New to the world of insurance claims? Feeling overwhelmed? You’re not alone. It’s a complex process, and much of that is by design.
Understanding your rights, sorting fact from fiction, and trying to discern when the insurance company is telling the truth — it’s a challenge for anyone, especially someone who is trying to recover from an accident or injury.
That’s why we wrote this guide. Here are eight things to know when dealing with an insurance company:
1. Insurance Adjusters Are Trained Negotiators
If you’re like most people, you probably haven’t handled many big insurance claims in your life. In fact, this might be your very first one. And that’s what makes you different from your insurance adjuster.
Insurance adjusters know what they’re doing. They’ve been around the block. They are specially trained to protect the insurance company’s interests and to undermine your claim whenever possible.
You can expect them to:
- Challenge your side of the story,
- Ask leading questions designed to trip you up, and
- Make unreasonable settlement offers that are dressed up to sound like a good deal.
Even though they are ultimately working against you, your insurance adjuster might seem friendly, reasonable, and genuinely concerned. That is by design. It’s part of their training. Be cautious and remember that the insurance companies are not on your side. As things progress, that friendly and helpful demeanor can suddenly turn cold, defensive, and aggressive.
Would you be wary of talking to the insurance company’s lawyers? While insurance adjusters are not necessarily attorneys themselves, you should be just as wary when talking to them. They are skilled and experience negotiators, and they have a team of attorneys on their side.
2. Do Not Accept the First Settlement Offer
When someone offers you money, it’s perfectly natural for your survival instinct to kick in and say, “Take it!” That’s why insurance companies make early settlement offers in the first place — they know that the offer will be tempting, even if it’s unfair.
But look at the offer from the insurer’s perspective. Why are they making you a settlement offer? Is it an act of charity? Offered out of the goodness of their hearts? Are they so moved by your story that they feel compelled to hand over full and fair compensation voluntarily?
Insurance companies are for-profit corporations. They answer to their shareholders. If they make an early settlement offer, it is usually to serve their own interests, not yours.
The insurance company’s goal is to make your claim go away quickly for the smallest amount of money possible. (Generally speaking, once you sign a settlement, it is impossible to go back and claim more money later.) That’s why accepting the first settlement offer is usually a mistake.
3. The Insurance Company Will Try to Avoid Paying Your Medical Bills
In a perfect world, the insurance claims process would be pretty straightforward. Accident victims would get the medical treatment they need, submit the bills to the appropriate insurance company, and then the insurer would pay — promptly and in full.
After all, isn’t that what insurance is for?
Sadly, we don’t live in a perfect world, and the insurance claims process is seldom so seamless.
Instead, the insurance company will look for every opportunity to avoid paying your medical bills (which often account for the largest portion of your economic damages and provide the biggest basis for your pain and suffering claim).
Here are just a few of the arguments an insurance company might use when trying to avoid paying your medical bills:
- You didn’t seek medical attention soon enough after the accident.
- Their policyholder was not responsible for your injury.
- You did something to cause your own injury.
- Your claim is excluded under the terms of the insurance policy.
- The medical treatment you received was unnecessary, unreasonable, excessive, or more expensive than it should have been.
- The statute of limitations has passed.
The experienced Omaha personal injury lawyers at Hauptman, O’Brien, Wolf & Lathrop, P.C. can help you fight back against the insurance company’s most aggressive and evasive maneuvers.
4. Anything You Say Can Be Used Against You
It’s a go-to tactic for insurance adjusters: using your own words against you. Here are a few things to watch out for:
- Statements you make at the accident scene (e.g. “I should have been more careful” or “It wasn’t your fault.”)
- Statements you make to law enforcement. (Cooperate, but don’t say too much. Don’t admit or assume fault.)
- Misleading statements from the insurance adjuster. (Insurance companies have a duty to act in good faith. Nevertheless, they are notorious for engaging in misleading statements, intimidation, and “doublespeak.”)
- Your own answers to the insurance adjuster’s questions. These questions are often designed to “trap” you into making contradictory statements, undermining your claim, or accidentally admitting fault.
- Your posts on social media. Even after setting strict privacy controls, you should assume that insurance adjusters can see everything you say or do on social media — and every photo you’re tagged in too. If they can twist your social media activity and use it against you, they will.
- Statements you make to family members and friends, who may be interviewed or even subpoenaed as part of the claims process. The less you say to others, the better.
- Recorded statements. The insurance company may ask you to give a recorded statement. Never agree until you’ve talked it over with an attorney. Recorded statements are high-pressure opportunities for the insurance company to get a convoluted or poorly worded statement from you on record. It’s easy to say the wrong thing under pressure.
One of the most important things to know when dealing with an insurance company is this: the insurance company is actively working against you. Proceed accordingly.
5. You Can Choose Your Own Body Shop for Your Damaged Vehicle
The insurance company would love to pick your body shop for you (and your doctors too). But you can choose your own instead — and you should. Choose a body shop you trust to fairly assess your damages and to provide the repairs you need.
Is the insurance company challenging your mechanic’s estimates (or your doctor’s diagnosis / treatment)? Come in and talk to the experienced Omaha personal injury lawyers at Hauptman, O’Brien, Wolf & Lathrop, P.C. We may be able to help.
6. Insurance Companies May Begin to Ignore You as a Delaying Tactic
One of the most common complaints people have when dealing with insurance companies is that they try to drag out the claim.
They do this for a few reasons:
- They hope to increase the “hassle factor” in the hopes that you will grow weary and drop the claim (or just take the lowball settlement offer and walk away).
- Insurance companies make most of their profits not from the premiums they receive each month but from the dividends they make by investing those premiums over the long term. Part of their business model involves holding onto money for as long as possible, so they have an incentive to delay big payouts.
- The longer your claim goes on, the more likely you are to say or do something that contradicts or undermines the facts you’ve alleged.
- The insurance companies work on quarterly and fiscal-year budgets. They have a certain amount of money set aside for claims during each period. If they expect to pay out a larger amount of money on your claim, they may try to push it back to another quarter, the end of the year, or the next fiscal year.
Another one of the most important things to know when dealing with an insurance company: many insurance adjusters use a “deny & delay” strategy.
If the delay is unreasonable or egregious, you may have an additional claim for compensation on the grounds of insurance bad faith. The Omaha personal injury lawyers at Hauptman, O’Brien, Wolf & Lathrop, P.C. can help you determine whether you might have a claim for bad faith in your case.
7. The Insurance Companies May Try to Scare You with Threats
Common examples of intimidation tactics by insurance companies include:
- Suggesting that if you don’t take a settlement offer right away, you’ll forever lose your chance to get compensation.
- Implying that you have done something wrong, that there might be an investigation of some sort, that pursuing the claim further will make life difficult for you, etc.
- Hinting that an investigation might cause you embarrassment among your family, friends, or members of the public.
- Telling you that hiring a lawyer will only make things worse, or that a lawyer will likely cause you to receive less money.
In addition to subtle threats, the insurance adjuster might also try to intimidate you by: constantly rushing you to make a decision, using scary-sounding legal language, twisting your words around to fluster you, making you feel guilty, or putting you on the spot.
8. Never Sign Anything Unless You Have Had a Lawyer Review It for You
Last but far from least on our list of things to know when dealing with an insurance company: never sign anything without a lawyer.
Unless you are a lawyer who has extensive experience in challenging insurance companies, you and the insurer are not on equal footing. They have a great deal more sophistication in these matters than you do, and any document they offer you has been carefully drafted to protect the insurance company’s interests over yours.
As we mentioned earlier, signing a settlement agreement usually means you’ll never be able to claim more money for the injury — even if your injury gets worse, you suddenly lose your job as a result of the accident, or you end up with “surprise” medical bills demanding many thousands of dollars more than you ever expected.
That’s why it is so important that you discuss your accident in-depth with an experienced attorney. Make sure you fully understand your rights, your options, and the unexpected contingencies that could arise down the road.
Talk to the Sarpy County & Omaha Personal Injury Lawyers at Hauptman, O’Brien, Wolf & Lathrop
Hauptman, O’Brien, Wolf & Lathrop, P.C. is a Nebraska personal injury law firm with years of experience and a long record of success. We are committed to giving our clients the time, attention, passion, and communication they deserve.
We are proud to offer confidential, cost-free, no-obligation case reviews for injured passengers, drivers, and pedestrians in Omaha, Sarpy County, and throughout Nebraska.
We handle auto accident claims on a contingency fee basis, which means if you hire us, we will not charge you a fee unless and until we recover compensation for you.
To talk with a Sarpy County & Omaha auto accident lawyer about your legal options, contact Hauptman, O’Brien, Wolf & Lathrop, P.C. today.