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4 Tricks California Insurance Companies Use to Deny Your Claim

Posted by Freeman & Freeman | Aug 27, 2023 | 0 Comments

4 Tricks California Insurance Companies Use to Deny Your Claim

A top priority for insurance adjusters is to reduce the exposure to losses against your claim. He or she accomplishes this goal by denying it or finding a way to reduce its value. The techniques they use put you in an awkward position since medical bills are piling up. Plus, the adjuster assigned to your claim might be aggressive in his or her position.

You are likely feeling overwhelmed at this point in the claims process. California personal injury lawyers see this happen to clients more often than most imagine.

Your first instinct is to protect your rights as an injured and insured person. Yet sometimes, it feels like no one is on your side. Arming yourself with insider knowledge and strategies insurance companies use to deny claims is your best ally in maximizing your claim.

Trick #1: Pretending to Be Working for You with Lesser Offers

An insurance adjuster is vigilant in contacting you immediately following a claim filing. Expect his or her demeanor to be sympathetic and kind. Avoid falling prey to a false sense of caring. By all means, be pleasant to the adjuster. Just make sure you are your best advocate at every communication touchpoint.

One technique commonly used by insurance companies is the agreement to pay bills plus give you extra cash ‘for the trouble.' At this point, you may begin to feel like everything is going better than expected. Steer clear of this trap. When an insurance company offers to give you extra money on their own volition, it signals that you may have a much bigger claim than previously thought.

Your top priority is to receive fair compensation. The insurance company wants you to sign a release and waiver stating that you won't pursue the claim further. Speak with a personal injury lawyer before signing anything to make sure the deal is fair.

Trick #2: Using Software to Value and Undercut Your Claim Value

Insurance companies standardize the claims process using applications to value your case. The main goal of using this software is two-fold:

  1. to create uniformity across the corporate environment in valuing claims; and
  2. to provide a paper trail of your claim for official records and potential lawsuits

The problem with claim software is that it doesn't consider the exact nature of your accident, treatments, and injuries. Keep this in mind when dealing with the adjuster. A personal injury lawyer can assist in evaluating the value of your claim against the number you were provided by the insurance company.

Trick #3: Recording Your Personal Statement ASAP

In the days following your accident, expect that the insurance company will make several attempts to talk to you about your accident. The insurance adjuster wants to speak with you before a personal injury lawyer does. Assume every call and exchange is being recorded.

Statements you make by phone or in writing are used as direct evidence if you decide to initiate a lawsuit. Even minor details that refute the efficacy of your claims can be blown way out of proportion in the courtroom. They are used to downplay your injuries, your role in the accident, and personal credibility.

Trick #4: Blaming Your Injury on a Pre-Existing Condition

It's not unusual for someone to have conditions or injuries that existed prior to an accident. They are known in the insurance world as pre-existing conditions. Expect the insurance adjuster to ask about your total health to gain perspective in this regard.

For example, an avid skier may have torn her ACL years ago and corrected it with surgery. However, if she broke the bones surrounding the ACL, insurance companies may attribute the break to her previous condition. The adjuster's assurances may actually have nothing to do with the previous injury.

Does that sound fair? Personal injury lawyers and jury members tend to think not. It is true that pre-existing conditions may play a role toward enflaming the injury. This is not always the case. Tread lightly and speak carefully about your overall health.

An Insurance Company's Response to a Lawyer is Different

The insurance adjuster does not want an aggressive personal injury lawyer to involve him or herself in your case. However, a personal injury lawyer is your best ally in maximizing your settlement. He or she can insulate you from:

  • unscrupulous claim denial tactics
  • evidence being gathered against you
  • your rights being violated

Speak with a lawyer as soon as possible. You will have the opportunity to learn more about your case and how he or she can help you maximize your claim. Your lawyer works for you at every angle.

At Freeman & Freeman, we want you to know you aren't alone. We have been serving Sonoma County and surrounding areas since 1957. You can schedule a free, no-obligation consultation by calling (707) 575-7141 or by submitting our contact form. We look forward to meeting you.

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