We use our own team of accident scene investigators for major crashes. We know how to prove liability, and our attorneys have decades of experience in negotiating with insurance. We employ attorneys who used to work in insurance defense, which gives us an edge with negotiations because we have insider knowledge of how insurance companies work to reduce or deny liability.

If you are injured and would rather not try to negotiate your own settlement with the liable party’s insurance company, Isaacs & Isaacs would be happy to help you. Our experienced team of legal professionals is standing by to assist you now. Give us a call at 800-800-8888, or fill out our online form for a free consultation with an experienced and aggressive Isaacs & Isaacs personal injury lawyer.

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