Insurance Company Tactics Used to Deny or Devalue Personal Injury Claims

If you have been injured in an accident in Georgia or South Carolina, the insurance company handling your claim is not your ally. Despite friendly phone calls and promises to “take care of everything,” insurers are businesses with a financial incentive to pay you as little as possible — or nothing at all. Understanding the specific tactics adjusters use gives you the leverage to protect your claim and avoid costly mistakes. The Wex entry on insurance from the Legal Information Institute at Cornell Law School explains how insurance works and why states regulate it.

Whether your case involves a car accident, a commercial truck wreck, or a slip-and-fall on someone else’s property, the playbook insurers follow is remarkably consistent. Below are the most common tactics used to deny or devalue personal injury claims in Georgia and South Carolina, along with the legal tools available to fight back.

Requesting Recorded Statements to Trap You

One of the first things an adjuster will do after an accident is call and ask for a recorded statement, framing it as routine or mandatory. It is neither. You have no legal obligation to provide a recorded statement to the at-fault party’s insurer in Georgia or South Carolina. Your own insurer is different: your policy usually requires you to cooperate, so let your lawyer handle its requests.

The purpose is to lock you into answers that can be used against you. Adjusters ask leading questions — “Were you feeling okay right after the accident?” or “Could you have done anything differently?” — designed to create the impression that your injuries are minor or that you share blame.

In Georgia, where the modified comparative fault rule under O.C.G.A. § 51-12-33 bars recovery if you are 50% or more at fault, even a minor admission of partial responsibility can be devastating. South Carolina applies a similar threshold — you cannot recover if you are found 51% or more at fault. A casual comment in a recorded statement can become the centerpiece of a comparative fault defense.

If an adjuster contacts you, politely decline to give a recorded statement and speak with an attorney first. This is especially critical in motorcycle accident claims and pedestrian accident cases, where insurers frequently try to assign blame to the injured victim.

Sending You to an “Independent” Medical Exam (IME)

Insurance companies regularly request that injured claimants submit to an “independent” medical examination. The name is misleading. These exams are conducted by doctors selected and paid by the insurance company.

In Georgia, once a lawsuit is filed, the defense can ask the court to order an exam under O.C.G.A. § 9-11-35; the judge decides whether there is good cause, sets the time, place, scope and examiner, and can refuse when your treatment records already answer the question. In South Carolina, Rule 35, SCRCP allows a court-ordered exam only where more than $100,000 in actual damages is at stake, for good cause, and your own physician may attend. In both states you are entitled to the examiner’s written report on request. Before litigation, you generally have the right to refuse the other driver’s insurer; your own policy may require an exam. If you do attend an IME, bring a witness or request to record the examination.

This tactic is especially common in traumatic brain injury claims and spinal cord injury cases, where the long-term cost of treatment is substantial and insurers have the most to gain by disputing severity.

Demanding Unlimited Access to Medical Records

After filing a claim, you will likely be asked to sign a medical authorization form granting the insurance company access to your medical records. What adjusters often fail to mention is that the authorization they provide is far broader than what your claim requires. HIPAA binds your health-care providers, not the auto insurer, and requires an authorization to say which records, from whom, to whom and until when (45 CFR 164.508), but it does not stop you from signing one that covers your whole history.

The insurer’s goal is to find anything that could be used to argue your current injuries are pre-existing or unrelated to the accident. A back complaint from five years ago or routine chiropractic visits can be twisted into an argument that the accident did not cause your condition.

You should never sign a blanket medical authorization. Before a lawsuit you owe the other driver’s insurer no records at all; in a Georgia motor-vehicle case, a lawyer’s pre-suit demand encloses the records the insurer needs (O.C.G.A. § 9-11-67.1). Once suit is filed, the discovery rules and the judge decide what is relevant, and providers release records under a court order or a subpoena meeting 45 CFR 164.512(e). Your attorney can prepare a limited authorization covering only the treating providers and timeframe connected to your accident.

Blaming Pre-Existing Conditions

Insurance companies love pre-existing conditions. If you had any prior injury or medical issue affecting the same body part, the insurer will argue the accident did not cause your current symptoms. This tactic is used even when the claimant’s prior condition was fully resolved before the accident.

The law in both Georgia and South Carolina protects injured victims through the eggshell plaintiff doctrine. Under Georgia law, a defendant takes the plaintiff as they find them — if a person with a pre-existing spinal condition suffers an aggravation of that condition in a wreck, the defendant is liable for the full extent of the aggravation. South Carolina follows the same principle. The insurer cannot escape liability simply because the victim was more vulnerable to injury than an average person.

Georgia also recognizes aggravation of a pre-existing condition as a compensable injury. If a collision turned a manageable back problem into a condition requiring surgery, the at-fault party owes damages for the worsening. The same rule applies in South Carolina.

Insurers will still try to attribute your entire condition to pre-existing issues, particularly in workers’ compensation cases where claimants often have years of documented physical wear on their bodies.

Delaying the Claims Process

Delay is one of the most effective weapons in the insurance company’s arsenal. Adjusters know that injured people are often out of work, facing mounting medical bills, and under financial pressure. The longer the insurer drags out the process, the more desperate the claimant becomes — and the more likely they are to accept a fraction of what the claim is worth.

Common delay tactics include repeatedly requesting the same documents, claiming paperwork was lost, transferring your file to a new adjuster, and failing to return phone calls for weeks. Some insurers delay strategically to push the claim closer to the statute of limitations deadline, hoping the claimant will give up or run out of time to file suit. Both states treat unreasonable claim delays as practices the insurance regulator can act on (O.C.G.A. § 33-6-34; S.C. Code § 38-59-20).

In Georgia, the statute of limitations for personal injury is two years from the date of injury under O.C.G.A. § 9-3-33. In South Carolina, the deadline is three years under S.C. Code § 15-3-530. If the insurer can stall past these deadlines, your legal right to sue evaporates entirely — and so does your negotiating leverage.

This is why it is critical to hire an attorney early. Once a lawyer is involved, the insurer’s lawyers may not contact you directly (Rule 4.2, Rules of Professional Conduct), adjusters deal with your attorney once notified, and strategic delays become far more difficult to sustain.

Offering Quick Lowball Settlements

On the opposite end from delay is the quick lowball offer. Within days of an accident, an adjuster may contact you with a settlement that sounds reasonable when you are facing mounting bills. But these early offers are calculated to close the claim before you understand the full extent of your injuries.

A settlement signed in the first week after a car accident cannot account for injuries that take weeks or months to manifest. Herniated discs, soft tissue damage, and concussions often worsen over time. If you accept the insurer’s first offer and later need surgery or long-term rehabilitation, the release you signed extinguishes your right to pursue additional compensation.

In both Georgia and South Carolina, a signed settlement release is a binding contract. Courts rarely set one aside, and not merely because your injuries turned out to be worse than you knew. Never accept a settlement offer without consulting an attorney who can evaluate the long-term cost of your injuries.

Disputing Causation and Severity

Even when liability is clear, insurers frequently challenge the connection between the accident and your injuries. An adjuster might argue that the collision was “too minor” to cause the injuries you are claiming, that there was a “gap in treatment” suggesting your injuries are not serious, or that your symptoms are exaggerated.

The “low impact” defense is especially common. Insurers hire biomechanical engineers to testify that a vehicle at a certain speed could not have produced enough force to cause the claimed injuries. This ignores the medical reality that occupants can suffer significant injuries in low-speed collisions, particularly to the cervical spine.

Treatment gaps are another weapon. If you waited two weeks to see a doctor, the insurer will argue that a truly injured person would have sought immediate care. There are legitimate reasons for delayed treatment — shock, lack of insurance, gradual symptom onset — but the insurance company will exploit any gap.

This tactic shows up regularly in dog bite claims and premises liability cases, where insurers argue that the injury could have happened somewhere else or that the victim is overstating the severity.

Bad Faith Insurance Practices in Georgia

Georgia law provides meaningful penalties when an insurance company acts in bad faith. Under O.C.G.A. § 33-4-6, if an insurer refuses to pay a covered claim within 60 days of the policyholder’s demand and the refusal is in bad faith, which Georgia courts define as a frivolous and unfounded refusal to pay (Taylor v. GEICO, 2019), the policyholder can recover the claim amount plus up to 50% of the loss or $5,000, whichever is greater, plus reasonable attorney’s fees. This statute applies to first-party claims — meaning claims you file against your own insurer. On uninsured-motorist claims, § 33-7-11(j) allows up to 25% or $25,000, whichever is greater, plus fees.

Georgia also holds a liability insurer answerable to its own policyholder when it unreasonably refuses to settle within policy limits and a verdict then exceeds them: the insurer may owe the excess (McCall v. Allstate, 1984; Southern General v. Holt, 1992). That claim belongs to the at-fault driver, who can assign it to you, and it creates powerful leverage when the at-fault driver’s insurer is stonewalling a legitimate claim. You cannot sue the other driver’s insurer for bad faith directly (Mills v. Allstate, 2007).

Georgia separately lists unfair claims settlement practices in O.C.G.A. § 33-6-34, such as failing to conduct a reasonable investigation, denying a claim without a written explanation, refusing to negotiate in good faith once liability is reasonably clear, and misrepresenting policy language. The Office of the Commissioner of Insurance and Safety Fire enforces those rules; they do not support a lawsuit. If you suspect your insurer is acting in bad faith after a truck accident or wrongful death claim, document every communication and consult an attorney immediately.

Bad Faith Insurance Practices in South Carolina

South Carolina addresses insurer misconduct through its improper claim practices statute, S.C. Code § 38-59-20, which the Department of Insurance enforces and which, unlike Georgia’s, expressly covers claims by injured third parties. Improper claim practices include making misleading statements about coverage, failing to act promptly on communications, and not attempting in good faith to effectuate fair settlements when liability is reasonably clear. It does not let you sue the other driver’s insurer (Kleckley v. Northwestern National, 2000).

South Carolina also recognizes a private cause of action for bad faith refusal to pay benefits. In Nichols v. State Farm, the South Carolina Supreme Court established that an insured can bring a tort action against their own insurer for bad faith denial of coverage, potentially recovering actual damages, consequential damages, and punitive damages. Under S.C. Code § 38-59-40, a policyholder whose insurer refuses to pay for 90 days after demand without reasonable cause or in bad faith also recovers attorney’s fees, capped at one-third of the judgment. Punitive damages are capped at the greater of three times compensatory damages or $500,000, a floor indexed each year ($739,245 for 2026), under S.C. Code § 15-32-530.

The South Carolina Department of Insurance also accepts complaints against insurers engaging in improper claim practices. A complaint puts the insurer’s conduct on the regulator’s record, and the Department acts on patterns, but it does not give you a bad-faith claim against the other driver’s insurer.

GA vs SC Bad Faith Comparison Table

How a Personal Injury Lawyer Fights Back

An experienced personal injury attorney knows these tactics because they see them in every case. Here is how legal representation changes the dynamic:

Blocking harmful communications. Once you retain a lawyer, the insurer’s lawyers may not contact you directly (Rule 4.2), and adjusters deal with your attorney once notified. No more recorded statements. No more pressure calls. No more attempts to get you to say something that damages your claim.

Controlling the medical narrative. Your attorney will ensure that only relevant medical records are disclosed and that your treating physicians — not insurance-hired IME doctors — drive the narrative about your injuries. If the insurer disputes your diagnosis, your lawyer can retain independent medical experts to provide objective opinions.

Documenting the full value of your claim. Insurance companies count on claimants not understanding what their case is worth. A lawyer calculates the complete cost of your injuries, including future medical expenses, lost earning capacity, pain and suffering, and diminished quality of life. This is particularly important in catastrophic cases involving traumatic brain injuries or spinal cord damage, where lifetime costs can reach millions of dollars.

Filing suit when necessary. The threat of litigation changes insurer behavior. Once a lawsuit is filed, the case moves into the legal department, where the cost-benefit analysis shifts dramatically. Discovery can reveal internal claim-handling guidelines designed to minimize payouts and communications showing the insurer knew the claim was valid.

Leveraging bad faith claims. In both Georgia and South Carolina, an insurer that refuses a reasonable settlement within its limits risks owing its own policyholder the entire excess verdict, and a policyholder whose own insurer stonewalls a UM/UIM or med-pay claim has bad-faith penalties to invoke. An attorney who understands which lever applies to which insurer can use them to force fair treatment of your claim.

Whether your case involves a motorcycle accident, a wrongful death, or a pedestrian collision, legal representation levels the playing field against insurers that have entire departments dedicated to minimizing payouts.

Contact Roden Law — Free Case Review

If an insurance company is delaying your claim, offering a settlement that does not cover your medical bills, or denying your case altogether, you do not have to fight them alone. Roden Law represents injured clients across Georgia and South Carolina on a contingency fee basis — you pay nothing unless we recover compensation for you.

With more than $300 million recovered for our clients and offices in Savannah, Darien, Charleston, Columbia, and Myrtle Beach, our attorneys have the resources and experience to take on the largest insurance carriers and hold them accountable.

Call 1-844-RESULTS or contact us online for a free, no-obligation consultation. The sooner you have a lawyer involved, the harder it becomes for the insurance company to take advantage of you.

About the Author

Graeham C. Gillin

Partner, COO