Tactics Insurance Companies Often Use to Deny Claims

Man with face in hands contemplating jumping through three hoopsIf you were injured in a car accident caused by another driver’s negligence, there is a good chance you will hear from that person’s liability insurance company soon afterward. They may say they are concerned about your well-being, and they want to make sure you are taken care of.

The insurance company may also say it is better not to hire a car crash lawyer in Brunswick. However, convincing injury victims to forego working with a legal expert is one of the many tactics used by insurance companies to deny claims brought against them so they may protect their bottom line.

Below, we discuss other common tactics used by insurance companies to deny claims.

Asking for a Recorded Statement

When liability for an accident is clear, or at least more difficult for the insurer to deny, they will try other tactics to trick you into admitting partial fault. One way they may do this is by calling you soon after the accident and asking you to provide a recorded statement.

This request seems innocent enough if you are telling the truth about the facts of the case. However, you may not remember everything. You may not have seen everything that happened and your statements this early in the process could be contradicted by information that comes out later. If this happens, the accuracy of your recorded statement may be called into question and used to assign partial fault to you or blame your damages on a preexisting injury.

For example, say you tell the insurance adjuster during your recorded statement that you do not feel injured, but then a week later cannot shake neck pain and an injury is discovered. The adjuster is likely to use that original statement against you to say your injuries occurred after the crash and therefore they are not liable. 

Referring You to an Independent Medical Exam

The insurance adjuster may try to convince you that you need to undergo an Independent Medical Exam (IME). The insurance company may say the examiner can help objectively evaluate your injuries and offer a prognosis for your recovery as well as a treatment plan.

Unfortunately, there is rarely anything independent about the doctors who conduct an IME. These medical professionals are contracted by the insurance companies to provide a medical assessment consistent with their own narrative. The examiner’s conclusions typically give the insurance company a reason to undervalue or deny your claim.

While the adjuster may argue this is a required part of the claims process, that is not always the case. A judge may order you to have one if a lawsuit is filed, but a claim for compensation does not always result in a lawsuit being filed. The insurance company is betting you will not know your rights or have someone on your side who knows them and is prepared to help protect them.

Asking for Permission to Review Medical Records

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) provides all Americans with the right to privacy concerning their medical records. This means that only you can give permission to another party to review your medical history. The insurance company knows this and is likely going to try to get you to sign a waiver that will give them unlimited access to your medical past.

The reason insurance companies do this is to comb through your records looking for any potential pre-existing conditions or prior injuries to claim you were already hurt and therefore they are not liable for your injuries.

Misrepresenting the Insurance Coverage Available

The insurance company may tell you they do not cover a certain type of treatment plan or surgery and deny your claim. While insurance companies are within their rights to refuse coverage for certain things, this information must be included in the language of the policy.

For example, the insurance company may be able to deny covering the costs of a massage therapy session since most insurers do not cover this type of treatment. However, if the policy does not mention this, our attorneys may be able to help you argue that coverage should not be denied, as it is not explicitly excluded from the liability policy.

Another example of insurance companies misrepresenting what they are and are not liable for include accidents with drivers who were breaking the law when the accident occurred. The insurance company will try to deny liability for a drunk driving crash by claiming they do not cover intentional acts, but while the act of driving drunk was intentional, the accident and your subsequent injuries were not.    

Speak to a Knowledgeable Attorney First. Call Us Today

Insurance companies like to use every claim as a learning experience to help them come up with new ways to deny injury claims. Fortunately, our attorneys at Roden Law are prepared for the excuses insurers use and are prepared to help you fight back.

The insurance company is going to use every trick in the book to protect their bottom line, so it is important to have someone with legal knowledge on your side who can help you navigate the process of filing a claim and fighting back against the insurance company’s tactics.

We offer a free consultation to discuss the facts of your claim and learn how we may be able to help you recover the compensation you need for medical bills, lost wages and other damages.