9 Ways to Avoid Getting Duped by Insurance Company Settlement Tactics… And Recover For Your Injuries
We’ve become very familiar with radio and TV ads portraying the friendly insurance agent…. your dear friend….. interested in watching out for only you. Yet faced with an injury claim, the reality is a bit different.
Insurance companies are not your friends, and like a sneaky fox, should not be trusted. It is important to understand their mission is to make money. They notoriously implement tactics to delay, deny or minimize the amount of damages payable to you (the injured claimant).
DON’T BE CAUGHT OFF GUARD. Insurance adjusters sure won’t – they are highly trained and deal with hundreds of claims a year. When you understand the tactics they use, you understand how to fight back and avoid being duped by insurance company settlement tactics.
Read below to learn the top 9 most common tactics used by insurance companies to fight your injury claim:
#1 Inaccurate or Missing Information
Just because the police report does not list all information about the accident and your injuries is not a reason for the insurance company to deny any claim. Accident scenes are very confusing. Not every injury is as obvious as a broken bone or laceration.
It is very common for non-life threatening injuries or soft tissue injuries to appear several days or weeks after the accident and not be listed in the police report.
Also, police do not respond to every car accident so there is not always a report. In the days immediately after the accident it is very important that you seek medical treatment for any symptoms that appear, otherwise the insurance company will argue that you are “gaming the system” or that your symptoms are related to some other injury sustained after the accident.
Here are typical examples of excuses related to inaccurate and missing information that insurance companies use to create doubt and uncertainty about your claim:
- The police report does not indicate that you had any complaints of pain at the scene of the accident.
- Your name is not listed on the police report.
- The police responded but a report was never made out.
- There are no independent witnesses to prove your version of the events.
- The police report contains errors.
- The insurance company relies only on its own insured’s statement of what happened, but not on yours.
- Your version of the accident is in question because you exaggerated the at-fault driver’s actions.
- The accident forensics conflict with your version of the incident. Either you are lying or exaggerating what really happened.
- How convenient that you can remember details that support your case but you can’t remember if you were distracted just prior to the accident.
#2 Comparative Fault
In Oregon, if your conduct, caused or contributed in some way to your injuries, then you may still seek compensation from the at-fault person as long as your portion of fault does not exceed 50%. Any money awarded to you would then be reduced by the percentage you are deemed to be at fault or having “contributed” to the incident that caused your injuries.
If your portion of fault exceeds 50%, then your claim for compensation against the other person or persons will be denied. See Oregon Revised Statute §31.600. Assessing and comparing fault between the injured victim and other parties is complex and requires an experienced injury lawyer to interpret and correctly apply the law.
Here are typical allegations of comparative fault insurance companies use to place the blame on you and diminish your compensation:
- You were not wearing your seat belt in violation of Oregon law, which is why your injuries are so severe.
- Your car wasn’t in great condition. Brakes and tires were worn beyond a recommended safety level, which is why the collision was so severe.
- You didn’t react quickly enough to avoid the collision. Data from the on board computer indicates you made no attempt to slow the vehicle or turn to avoid the collision.
- You made an abrupt or unnecessary stop, which is why our insured rear-ended you.
- You made a lane change without using your turn signal.
- You are partially at-fault for the accident because you were distracted by something..
- You were intoxicated or had alcohol in your system.
- You were under a doctor’s care and taking medications that could affect your ability to drive, which is why you are partly responsible for the accident.
- You were at fault, or partially at fault, for exceeding the posted speed limit.
- At the time of the accident you were talking on your cell phone and not paying attention.
- You are required to wear glasses to drive, but you were not wearing glasses at the time of the accident as seen in accident photos.
- You did not notice our insured until the crash happened, so you must not have been paying attention.
- You were not the first vehicle in the intersection. Our insured will testify he had the right-of-way.
#3 Insurance Claims Process
Insurance company adjusters are highly trained individuals who deal with hundreds of claims every year. They know how to negotiate a claim and exploit every crack or inconsistency in the case. The negotiation process usually starts with a lot of fact gathering by the insurance company, and proceeds through various phases of delay, deny and defend.
This is done through “take it or leave it” tactics and never-ending requests for cost verifications, medical records, physical examinations and assessments by insurance company-sponsored doctors who seem to always arrive at the same diagnosis of minimal injuries.
View CNN 360 Anderson Cooper’s Auto Insurance Part 1
and Auto Insurance Part 2….
Here are typical tactics used in the insurance claims process to minimize your claims:
- Offering to settle for a nominal amount within a few days of the accident before the injured victim knows the true extent of his or her injuries and financial losses.
- Requiring that you give a recorded statement and sign an overly broad medical authorization when you are not required to do either.
- Closing your file because the insurance company did not receive statements or documentation within some arbitrary timeline.
- Continually requesting additional information and documents to delay and drag out the process.
- Relying on an insurance company doctor’s evaluation of your injuries instead of your own treating doctors’ diagnosis and opinions.
- Acting extremely nice and concerned for the injured victim while actively working against their best interests.
- Low-balling: offering to settle well below the claim value.
- Dragging out the claims process so the accident victim will get tried, frustrated and will eventually give in and settle for an amount far less than the true value of the claim.
- Discouraging victims from hiring an attorney by making false claims.
#4 Pre-existing Conditions
Insurance companies will devalue and deny injury claims that involve pre-existing medical conditions. Their goal is to transfer blame to the pre-existing condition (which is someone else’s responsibility, i.e. not the at-fault driver) for your injuries and pain, as opposed to the accident.
However, under Oregon law, you are entitled to seek compensation for all injuries caused in the accident including aggravations of a previous injury or medical condition.
For example, if you received medical care for a back injury 5 years ago and made a full recovery, and then reinjured your back in a car accident, the pre-existing back injury should have no effect on the current claim. That does not mean the insurance company won’t try to argue and convince a jury that the previous injury accounts for X% of the current injury. Since the injured victim has the burden of proving that the accident caused their injuries or aggravated a prior condition, the insurance company and its lawyers will use tactics and arguments to relate the pain and symptoms to the prior condition. For example:
- The injuries you claim to have sustained in your auto accident are actually related to a prior injury or physical illness. We do not cover injuries un-related to the accident.
- You medical records prior to the accident indicate you were being treated for chronic pain, insomnia, and a previous back injury, hence your claim is being denied because of this pre-existing condition.
- We will not cover the cost of a hip replacement because your medical records indicate you were evaluating the need for a hip replacement prior to the accident.
- We will not compensate you for emotional distress or PTSD from the rollover car crash because you were already taking depression medication and had been seeing a psychiatrist at the time of the accident.
- There was a significant gap in your medical treatment, therefore, the current symptoms that caused you to seek medication attention again must be related to your pre-existing condition, not the subsequent car accident.
#5 Inconsistent Actions
One of the most effective insurance company settlement tactics is to create uncertainty. They can do this by exploiting inconsistencies, real or imagined, in an effort to convince you to settle for a lesser amount, because a jury may see you as untruthful, manipulative, and simply interested in a “large pay-day.” Do not be coerced into a settlement based upon suspicion or innuendo when you are confronted with statements like:
- Why did you wait to seek medical treatment for your alleged injuries until after your lawyer called us?
- You medical records indicate that you missed almost half of your scheduled physical therapy treatments. Is that because you really do feel better?
- Your recollection of the accident facts is completely different than witness statements and data gathered at the site.
- No one else was injured in the accident. How could you be the only person with injuries?
- How could you have sustained that level of injury if the property damage was not severe?
- Records indicate that in spite of your injuries you went on vacation.
- You seem to make a habit of being injured.
- You did not have any obvious signs of injury at the scene of accident: no cuts, broken bones, or bruises.
- The type of injury you sustained could not have possibly been caused by the accident.
- You seem to have trouble explaining the accident, is that because you know you were at fault?
- Your medical diagnosis and records do not confirm the complaints related to the accident.
- There is no objective proof of your injuries, just your subjective complaints.
- You previously told us you didn’t think you were seriously injured in the accident.
#6 Injuries and Medical Treatment
If you were injured in an accident, then you must take positive steps to seek medical treatment. Not going to the hospital, gaps in treatments with multiple missed appointments, or inconsistent statements about your symptoms are issues that might lead one to conclude you were not hurt.
Because an accident can induce “an adrenalin rush,” you may not feel immediate pain as you normally would, or you may think your injuries are not severe. Let the medical professionals sort out the facts. Here are examples of insurance company statements designed to cast doubt on the severity of your injuries:
- You did not go to the emergency room or your doctor immediately after the accident. Sounds like you were convinced you did not have any serious injuries.
- At the time of the accident, your complaints to the doctor were minimal and did not include “severe neck pain.” What has happened since the accident to cause this change?
- Your complaints to your family doctor did not match the complaints you gave to the ER doctors.
- You didn’t take an ambulance from the scene of the accident.
- Your pain and symptoms caused by the accident vanished shortly after the accident.
- You missed several doctor’s and therapy appointments. Either you were feeling better or you may have aggravated the injuries by not seeking proper medical treatment.
- You failed to mitigate your injuries by missing appointments and not following your doctor’s recommendations.
- You had numerous gaps in your medical treatment so you were either not really hurt or your symptoms were caused by something other than the accident.
- Your injuries were totally subjective. There is no objective proof of your injuries shown onX-rays, an MRI, or any orthopedic tests.
- You were examined by a doctor that was recommended by the insurance company soon after the accident and were found to be uninjured and not in need of treatment.
- You may have aggravated your injuries by failing to obtain proper medical treatment.
# 7 Personal Character Attack
Another tactic to minimize claim values is to put the “victim” on trial as opposed to the at-fault person. The goal is to convince you that a jury will not have empathy for you or be inclined to reward you because of your character. Here are examples of insurance company settlement tactics used to cast dispersion on your character and minimize your claim value based on irrelevant information:
- Questioning your credibility based on inconsistent recounting of the accident facts.
- Bringing up prior mistakes such as a DUII, or other criminal conduct.
- Introducing your history of mental illness or emotional problems.
- Raising your history of making personal injury claims to suggest your claim is a bogus attempt to extort money.
- Bringing up workplace problems, such as being fired from your last place of employment because of a positive drug test.
- Citing your driving record to imply prior violations means you were driving the same way at the time of the accident.
#8 Violation of Law
If you were in violation of certain laws at the time of the accident (such as expired registration, expired license, not wearing a seat belt, speeding, etc.) you can still seek damages from the at-fault person. You may be cited for the violation and most likely be fined, but these actions will not necessarily prevent you from pursuing an injury claim. Violation of laws that affect the cause or outcome of the accident, such as speeding, distracted driving, or not wearing your seat belt, may create comparative fault on your part and may significantly reduce the value of a claim.
Also, driving while intoxicated or driving while uninsured can also bar you from pursuing non-economic damages for pain & suffering unless you meet certain exceptions. Regardless, insurance companies will attempt to use any violation of law on your part against you. The following are common insurance company accusations to limit your damages:
- You were driving with a suspended license.
- You were driving with an expired registration.
- No one called the police and you failed to submit an accident report as required by Oregon law.
- You were driving while uninsured.
- You were driving while intoxicated.
- You were distracted and talking or texting on your cell phone at the time of the accident.
- Your were driving in excess of the speed limit or for road conditions at the time of the accident.
- You were not wearing you seat belt in violation of Oregon law, which also caused most of your injuries.
#9 Liability Denial
In some instances, insurance companies will completely deny your claim, or attempt to convince you their insured has no liability for the incident that caused your injuries.
Unfortunately, too many people give up and walk away when insurance companies deny their claims without ever receiving the compensation they truly deserve. These are the situations where injured victims need the assistance of an experienced personal injury attorney the most. Here are a few typical examples of instances where insurance companies will deny liability for the accident that caused injuries to innocent people:
- They claim you are 100% at-fault for causing the accident.
- They deny that their insured’s conduct was improper, unlawful or negligent.
- An “act of God”, i.e., weather event, earthquake, or war caused the accident.
- An unidentified person caused the accident.
- A known third person directly caused the accident.
- Exclusions – there is no coverage under the insurance policy for the particular incident.
- Statute of Limitations – you waited too long to bring your claim.
- They believe their insured’s version of the facts of the accident, not yours.
- One or more independent witnesses support the insurance company’s version of the accident facts.
How to Combat Aggressive Insurance Company Settlement Tactics
If you have been injured in an accident that was caused by some other person or company then you have likely experienced one or more of the aggressive insurance company settlement tactics discussed above. It is important to understand that the insurance company’s mission is to avoid paying on claims or pay as little as possible. Therefore, the tactics used and statements made by the insurance company should be taken with a grain of salt.
Rather than accept the insurance company defenses as truth, seek the help of a qualified Oregon personal injury attorney to evaluate your injury claim and pursue compensation.
Because I do this for a living, I never recommend pursuing a claim on your own. An experienced injury lawyer will know the law, how to analyze and evaluate your personal injury claim, and which tactics have merit and which tactics are bogus. More importantly, a good personal injury lawyer can help maximize the strengths in your claim while overcoming the weaknesses. If choose to go it alone, you could be leaving a lot of money on the table. Do not make that mistake.
Attorney Travis Mayor
As a Portland personal injury attorney, my sole focus is to represent victims and their families who have been wrongfully injured as a result of another’s careless or intentional conduct. I hope this website is a place to learn more about our law firm, as well as, an educational resource for Oregonians who have been victims of accidents. It is not intended to be legal advice, as every case is unique and should be accurately evaluated.
If you or someone you know has been injured as a result of another person’s conduct, and you are looking for a skilled attorney to lead you through the insurance roadblocks, please call today for a free and confidential case evaluation. Local (503) 444-2825 Toll free 1-800-949-1481 or email email@example.com.
For additional information about personal injury cases, insurance, and maximizing your financial recovery, I recommend the following articles on my Blog: