7 Insurance Company Tricks to Look Out for if You Handle Your Own Personal Injury Case

You’ve been hurt, and you need help. You unknowingly entered a war zone when you were injured even if you didn’t know it. You find yourself in unfamiliar territory “owned” by an insurance company. You’ve on its turf.

The insurance industry has spent billions on advertising that has spread false and misleading information about accident claims. Insurance companies have lobbied their state legislators to pass laws limiting your rights as a citizen, restricting how much they have to pay out, and changing the legal landscape to make it easier for them to deny claims. I’ve witnesses a whirlwind of changes in the way I’m allowed to handle claims just in the last decade. And they keep coming.

Many people who wind up on juries believe too many myths the insurance companies spread, for example, a large award to a personal injury claimant will make all the prices go up for the things we have to buy, including insurance. They’ll say that certain claimants are just trying to get rich and get “jackpot justice.”

These attitudes can be a huge obstacle for you in your case. The insurance company is aware of this, and the adjuster will use any means necessary to pay out as little as possible, even on legitimate claims that involve serious injuries. Insurance adjusters receive extensive training on how to save their companies money and how to document their files early on with information that will help them defeat you. They are a skeptical bunch. I know. I used to work amongst them. It was a “protect your own” and “us against them” mentality that truly alters how a person thinks about such claims.

Many companies reward their adjusters with bonuses related to how much they save their companies by paying less in claims and lowering claims expenses. The claims adjuster accomplishes this in several ways.

  1. Intentional delay of your case. They know you’re hurting for money. You’re on the phone telling them how desperate you are to get your case settled. They love hearing you spill your guts about this. They know they hold all the cards, and they will lowball you because they know you’re desperate. So they take their time and slow-walk your claim because that tactic gives them the edge. Time is not your friend if you’ve been hurt. Also, you may be getting close to the filing deadline if you wait too long. Don’t let them put you in this bind by waiting until the last minute.
  1. Requesting unnecessary information. They don’t mind waiting another eight weeks to get unnecessary information that will not add any value to your claim. They do this to intentionally delay your case. See Rule 1 above.
  1. Disputing medical treatment. Adjusters are trained to think they know what’s best regarding your medical care even though they likely have never had any medical training. The insurance company puts arbitrary deadlines in their heads that they parrot: “Soft tissue injures should always heal in eight to twelve weeks.” Really? Don’t ask them for any medical literature to support their claims because they don’t have any.
  1. Adjusting the medical costs downward. Never upward. In all their collective wisdom, they know how much your doctor should charge you, and they will cut your medical bills without first corroborating the amounts with your doctor. You still owe all your balance, but adjusters think that’s your problem. They’re going to pay you what they feel they should and expect you to live with it.
  1. Misrepresenting or refusing to tell you your insurance benefits. You don’t believe me? Just ask your adjuster who’s being so nice, “Can you tell me the insurance liability limits your client who hit me had?” Listen to the adjuster say he or she would love to but can’t because of company policy or the law. Baloney. No law prohibits an adjuster from telling you how much an insured has. It may be company policy to hide this information, but it isn’t the law. I have insurance companies tell me their limits every week. Don’t buy their hype.
  1. Telling you to not hire an attorney. They will claim a mysterious study says you’ll get less money if you hire an attorney. They’re wrong. They will pay more money and you will get more money if you hire the right lawyer.
  2. Acting as if they’re your friends. When I was an adjuster, we were required to meet with a claimant within eight hours of the claim being reported; insurance studies showed that if you could meet in person at a claimant’s home or workplace quickly, you would drastically save money by lowering attorney involvement. This is simply a tactic to keep you from hiring a lawyer. I’m not saying all adjusters are bad or evil people; I still have friends on that side of the claims world. But they have to answer to their supervisors, who answer to stockholders. Keep in mind that folks are loyal to those who butter their bread. Just know they have one goal in mind—settling your claim for as little as possible.

Do You Really Need an Attorney for Your Personal Injury Case?

Can you handle your case by yourself? Of course you can. Is it a good idea? It all depends. You definitely don’t need an attorney for a small accident case, one that involves little or no property damage to your car and one in which your injuries and treatment last no more than a month or two.

My firm doesn’t accept small accident cases because of my belief we should take cases only when a client could receive a significant benefit in return for our time and expertise. We can help clients even with small cases, but after the fees we’d need to charge to be fair to our obligations to our firm—including the attorney, case manager, paralegals, medical records review specialists, and others—there might be little left over, and that wouldn’t be fair to clients with small claims.

I counsel potential clients every week about the projected values of their cases and give them free advice on what they need to look out for if they decide to go it alone. Those calls—and I take them almost every day—are one of my motivations for writing this book.

An experienced personal injury attorney who goes to court (and wins) has a better understanding of what a claim is worth and can often effectively communicate the value of the claim to insurance adjusters. Unless you’re in the business of settling and litigating injury cases, you will be at a serious disadvantage when dealing with a seasoned insurance claims representative if you don’t have an experienced lawyer at your side.

I recommend handling your case alone in Tennessee only if the property damage is very minimal (less than $2,000, say), and your non-surgical, non-permanent injuries totally healed in less than ninety days after the accident. But if you’re experiencing any ongoing pain, you need to be extremely careful about settling your case. You may think you’ll recover completely from your injury in a month or so from now, but be careful! Many people who suffer soft tissue injuries (such as whiplash) get 90 percent better in the early months but might have to deal with continual neck or low back pain for the rest of their lives. You need to be totally pain free for at least sixty days before you consider settling your case. Once you settle, you settle forever. You get only one shot, so make sure you’re secure in your decision.

Accidents due to grossly negligent actions (i.e., DUI) expose the carrier to what are called punitive damages, which are designed to punish and deter wrongful reckless conduct. The insurance company may tell you its policy doesn’t cover such damages. While that may (or may not) be true, it could factor into your case evaluation. You may have been hit by a third-offense drunk driver who attempted to flee the scene, or you may have been hit by a wonderful older woman on her way to church. Juries feel. Sometimes they feel anger. Sometimes compassion. Their verdicts will reflect that feeling. It can cut both ways. Bottom line, if you are hit by a DUI driver, your case is worth more. The adjuster fears defending their drunk insureds. Don’t let the adjuster sway you otherwise.

Before you decide to go it alone …

In 1999, the Insurance Research Council (IRC), a nonprofit supported by insurance companies in the United States, performed a study to find out if people who had accident claims received more money in settlements by using attorneys than did those who settled on their own. The IRC (IRCweb.org) found that people who used attorneys received on average three and a half times more money in settlements than those who settled on their own. This study debunks the myth the adjusters feed you to keep you from hiring a lawyer who will have only your interests in mind.

How Much Time Do You Have to File a Personal Injury Claim

Tennessee has the shortest time of any state in the union to file a claim for personal injuries. (Only two other states have the same one-year statute of limitations from the date of injury to file a claim.) If a year goes by and you haven’t settled your case or properly filed a lawsuit, you’ll find yourself out of luck and will have to kiss any thoughts of recovery in your case good-bye.

This can be an issue for people out of state who have no idea of Tennessee’s one-year statute of limitations. I’ve run across lawyers in other states who think it’s two years or more in Tennessee; they couldn’t imagine it being less than that. I’ve had the unpleasant experience of having to sue such lawyers for not advising their clients properly and causing them great harm by losing their clients’ cases without even showing up for the fight.

Never wait until close to the year anniversary before filing your case. You should talk to a competent Tennessee personal injury lawyer before it gets too late. Cars get moved, fixed, or destroyed without photos. Skid marks disappear. Witnesses move, disappear, or die without their information and testimony properly recorded. Witnesses’ memories fade. If the statute of limitations slips by, so will your claim. Don’t delay speaking with a lawyer.

Insurance claims adjusters will sometimes intentionally delay your claim just to get you as close to the statute of limitation as possible. They will have already obtained all the documentation they need, but they’ll claim they just need a few more medical bills so they can properly evaluate your claim. Then next week, it’s another thing they need, perhaps a statement from your employer, but it will always be something else and then something else; they’re in no hurry; the last thing they want to do is speed up the process.

Be especially aware of any adjuster who says he or she is willing to give you an extension in writing on a statute of limitation just for you—that’s a huge red flag. One of my clients was told that by an insurance company. The client had suffered a severe injury and was afraid the “lawyers would take all of the money” if he hired one, so he didn’t at first. He was given an official-looking letter that guaranteed he could sue the insured if the company couldn’t resolve his case. As it turns out, the at-fault party the insurance company was protecting was working for another separate contractor; that meant there were two parties and thus two insurance companies responsible for paying the claim.

When I first met the client, the statute of limitations had already expired for the separate, unknown contractor, whose insurance company was thus off the hook. The at-fault party didn’t have enough insurance coverage with the insurance company that had given the written extension. Fortunately, we were able to fix this mistake, but a good lawyer would have found all the available coverage up front and not created the pit of despair my client had to endure. Getting an extension agreement past the statute of limitations with an insurance carrier is extremely risky. Please don’t ever do it.

There are some exceptions to the one-year time limit; minors have until one year past their eighteenth birthdays to file claims, but if that year slips by, they’ll be out of luck.

Time is your enemy; delay serves no one but the insurance company. Don’t needlessly endanger your case outcome by waiting.