Tactics Insurance Companies Use to Avoid Paying Claims

Posted by on February 9, 2021 in Investing and Insurance with 0 Comments

The insurance business is one that aims to make a profit, and these companies are great at doing just that. The car insurance industry brings in tens of billions of dollars in profits annually.

If you’re in an accident and you’re working with a car insurance company, or you have a claim with other types of insurance companies like your homeowners’ insurance, you may have found that they seem very reluctant to pay out.

The reason is that, again, their objective is profitability.

It’s unfortunate when you find yourself in a situation where you’ve paid your premiums likely for years to an insurance company, and yet they don’t seem to uphold their end of the deal when you need them the most. Additionally, if you’re in an accident with someone else, their insurance company is going to similarly want to avoid paying the claim. They’ll use all the same tactics to save money.

An insurance adjuster’s entire goal in their position with the company is essentially to reduce what’s paid out in claims.

Understanding why and how insurance companies avoid paying claims can actually help you fight it and get what you deserve as a customer of the company.

The following are some tactics insurance companies frequently use. If you find yourself in a situation following a car accident, for example, and you believe these tactics are being used on you, you should consult with an attorney.

Delaying a Claim

The number one tactic all types of insurance companies use is delaying a claim.

If you have an injury claim after an accident, they might try to make the process so frustrating for you that your evidence is diminished, or maybe you grow impatient and simply give up.

Within the larger category of delaying a claim, an insurance company might use other specific tactics.

For example, an insurance company might purposely make the process to receive compensation so complex that you’re frustrated and give up. They can do this by asking you to fill out complex forms and jump through hoops that aren’t actually needed.

Many times, these forms will require you to dedicate time to complete them and also tracking down supplemental information.

Then, when you complete them, the insurance company might tell you they aren’t correct, or they’re incomplete.

You can stay tied up in this shuffle of paperwork for months.

The insurance company might make it hard to get in touch with the appropriate person, and you can be passed around between departments, never reaching any real resolution.

Another way to delay a claim is to let your evidence deteriorate.

What this means is that if they have enough time to pass, then it can be harder to track down needed evidence. For example, if you don’t contact a witness to a car accident right away, they might forget details, or they might not even want to provide information at that point.

You also have to consider the statute of limitations, which is a time period within which you have available to file a lawsuit.

Denial

An insurance company might deny a claim.

For example, if you’re in an accident with someone else, and it’s apparent they were at fault, their insurance company might deny your claim and say they weren’t.

You have recourse in these situations by filing a lawsuit, but insurance companies often hope people don’t realize what options are available to them.

Another form of denial insurance companies use is minimizing injuries.

The severity of your injuries following an accident is a big part of your claim and how much your compensation will be.

One specific way an insurance company might minimize your injuries is by using a pre-existing condition.

They might say that yes, you were injured in the accident, but they could say that your pre-existing conditions exacerbated your injuries or that your current injury is solely because of a pre-existing condition and not the result of the accident.

If an insurance company can’t outright deny a claim, they might say that your expenses related to your injuries aren’t as much as you say they are.

An insurance company can also take the route of saying your actions worsened your injuries. For example, they might say that since you didn’t seek medical care right away, your injuries became more serious.

Defend

An insurance company will often move through the first two tactics of delaying and denial first.

Then, if those aren’t working, they will start trying to pay as little as possible, which is a phase of defending against a claim.

If the insurance company has figured out they’re going to have to pay something, they then put their efforts toward minimizing that amount.

Insurance companies are massive corporations, and they have some of the most high-paid lawyers at their disposal, which is a fact you may underestimate initially.

Their attorneys and investigators will do everything possible to defend against a claim.

Then, what will happen is that you may accept whatever figure the company comes up with for compensation without question. These are going to be lowball offers.

You could find that once you’re at this phase, the insurance company will also start to blame someone else entirely for an accident. That can make things more complex. For example, maybe they’ll begin to say that the manufacturer of your car is responsible.

An insurance company has a real financial incentive to engage in all three of the above.

That’s why if you’re in an accident or dealing with an unscrupulous insurance company of any kind, you should really think about talking to a lawyer.

Even if it’s just for a consultation, an experienced attorney can shed some light on what the insurance company is trying to do and what your options are to fight back.

If you are dealing with an insurance company for any reason, try to avoid signing anything until you talk to a lawyer first and don’t agree to anything that insurance company asks of you.

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