Monday, May 13, 2013

5 Dirty Little Tactics Insurers Use to Deny Legitimate Claims

The bottom line is that all insurance companies really care about is their bottom line. Nowhere else is this more evident than when a customer tries to make a valid claim, but is turned away and denied the coverage they not only need, but are entitled to. For example, take the case of Molly Jefferson. Molly, at age 24, was seriously injured in a car accident. Initially, her insurance carrier refused to pay more than $100,000 in damages, falsely stating that the policy limits extended no further. Molly hired legal representation and sued for bad faith. The company, knowing they were in the wrong, settled for $2 million out of court-enough to cover Molly's medical expenses and lost time at work. Insurance companies have all kinds of tactics to avoid paying for the job they are obligated to do. Here are five of the most common. Tactic #1: Standard claim denial For many insurance companies, it is standard procedure to deny claims the first time around. The reason is that most claimants will not attempt to fight the decision, and the company will get out of having to pay coverage. However, if the claimant does indeed pursue coverage further after the initial denial, the company will then pay up. Tactic #2: Lowball settlement offers In many personal injury cases, such as car accidents, the victim is scrambling to pay expensive medical bills and recover from lost time at work. Insurance companies use this financial stress to their advantage by persuading claimants to settle too quickly for insufficient offers and sign a form that releases the company from future claims. Most people underestimate the time and expense of fully recovering from their injuries, and insurance companies count on that to get out of providing your complete coverage. Tactic #3: Recorded statements The job of insurance adjustors is to record your statement in the hopes that you will say something that the insurance company can use against you to deny or reduce coverage. Adjustors have an extensive knowledge of the legal system, which they use to try and twist your words around in their favor. Tactic #4: Requesting medical records Insurance companies ask for claimant's medical records in order to find information suggesting that the injury was not caused by the accident, but rather a preexisting condition. They will also try to use the medical records to argue that your injury is not as severe as claimed. Tactic #5: Video surveillance For claims that the insurance company finds highly disputable, they may send a private investigator to video record a claimant engaging in chores, recreation, or other activities. The intention of video surveillance is to show that the claimant's injuries are not that severe, since they are able to mow the yard, lift objects, play sports, etc. Protect Yourself Insurance companies have plenty of tactics to get out of paying for injuries and damages, as well as a knowledgeable legal team to fight on their behalf. Without a doubt, so should you.