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Counsel That You Can Trust & Depend On

The Tactics Utilized by Insurance Companies in Handling Personal Injury Cases

Guy DiMartino Oct. 19, 2021

Interviewer: What tactics have you seen insurance companies use? What do you do if they're really getting aggressive with you?

Guy S. DiMartino: What I've seen and what auto accident claimants hear is, “I want to take your statement so I can get you paid”, and then a client will say, “Well, I'm really uncomfortable with that. I want to go ahead and hire a lawyer”, and then the insurance adjuster will say, and Allstate was famous for this years ago and also the information was put in the book, I can't remember his name but it was from Good Hands to Boxing Gloves. What their mantra was or their script was, “You can go and hire a lawyer all you want. Your offer is not going to get increased because you're hiring a lawyer. So, you don't need to hire a lawyer”. How would an insurance adjuster know at day 3 all the facts and circumstances of the accident or the nature and extent of somebody's injuries to know whether the offer is going to increase later on?

Insurance Companies May Offer Financial Aid but Will Require the Claimant to Provide Medical Authorization

I've seen folks pushed by insurance adjusters this way, the adjuster will say, “Oh, I understand you don't have money. We'll advance you some money to pay for your medical bills”, and they sort of trap them that way. But in order to do that, in order for us to pay your medical bills, we need you to sign the medical authorization. So, what they'll do is they'll send the injured person a medical authorization. When you look at the authorization, it is the broadest authorization that you could see out there. They don't limit it in time or to any particular doctor. And so, the injured person will sign the authorization and the insurance company will go out there and gather all those information that is irrelevant, and information that they should not have.

Insurance Adjusters Will Use Any Information that They Can Get Regarding the Claimant

Let me give you case in point. Say you have a client that suffered significant anxiety, five years before the accident. They go ahead and they get this information and one of the clients' triggers for anxiety is say confrontation. So, now, the insurance company knows that this client or this person who is injured has problems with anxiety, has been on medication for anxiety and becomes anxious when somebody confronts them. Don't you think that that insurance adjuster could use those three pieces of information to get this so painful for the person that they'll go ahead and settle at no cost? All the insurance adjuster would need to do is would take that information and say, “Okay. I'm just going to be confrontational with her”.

Insurance Adjusters May Use Any Information to Get the Result that They Want

So, it's as much the injured person's fault because they didn't know and they stepped into it. But if you have somebody who gets bonused on profit for the company or gets bonused on how many cases they close within a six months period from the insurance company, people are human beings, they're going to use what they can to get the result that they want. The other thing with the insurance adjuster calling up is that a lot of times, folks will get confused when it's, say, a State Farm on State Farm accident, when both parties have the same insurance company. The confusion comes in when the adjuster calls up and says, “Hi, I'm Betty from Acme Insurance”, and so you don't know if Betty is your insurance adjuster or the other person's insurance adjuster.

Your Responsibility to Your Insurance Company is Different than Your Responsibility to the Other Insurance Company

Your responsibility to your insurance company is different than your responsibility to the other insurance company. You have a responsibility as an injured person to give a statement to your insurance company. But if Betty calls up and says, “I'm from Acme”, you don't know if she's the other driver's adjuster or your adjuster. So, it could be Betty from Acme being the other driver's adjuster and then, you spill the beans and give her all the information that she can use against you. It's not sinister, this is just the landscape. Definitely it's a trap for the unwary because, most people come from the position that other folks have their best interest at heart but, you know, this is business to the insurance company and it's not having the injured person's best interest at heart. The injured person is just a number and nothing else to the Insurance company. The injured person is just like we talked about earlier, just the loss reserve, just a number on the spreadsheet, whether it's $5,000, $25,000 or a million bucks.

Neglecting to Mention any Prior Injuries in a Personal Injury Case May Impact a Person's Credibility in Court

The final thing that I see, and it's probably the biggest mistake, and it has to do with the whole credibility issue. Not telling your lawyer about prior accidents, not telling your lawyer about prior injuries to that area of the body, not telling your doctor about prior injuries or past medical issues. In a car accident case, your doctor is the most important person because he has to make that link between the accident and your injury. He or she has to render an opinion that the accident caused the injury. One of the things that the doctor does to make that determination is they rule out that you did not have that problem on the day of the accident or in the past. So, if you say, “No”, to the doctor and so the doctor renders an opinion and gives an opinion, “Yes. The accident caused the herniated disk in your neck and you need a surgery for that”, but yet there's a medical record that pops up that shows six weeks before the accident, you were diagnosed with a herniated disk in your neck.

It is in Your Best Interest to Provide Truthful Information Regarding Injuries in a Personal Injury Claim

Not having that information is going to hurt the doctor's credibility, and when the doctor said he relied on the patient's history, it is going to undercut the injured person's credibility. It would be better for the injured person to say, “Yes. Six weeks before the accident, I went to the doctor. He told me I had a herniated disk but he didn't say that it was surgical. I was involved in the accident. The herniated disk got worse and now, I needed the surgery.” That flies much better to an insurance adjuster or a jury.