Insurance is necessary in case you’re involved in an accident and need protection. This system is meant to cover extra costs for medical bills or lost wages if you’re involved in an accident or get sick. This brings people comfort knowing they are covered in a worst-case scenario. But there are times when insurance companies choose their profits over their clients, trying to opt out of paying for damages they would cover. It’s in your best interest to watch out for such tricky tactics and keep yourself covered in case you’re caught dealing with these issues.
Table of Contents
- 1 Claim Denial Based on Policy Exclusions:
- 2 Questioning the Severity of Injuries:
- 3 Disputing Liability and Establishing Fault:
- 4 Utilizing Independent Medical Examinations (IMEs):
- 5 Delaying the Claims Process:
- 6 Low Settlement Offers:
- 7 Monitoring Your Actions:
- 8 Ambiguous Policy Language:
- 9 Pressuring Claimants to Provide Recorded Statements:
Claim Denial Based on Policy Exclusions:
One common strategy employed by insurance companies is to deny claims by citing policy exclusions. These are details you hadn’t heard previously that they are throwing at you now to save money. Policies often contain clauses that exclude coverage for specific types of injuries or incidents. For instance, if an injury occurs under the influence of alcohol or while engaging in certain high-risk activities, the insurance company may use these exclusions to deny the claim. Which leaves you feeling confused about why these rules were not mentioned previously.
Questioning the Severity of Injuries:
Insurance adjusters may attempt to downplay the severity of injuries reported by claimants. Sometimes they don’t want to deal with the damages and want to keep everything at a minimum. They may argue that the injuries are pre-existing or unrelated to the incident in question. By challenging the extent of injuries, insurers aim to reduce the amount of compensation owed to the claimant. Make sure to keep track of medical records to show your insurance that these damages need to be covered.
Disputing Liability and Establishing Fault:
Insurance companies usually try to shift liability or establish shared fault to minimize payouts. Instead of covering the damages themselves, they would rather spin the situation back to you. Claiming that you should be the one to cover damages, even if it’s not your fault. They may argue that the claimant was partially responsible for the incident, thus reducing the amount of compensation owed. In some situations, it’s hard to see who’s liable, but you don’t need to be manipulated to take all the blame.
Utilizing Independent Medical Examinations (IMEs):
Insurance companies may request claimants to undergo independent medical examinations conducted by doctors of their choosing. Which can make it harder to get the medical care you need. These exams are often used to dispute the severity of injuries or to find inconsistencies in medical reports. The findings of IMEs may be used to challenge the need for certain medical treatments or question the validity of the claim. Keep track of your own details to show that you need these medical costs covered.
Delaying the Claims Process:
Insurance companies may intentionally prolong the claims process as a tactic to wear down claimants. Their goal is to try and get you to give up in some way. Sometimes people can’t wait for these damages to be covered and do it themselves. Lengthy delays can create a financial strain on individuals, forcing them to settle for a lower amount or abandon their claims altogether. Timely resolution is crucial for claimants, and delays should be addressed promptly.
Low Settlement Offers:
Insurance adjusters may present low settlement offers to entice claimants into accepting less than what they deserve. The hope is that you’ll take whatever is handed to you. Some people do because they don’t want to deal with the hassle of arguing for more. Individuals may feel pressured to accept these offers, especially when facing financial hardships or uncertainties. It’s important to review the damages with a trusted attorney who can fight for a better one.
Monitoring Your Actions:
Insurance companies tend to hire someone to investigate your every move after you’ve made your claim. They try to find information they can use against you and claim that you don’t need their money. Additionally, they often scrutinize claimants’ social media activity to find evidence that shows that the accident has not affected them in any way. Claimants should be mindful of what they share online and be aware that their activities may be under scrutiny.
Ambiguous Policy Language:
Insurance policies can contain ambiguous language that allows for multiple interpretations. This is meant to confuse people and have them agree to something they didn’t understand. Leaving them in a worse situation than before. Insurance companies may exploit these ambiguities to their advantage, interpreting policy language in a way that favors denial or limited coverage. Clear communication with the insurer and, if needed, legal assistance can help navigate these linguistic nuances.
Pressuring Claimants to Provide Recorded Statements:
Insurance adjusters may pressure claimants into providing recorded statements. They try to catch people saying something that could be construed as admitting fault. Which causes people to be out of compensation that they initially deserved. While cooperation is encouraged, recorded statements can be manipulated or used against claimants. Individuals have the right to refuse or seek legal advice before providing recorded statements to ensure they don’t inadvertently harm their claims.
While having insurance is great and necessary to protect yourself, there are times when insurance companies will try to work against you. They want to keep their profits high and having to pay out someone costs them money. This leaves you in an annoying situation of fighting for the compensation that you are owed. If you feel you aren’t being treated fairly by these insurance companies, hire an attorney to talk to them. They will review your case and speak with the insurance adjuster to fight for your money.