What Defenses Do Insurance Companies Use To Avoid Paying Out On Injury Claims?

Insurance companies want to pay the least amount of money possible on injury claims; starting at 0 and going from there if they can. Their main goal is to try to avoid liability and then reduce damages. For example, “Your client ran the red light, not my client,” or some other issue that shifts the responsibility for the action to somebody other than their insured driver. They do this because if the liability becomes too great for the party that was injured, the insurance company will try to resolve the case for a smaller amount.

They will also try to keep their costs down. They want to determine what the actual damages are. Although they owe a reasonable amount of effort to defend their insured, they also have a duty to their stockholders to keep the amount paid out as low as possible. They will ask for medical records and assess the medical records. Then they’ll claim you paid too much for a procedure or that a procedure wasn’t necessary. They will have the affected party go through medical examinations where they’ll call their own expert to evaluate the injuries to the injured person. They then say that this person wasn’t injured as badly as they claim.

In order to reduce damages in a clear liability case, they may send out private investigators to conduct what are called Sub Rosa investigations. This is where they make secret recordings of the person who claims to be injured. If the injured person claims, “I can’t lift my hands above my shoulders,” but secret recordings show them playing softball, tackle football, or even just taking the trash out, they will try to use those recordings to show that the person is malingering or exaggerating their injuries.

That said, they do have a responsibility to try and resolve the case in good faith. A personal injury attorney will put them on notice of their obligation to resolve this case in a timely manner. That attorney will make demands to settle for what they consider to be the correct sum. The insurance company must assess whether or not they want to pay that or risk having their policy opened above the limit and end up paying something more.

Why Would Someone Need An Attorney If They Have Been In An Auto Wreck?

Insurance adjusters know that when somebody handles their own case, the insurance company is in charge of the show.

The injured party is generally not as equipped to deal with these cases, as seasoned adjusters handle these cases day in and day out. Adjusters will tell the injured party that they know what the value of these cases are. They will tell the injured person, “This is what we are going to pay.” The injured party can handle it on their own if they choose, but they can be sure they’re going to get nothing or far less than they would if they had an attorney, particularly if they’re seriously injured.

If your car is damaged and you feel fine then you can make a claim to the carrier and say, “This is the damage to my car. Fix my car,” and most insurance carriers may do that. As long as you’re not making an injury claim they’re happy to get out from under that risk for a full and final settlement. It’s a misconception to think that an insurance company is going to handle everything in your best interest because insurance companies have stockholders. The adjusters are responsible to their supervisors and their goal is to keep their costs down. Their goal is to pay as little as possible for the case. You need a seasoned attorney on your side to negotiate the case, make a demand for a settlement, or litigate the case and take it to trial unless the insurance carrier pays full value to compensate the injured client.

In addition, if somebody is seriously injured, they don’t generally know the nuances of how to handle these cases. Things like, what doctor should I go to, should I see a doctor, what should I be evaluated for? Or if I do, who’s going to pay for it? There are also costs associated with managing these cases that many laypersons don’t understand. An attorney who is knowledgeable can guide them through that.

For more information on Defenses Used By Insurance Companies In CA, a personal case evaluation is your next best step. Get the information and legal answers you are seeking by calling (714) 769-1200 today.