Here are 8 secrets that insurance companies likely won’t tell you in your personal injury claim.
1. The Reserve Amount
See what an insurance company reserve is, and why it’s a big secret in a personal injury case.
2. Low First Offer Doesn’t Mean Low Case Value
A low first offer does not mean that you don’t have a great case. I have had many cases, where my client received a low first offer, yet the claim ended up settling for multiples of that offer.
Example – Low Offer May Not Mean Much
Now, the adjuster told me that he only had authority to offer me $20,000.00. He said that his hands were tied.
We ended up filing a lawsuit and just a few months later, after hard-fought litigation, we settled the case for $210,000.00.
The moral of the story is, just because you get an initial low offer, don’t think that your case is not worth that much.
Sometimes Insurance Companies Won’t Offer More $
On the other hand, there are some cases where the insurance adjuster will offer you $4,000, $7,000, or another amount, and the insurance company will dig in its heals and not offer you more money. You then need to decide whether to accept it to sue.
But just because the insurance company doesn’t offer more money, doesn’t always mean that your case is not worth a lot more.
3. Denying Liability Doesn’t = Bad Case
Insurance companies sometimes deny liability even if their insured’s negligence may have caused your injury. If the insurance company denies liability, don’t expect them to tell you that you may still have a case.
Just because an insurance company denies liability, it doesn’t mean that you don’t have a fantastic claim. Let me give you an example.
Example of Good Case Even Though Insurer Denied Liability
However, the fall made it much worse and he had to have a couple of skin grafts. The supermarket’s third party administrator (TPA) initially denied liability.
They even sent a copy of the surveillance video showing the fall. They said “Look at the video, we did nothing wrong.”
Offer before Lawsuit: Zero (Denied Liability)
Settlement after Lawsuit. $300,000
I ultimately filed a lawsuit and we settled for $300,000.00 sometime later after hard-fought litigation. The point of the story is that just because an insurance company denies liability and says that its insured did nothing wrong, it doesn’t mean you don’t have a claim that has value.
On the other hand, there are times where an insurance company does deny liability, and you really may have a terrible claim.
4. Whether There is Other Available Insurance
Don’t expect the insurance company to do a solid investigation to see if there’s any more available insurance out there. Many adjusters won’t do it.
Let’s say you’re in an auto accident and you have an injury claim against the driver. You could send a letter to them requesting that they tell you, under oath, what the BI insurance limits.
The insurance company tells you that the driver has $10,000.00 of bodily injury (“BI”) liability insurance. In their response, they say that they don’t know of any other available insurance that may pay for your damages.
They’re not always right.
Adjusters May Not Take Time To Ask Insured About Other Insurance
Sometimes the adjuster doesn’t take the time to ask his/her insured – the person who caused your accident – about other insurance that would pay for your injuries. The adjuster might not ask the insured one or more of the following:
- if they have any other umbrella insurance
- Were they working for an employer at the time of the accident?
- Were they driving a car for Uber or Lyft?
- Were they volunteering at the time of the crash?
- Do they live with a resident relative whose insurance may cover you for this accident?
Insurance Adjusters Are Overworked
Bottom line: Insurance adjusters are loaded up with claims. They may not take the time to research and speak with their insured and find out if there’s additional insurance that applies to your claim.
You need to:
- Investigate additional insurance possibilities.
- Send the proper letters to look for more insurance.
- Demand that they give you an answer.
Don’t expect the insurance company to do the work for you. If you don’t know how, or don’t want to do the work, hire a lawyer to do it for you.
5. Suing May Get a Higher Offer
Don’t expect the insurance company to tell you that suing their insured may get you a higher offer. They’re not going to do it.
Now, occasionally an adjuster will say to me “If you want to get more money, you have to sue.”
However, overall don’t expect them to tell you this. I heard that one particular insurance company doubles their settlement reserves after a lawsuit is filed.
Insurance Companies Want to Avoid Hiring Outside Attorneys
One of the reasons that suing them may get a higher offer is because a lot of insurance companies have to then hire outside attorneys to defend the case. They have to pay them hourly fees which can really add up very quickly.
Also, when you file a lawsuit the insurance company, they may switch the adjuster. The new adjuster may have more settlement authority – money – to pay your claim.
Suing Might Not Get You More $ in a Bad Case
If you have a case that is bad, don’t expect suing to get you any money.
6. You May Not Have to Give a Recorded Statement…or a Statement
One of the best kept secrets in the insurance business is that you may not have to give a recorded statement. In many cases, you don’t have to give a recorded statement.
There are some cases where you do have to give the recorded statement. For example, if you’re making a claim against your own auto insurer, there’s a very high probability that you have to give a recorded statement.
But, if you’re injured on someone else’s premises, you generally never have to give a recorded statement.
If you’re making a claim against a careless driver – or an owner of a vehicle – who caused your injury, you generally never have to give a recorded statement.
Recorded Statement Will Be Used Against You
The recorded statement will later be used against you.
The insurance company may say that you said that you weren’t in pain when you gave the statement, and now you’re telling the insurance company how bad your life has been damaged because of the accident.
The recorded statement generally only favors an insurance company.
You Might Not Have to Give a Non-Recorded Statement
A non-recorded statement is an informal statement. You generally have to give a statement to your insurance company.
If you’re making a claim against someone else’s insurance company, for damage that they caused to you in an accident, you generally never have to give a recorded statement.
7. Not Going to the Hospital (or Gaps in Treatment) Lower the Case Value
Don’t expect an insurance company to tell you that you should go to the hospital or get medical treatment. If you don’t go to the hospital or get medical treatment, expect them to offer you less to settle your personal injury claim.
Don’t expect an insurance adjuster to tell you that you to go to the doctor if you haven’t received medical treatment in a while. They won’t tell you that going to the doctor may help your case.
8. Bad Facts That Their Insured Tells Them
The insurance company for the careless party likely will not won’t tell you bad facts that hurt their insured’s claim. Essentially, they won’t tell you facts that make your claim better.
What are examples of this?
- Their insured tells them that he/she was speeding at the time of the accident.
- A slip and fall in a supermarket, and the supermarket knows that the liquid was on the floor for a long time before your fall.
- Their insured was on a cell phone at the time of the crash
- Many, many, many worse facts that can hurt the other side’s claim.
Do not expect the insurance company to tell you bad facts for their case.
Sometimes Adjuster Will Tell You Bad Facts
That being said, I’ve had cases where the insurance adjuster has told me bad facts that hurt their client’s defenses.
For example, I had a client who was injured when shower glass broke and sliced him in a hotel bathroom. The insurance adjuster for Liberty Mutual told me, that the hotel they have had past instances of glass breaking.
She did say that those instances didn’t happen in the shower. She said that they happened in other areas in the bathroom.
That helped my client’s claim because it allowed me to show that the hotel was arguably on notice of a problem with the glass.
I’ve had many other cases where the insurance adjuster has shared with me bad facts that made it easier for us to prove that their insured was negligent. However, it’s the exception to the rule. It rarely happens.
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