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May 7, 2016 by Greg Baumgartner
People who have been injured in a car accident often do not understand the claims handling process and the complexities of their injury claim. Insurance companies train their adjusters to handle claims in a manner that reduces or eliminates their need to pay the claim. Car accident victims must be aware of the common insurance company tricks.
The less money an insurance company pays out in adverse claims, the greater its profit. 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 the Texas insurance department does not scrutinize someone who ran into you, as the insurance company owes you no duty, and their claims handling practices.
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 initial contact with the adjuster, they found no follow-up, and their telephone calls went unanswered.
This is particularly frustrating for people handling their injury claims, as 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, a common tactic 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 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 consider hiring an accident lawyer. In some cases, the injured person fails to take appropriate action within the two-year limitation period, effectively waiving their claims.
One tactic that is part of the delay tactic above is the ever-increasing requests for additional information. Usually, this revolves around medical treatment, and the adjuster will typically say they cannot decide until they have the additional records.
After those records are obtained, the adjuster will find another piece of information that they need 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 they cannot proceed with the claim without a statement. This is usually not the whole truth, and many good attorneys refuse to provide statements from their clients, particularly in clear-cut liability matters.
When the adjuster takes a recorded statement from an unrepresented person, the intent is usually to find a way to defend the claim, rather than simply obtaining the information necessary to value it.
Typically, the adjuster attempts to obtain a statement early in the process, often before the car accident victim has been fully diagnosed with any medical issues.
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 the need for an attorney. In that case, the insurance company will surely pay less money in the end.
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 obtain a statement from the car accident victim that can be used against them and obtain other information that will only 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 are typically not time-limited. 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.
Certainly, records more than ten years prior to 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 tactic employed in both settlement negotiations and litigation defense.
Car accident victims who do not understand Texas laws are often offered coverage 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 can trap unsuspecting people 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 a car accident victim first understands that they need an attorney, the subject of money arises. 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 drives 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 involve investigators sitting in parked cars down the road from your home, hoping to film you engaging in physical activities, such as playing with your children, disposing of the garbage, or mowing your yard.
Accident victims must be forthcoming about the extent of their injuries and refrain from exaggerating them. Usually, investigators are brought in when the company believes 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
Since establishing Baumgartner Law Firm in 1985, Greg Baumgartner has built a reputation as one of Houston’s leading personal injury attorneys, dedicated to representing severely injured victims and families who have lost loved ones due to negligence.
Greg holds two law degrees, a distinction earned by less than 1% of all attorneys, demonstrating his exceptional legal expertise. He is also a prestigious Trial Lawyers College graduate, further enhancing his skills in trial advocacy and litigation.
His relentless commitment to legal excellence and client advocacy has earned him recognition from prestigious organizations, including Super Lawyers, the Top 100 Trial Lawyers, and many others.
With decades of experience, Greg has consistently received top peer reviews. He holds a preeminent rating, a testament to his unwavering dedication to securing justice and maximum compensation for his clients.
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