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May 7, 2016 by Greg Baumgartner
People who have been injured in a car accident do not usually understand the claims handling process and the complexities of the injury claim. Insurance companies train their adjusters to handle claims in a manner that reduces or eliminates their need to pay the claim.
Obviously, the less money an insurance company pays out in adverse claims, the more profit for the company. However, here is some insight from a top-rated car accident attorney in Houston.
This is particularly true with claims against a third-party insurance company that ensures someone who ran into you as the insurance company owes you no duty and their claims handling practices are not scrutinized by the Texas insurance department.
Here are the top 10 tricks that car accident victims find themselves learning the hard way when trying to handle a personal injury claim on their own.
People who are in a car accident and expect the insurance adjuster to contact them are often surprised when they do not receive a phone call. Even after the first contact with the adjuster, they found no follow-up, and their telephone calls were not returned.
This is particularly frustrating to people who are handling their own injury claims because they do not expect an adjuster to avoid them. This is part of the design of having an adjuster handle hundreds of cases at a time, making it very difficult, if not impossible, for reasonable service to occur.
As with failing to respond to your telephone calls and inquiries, one common thread in tactics for handling car accident claims is the delay tactic. The longer the adjuster can drag out the claim, the longer they keep their money-earning interest and the better chance they have of settling the case for peanuts.
The general statute of limitations in Texas is two years from the date of the accident. The closer that the adjuster can get the claim to the statute of limitations, the better for the insurance company. Most of the better personal injury attorneys in the Houston area will not accept a case that is only days or weeks away from the statute of limitations.
So never wait until the last minute to think about getting an accident lawyer. In some cases, the injured person fails to take appropriate action within the two-year limitation period, and they have effectively waived their claims.
One tactic that is part and parcel of the delay tactic above is due to ever more requests for additional information. Usually, this revolves around medical treatment, and the adjuster will usually say they can not decide until they have the additional records.
After those records are obtained, the adjuster will find another piece of information that they need in order to proceed, and so on… This is part of the delay tactic above and a trick many automobile accident victims experience.
Many adjusters tell the personal injury victim that they cannot proceed with the claim unless they have a statement. This usually is not the whole truth, and many good attorneys refuse to provide statements from their clients, particularly in clear liability matters.
When the adjuster takes the recorded statement from an unrepresented person, the intent is usually to find a way to defend the claim instead of simply obtaining the information necessary to value a claim.
Usually, the adjuster tries to take a statement very early on in the process and often before the car accident victim has been fully diagnosed with medical problems.
Additionally, part of the statement also includes leading questions such as “When did you first see it.”, “What did you do to avoid…” and the like. These are calculated to do nothing more than give the adjuster an excuse to discount or deny the claim or use it against you in court.
Usually, the adjuster will say something like “we accept responsibility“, or “our insured was at fault,” and the car accident victim assumes that means that the adjuster will be fair and reasonable when talking about settlement. Nothing could be further from the truth.
This is part of a designed program to pay out as little as possible on car accident claims. If the adjuster can script the relationship, the car accident victims believe they can handle the case independently, without an attorney. In that case, the insurance company will surely pay less money ultimately on the case.
With commercial vehicle accidents, one common tactic is to reach out and offer a fraction of the case’s worth, hoping you will accept.
In the meantime, the insurance company can get a statement from the car accident victim that can be used against them and obtain other information that will do nothing but hurt the case.
An insurance company adjusting a car wreck claim has a reasonable right to ask for relevant medical records that pertain to the injury sustained in the accident. However, in practice, what the insurance company will do for those representing themselves is to ask for an unlimited release of medical records through authorization for the release of medical.
The releases usually are not limited in time. Usually, they do not include only those medical records related to the wreck, but all of your medical records to the date of your birth may be obtained by the insurance company.
Surely, records more than ten years before the accident are irrelevant. And some medical information unrelated to your injuries is none of their business!
One trick that adjusters frequently use is to “disregard” or “disallow” some of your medical expenses incurred by following your doctor’s orders for injuries sustained in the accident. They use many different justifications, from too much to disallowing treatment.
In every instance, you can be sure that the adjuster will find issues with your medical treatment. It may be that the treatment was “excessive,” or maybe that there were “gaps” in treatment, or the treatment was not warranted or unrelated to the injury caused by accident (according to the insurance company).
This is a common trick used both in settlement negotiations and for litigation defense.
Car accident victims who do not understand Texas laws are often offered based on out-of-pocket expenses or co-pays paid to the medical providers.
In other words, if your health insurance company paid $4500 and your out-of-pocket expenses were $500, the offer would be based upon your out-of-pocket $500 in expenses and not the whole medical bill that was paid.
This leaves unsuspecting people in a trap when their health insurance company asks later for reimbursement of amounts collected from third parties after an accident.
It is also contrary to the law in the state of Texas, where car accident victims are entitled to collect the whole amounts “paid or incurred” for medical expenses related to the accident.
Your medical claims are not limited to co-pays but also include amounts paid by your health insurance company or all related medical expenses outstanding and unpaid that are reasonably related to the injury sustained in an accident.
Usually, when the car accident victim first understands that they need an attorney is when the subject of money comes up. Until then, they had been told that the insurance company was accepting responsibility for the accident, and they mistakenly believed that that would lead to a reasonable offer.
When the insurance company says they “accept responsibility,” that usually only implies you will receive an offer and has nothing to do with the fairness of the offer. As a rule, for those not represented by experienced counsel, the offer is almost universally a joke.
One reason for this lowball offer tactic is that the insurance company is driving the process until the people understand they need a lawyer.
In the meantime, they have obtained all of your medical records, even those they would not otherwise obtain, and have taken a statement that they can use against you in court. Further, the cases have been substantially delayed and have consequences.
In cases with substantial insurance coverage, such as a commercial or company vehicle, many companies hire “investigators” to monitor the accident victim and obtain a video film after the accident.
Typical cases would include investigators sitting in parked cars down the road from your home with the hope of filming you doing something physical like playing with your children, dumping the garbage, or mowing your yard.
Accident victims must be forthcoming with the extent of their injuries and not exaggerate them. Usually, the investigators are brought out when the company believes that the victim may be exaggerating.
The best bet for automobile accident victims is to talk with the best personal injury lawyer you can find as soon as possible after the wreck. Here is an article on what you need to know in dealing with an insurance company.
If you have been injured in an accident in Houston, TX, and need help, contact our Houston truck accident attorneys at Baumgartner Law Firm by calling (281) 587-1111.
6711 Cypress Creek Pkwy
Houston, TX 77069
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Since founding the Baumgartner Law Firm in 1985, Greg Baumgartner has established himself as a leading personal injury attorney in Houston, Texas, with a focus on representing severely injured accident victims and families who have suffered the loss of a loved one. His commitment to excellence in legal advocacy has earned him recognition from prestigious organizations, including Super Lawyers and the Top 100 Trial Lawyers and others. With decades of experience, Greg is consistently peer-reviewed and holds a preeminent rating, reflecting his dedication to achieving justice for his clients.
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