Shielding Your Rights: Deconstructing Insurance Companies’ Schemes

Interacting With The At-Fault Party’s Insurance Company

Dealing with insurance is a hassle under normal circumstances, but having to deal with the other party’s insurance in light of an accident is magnitudes worse. Unfortunately, this is more likely than not an unpleasant reality you will have to face. This is especially so once they are made aware of the incident and realize their insured driver may be liable. There are significant risks to having contact with the at-fault party’s insurance company, such as:

Potential Admissions Of Fault

Insurance adjusters may try to obtain statements from you regarding the accident. If you are not cautious, you could unintentionally make statements that the insurance company can use to diminish or deny your claim. Avoid admitting fault or speculating about the accident.

Lowball Settlement Offers

Insurance adjusters may offer quick settlements that do not fully compensate you for your injuries and damages. These offers are often designed for one thing: to save the insurance company money. Accepting such offers without consulting an attorney could result in inadequate compensation.

Complex Legal Language

Insurance companies may use complex legal language (legalese) when communicating with you. Make every effort to understand the full implications of what you are signing or agreeing to before you do. As challenging as this can be, especially without legal assistance, it is absolutely necessary.

Limited Information

Initially, you may not have a complete understanding of the extent of your injuries and damages. Prematurely settling with the insurance company could leave you without sufficient compensation to cover future medical expenses and other losses.

To mitigate these risks and protect your claim, you may consider taking the following steps:

Consult An Attorney

Before having any direct contact with the at-fault party’s insurance company, consider consulting with a personal injury attorney. They can help you communicate with the insurance company, if not entirely do so on your behalf, protect your rights, and avoid making statements that could harm your claim.

Provide Only Basic Information

If you do choose to speak with the insurance company, you can provide basic information about the accident, such as the date, time, and location. Avoid going on at all beyond that by providing a detailed statement about fault or your injuries.

Limit Communication

You are not obligated to engage in lengthy or detailed conversations with the insurance adjuster. You can politely inform them that you will be seeking legal counsel and that your attorney will be in touch.

Do Not Sign Anything

Avoid signing any documents or agreements presented by the insurance company without consulting with an attorney. These documents may include settlement offers, waivers, or releases.

Keep Records

Maintain a record of all communications with the insurance company, including dates, names, and the content of conversations. This will be helpful if you need to provide information to your attorney.

Focus On Your Recovery

Your primary focus should be on your recovery and well-being. Let your attorney handle the negotiations and communications with the insurance company while you concentrate on your health.

Remember: insurance adjusters work for the insurance company, and their primary goal is to protect the company’s interests by minimizing payouts. Having legal representation will pay dividends in terms of ensuring you receive fair compensation for your injuries and damages.

Tactics Insurance Companies Employ

Insurance companies often employ various defenses in personal injury cases to deny or limit settlements. These insurance defenses in a personal injury claim are designed to do one thing and one thing only — protect the insurer’s interests and reduce the amount it pays the injured party. Here are some common defenses used by insurance companies:

Comparative Fault

Kansas follows a modified comparative fault system, which means that if the injured party is found to be partially at fault for the accident, their recovery may be reduced or denied. Insurance companies may argue that the injured party’s own negligence contributed to the accident, therefore reducing their liability.

Pre-Existing Injuries

Insurers may claim that the injuries for which the injured party is seeking compensation existed before the accident and were not caused by the incident. They may argue that the current injuries are unrelated to the accident, which can limit the amount of compensation awarded.

Lack Of Causation

Insurance companies may dispute the link between the accident and the injuries, arguing that the injuries were not a direct result of the accident or that there is insufficient evidence to establish causation.

Low-Impact Defense

In cases where the accident was low-impact, such as minor fender-benders, insurers may contend that the injuries claimed are inconsistent with the severity of the accident. They may assert that the injuries should be less significant than alleged.

Failure To Mitigate Damages

Insurers may argue that the injured party failed to take reasonable steps to mitigate their damages. This can include not following prescribed medical treatments, returning to work prematurely, or not seeking medical treatment promptly.

Statute Of Limitations

Insurers may assert that the injured party filed the lawsuit after the statute of limitations had expired, making the claim invalid.

Policy Exclusions

Insurance policies often have specific exclusions that can limit coverage. Insurers may argue that the injuries or damages fall under one of these exclusions, thereby reducing or denying coverage.

Independent Medical Examinations (IMEs)

Insurers may require the injured party to undergo an IME conducted by a doctor of their choice. The IME doctor may provide an opinion that contradicts the treating physician’s diagnosis and recommendations.

Questioning Medical Necessity

Insurers may challenge the medical necessity of certain treatments or procedures, claiming that they were excessive or not required for the injuries sustained.

Allegations Of Fraud

In rare cases, insurers may allege that the injured party is committing fraud or exaggerating their injuries and damages to obtain a higher settlement.

You’ll likely benefit from consulting with a personal injury attorney when going up against these common defenses. An experienced attorney will build a strong case, gather evidence, and counter the insurer’s defenses to maximize your chances of obtaining fair compensation for your injuries and damages.

Rob Titus is a charismatic Kansas lawyer with over a decade of experience litigating all manner of civil law claims and lawsuits. His succinct and persuasive voice in court translates to clear and easy-to-follow writing for anyone looking for a fundamental understanding of their civil law options and rights.

Connect with the Titus Law Firm to get all the latest on Kansas civil law legal trends and courtroom developments.

Call Us Now To Get Your Case Reviewed (913) 543-4500 

Settlement Offers

Whether to accept an insurance company’s settlement offer right away depends on several factors. Regardless, you need to approach such offers with caution, keeping in mind some key considerations.

Before accepting any settlement offer, consult with a personal injury attorney. They will assess the offer, review the details of your case, and provide guidance as to whether the offer is fair and reasonable given the circumstances. From there, be sure to:

Fully Understand Your Injuries

It’s important to have a complete understanding of the extent of your injuries and the potential long-term consequences. Some injuries may not fully manifest immediately, and accepting an early settlement may not account for future medical expenses or ongoing treatment needs.

Have An Evaluation Of Your Damages

A thorough evaluation of your damages is necessary to determine the appropriate compensation. This includes medical bills, lost wages, pain and suffering, rehabilitation costs, and any other losses related to the accident.

Avoid Rash Decisions

Insurance companies may make early settlement offers to resolve claims quickly and potentially save money. These offers are often lower than what you are entitled to. Avoid feeling pressured to accept an offer before you have had the opportunity to fully evaluate your situation.

The Capacity To Negotiate

Accepting an early settlement offer may leave no room for negotiation. Once you accept an offer, you typically cannot seek additional compensation later, even if your injuries worsen or you discover new damages.

An Idea Of Future Expenses

Consider the potential future medical expenses and ongoing treatment. If you accept a settlement offer too early, it may not adequately cover these costs.

Legal Counsel’s Assessment

Your attorney can assess the offer and provide a professional opinion on its adequacy. They can negotiate on your behalf to seek a more favorable settlement if necessary.

Other Parties Involved

If there are multiple parties involved in the accident or multiple insurance policies that may apply, it can complicate the settlement process. An attorney can help navigate these complexities.

Statute Of Limitations

Be aware of the statute of limitations, which is the time limit for filing a personal injury lawsuit. Accepting an early settlement could prevent you from pursuing legal action if your injuries worsen later.

In many cases, insurance companies offer low initial settlements in the hope that you will accept them without question. Don’t fall for it. Instead, take your time, gather all necessary information, and seek legal advice before making any decisions. Your attorney can help you determine whether the offer is fair and whether it makes sense to accept it or negotiate for a more appropriate settlement based on your circumstances.

Following Medical Treatment Plans

Like seeking medical care promptly, thoroughly following all medical treatment instructions you are given serves the twofold purpose of facilitating the healing process and bolstering your personal injury case. Failing to do so — having a “gap” in your case — can have significant consequences that prove detrimental. Here’s why it’s essential to adhere to medical treatment plans:

Maximizing Recovery

Following medical treatment plans as prescribed by healthcare professionals is essential for your physical recovery. Skipping appointments or not following recommendations can hinder your healing process and potentially lead to complications.

Establishing Causation

Medical records and documentation of your treatment are vital evidence in a personal injury case. They help establish a clear link between the accident and your injuries. If you miss appointments or treatments, it can agitate a sense of doubt about the severity or legitimacy of your injuries and the causal relationship to the accident.

Demonstrating Damages

Consistent medical treatment and adherence to a treatment plan provide evidence of the damages you have suffered. This includes medical bills, prescriptions, therapy, and other related expenses. A gap in care can make it difficult to prove the full extent of your damages.

Avoiding Claims Of Malingering

If you miss appointments or treatment sessions, the opposing party or insurance company may argue that you are exaggerating your injuries or attempting to prolong the case unnecessarily. This can harm your credibility.

Supporting Claims For Pain And Suffering

Adhering to medical treatment plans helps document the pain and suffering you have experienced as a result of the injuries. It provides a record of your physical and emotional distress.

Mitigating Damages

In some cases, insurance companies may argue that you have failed to mitigate your damages by not following recommended treatment. This argument can be used to limit the compensation you receive.

Adherence To Medical Standards

Demonstrating that you have followed established medical standards of care reinforces the legitimacy of your case. It shows that you are taking your injuries seriously and seeking appropriate treatment.

Strengthening Your Case

Consistent medical treatment and adherence to a treatment plan can strengthen your case by providing clear documentation of the impact of the injuries on your life and the expenses you have incurred.

As mentioned earlier, a gap in care refers to any period during which you do not seek or receive medical treatment or fail to follow prescribed treatment plans. This gap can be used by the opposing party or insurance company to argue that your injuries are not as severe as claimed, that you are not taking your injuries seriously, or that your injuries were not caused by the accident. To protect both your health and your personal injury case, it’s essential to:

• Attend all medical appointments and follow your healthcare provider’s recommendations.
• Keep a record of all medical treatments, medications, and expenses related to your injuries.
• Communicate with your healthcare provider about any concerns or changes in your condition.
• Consult with a personal injury attorney who can guide you on how to navigate the legal process and the importance of medical documentation.

Consistency in medical treatment and adherence to treatment plans are key factors in building a strong personal injury case and ensuring that you receive appropriate compensation for your injuries. Don’t drop the ball here — stay committed, stay consistent, and ensure that your voice and your rights are heard and respected.

For more information on Insurance Defenses In A Personal Injury Claim, an initial consultation is your next best step. Get the information and legal answers you are seeking by calling (913) 543-4500 today.