The Inside Scoop on How Insurance Companies Will Fight Your Personal Injury Claim

If you are pressing a personal injury claim against an insurance company, remember this much: the insurance company is not a “good neighbor.” 

Rather, it is a business that exists for a single purpose, and that is to make a profit. Accepting premiums adds to their profit. Paying claims subtracts from it. It is this reality that makes the insurance company your adversary while your claim is pending. 

Strategies and Tactics: The Insurance Company Playbook

Following is a list of the tactics that the insurance company is likely to use against you. Always remember that the better your lawyer’s track record of winning in court, the fewer games the insurance company will play with you.   

  • Accusing you of exaggerating or fabricating your claim. The insurance company is most likely to use this one as their initial strategy, especially if you are not yet represented by a lawyer.
  • Asking for unlimited access to your medical records, and then going on a “fishing expedition” designed to find something they can use to claim that your current injuries predated the accident.
  • Dragging their heels during negotiations to wear you down so that you will accept a lower settlement. The greater the urgency of your financial situation, the better this one is likely to work.
  • Giving you the runaround by shuffling you from person to person, or by simply ignoring you. They will not dare try this tactic if you have hired an attorney.
  • Arguing that some of your medical treatments were unnecessary or unrelated to the accident. This tactic takes advantage of the fact that insurance companies need only pay for “reasonable and necessary” medical treatment.
  • Asserting that their policyholder is not at fault. In some cases, it is the insurance company’s duty to advance this argument.
  • Asserting that you bear a greater degree of contributory fault than you actually do. If you agree that you were 20% at fault, they might assert that you were 50% at fault, for example.
  • Attempting to discredit witnesses who support you. This could happen at trial or at a deposition.
  • Confusing you with incomprehensible ‘legalese’ (otherwise known as the “smokescreen strategy”). They won’t dare try this one if you hire an experienced personal injury lawyer.
  • Employing private investigators to watch you, hoping to find evidence to defeat your claim. 
  • Focusing on your pre-accident health issues to suggest they are the cause of your current injuries.
  • Taking your own words and using them against you. Don’t give them a recorded statement, and let your lawyer check over any written statement you give them. 
  • Misrepresenting their policy terms to suggest that their policy doesn’t cover your claims.
  • Spying on your social media accounts, looking for any material that might contradict your injury claims. They can use your public social media posts as evidence at trial. 
  • Refusing to acknowledge or adequately value your claim for non-economic damages (pain and suffering, emotional distress, and more). They will try to take advantage of the inherently ambiguous nature of these claims.
  • Using any delays or gaps in your medical treatment as evidence that your injuries are not as serious as you claim they are.
  • Offering you a ‘lowball’ settlement that is worth only a fraction of your claim’s true value. Under these circumstances, they are hoping that you’ll accept the settlement just to get the money immediately.
  • Giving you inaccurate information about the deadlines for filing a claim, to discourage you from pursuing it. That might mean, for example, falsely claiming that the statute of limitations deadline has already expired.
  • Insisting you use doctors recommended by the insurance company. These doctors have a financial incentive to downplay the seriousness of your injuries.
  • Discouraging you from hiring a lawyer. This tactic, if effective, can prevent you from defending yourself against any of their other tactics.
  • Using excessive documentation requirements to delay the processing of your claim.
  • Stonewalling you–using stalling tactics to prolong the claim process. This is a way of trying to wear you down so that you’ll eventually accept a lower settlement.
  • Denying your claim automatically, without even bothering to investigate it first.
  • Presenting you with a “take it or leave it” offer with an arbitrary deadline. Never forget that the insurance company has no authority to set the statute of limitations deadline for filing your claim. Only the State of California can do that.

Believe it or not, this list only scratches the surface of the common tactics that insurance companies like to use to fight a personal injury claim. 

Insurance Bad Faith

Some of the tactics above, such as delay, are not illegal as long as the insurance company doesn’t take them to the extreme. Other tactics, such as misrepresenting the terms of the applicable insurance policy, are illegal under just about any circumstances. 

Nevertheless, it is typically difficult to win an insurance bad faith claim. Your best shot is to hire an experienced attorney. Remember that an insurance bad faith claim is separate from your personal injury claim.

If you do win, there is more than one possible remedy:

  • Damages for breach of contract. You can win this claim even if you file a third-party claim against the at-fault party’s liability insurance policy, since you are a third-party beneficiary of the contract between the insurance company and the at-fault party.
  • Bad faith damages including economic losses, emotional distress, and possibly attorney’s fees. 
  • Punitive damages, if the insurer acted with fraud, oppression, or malice.

The availability of remedies depends on the circumstances of your case. 

You Don’t Need a Dime To Hire a Vista Personal Injury Lawyer

Personal injury lawyers, unlike most other lawyers, don’t charge based on “billable hours.” Instead, they use the contingency fee system, under which your legal fees equal a certain percentage of the amount of money you win. 

And in the unlikely event that you don’t win-–well, any percentage of zero is still zero. In other words, your lawyer either wins compensation for you, or they work for free. That is why you don’t need a dime upfront to hire a Vista personal injury lawyer.