Top 8 Secrets About An Insurance Companies [Personal Injury Claims]

Top 8 Secrets About An Insurance Companies [Personal Injury Claims]

Today I'm going to tell about 8 secrets that insurance companies won't tell you in a personal injury case. The insurance companies will never tell you by yourself and will always try to know that you do not know these things. Which will benefit the insurance companies and reduce your personal injury claims, which will benefit the insurance companies and you will suffer losses? That's why I am telling you all these things from Talkies and maybe those who know you can benefit. I have all the secrets very easy to remember. Some things are a bit tricky but when you read this article, you will understand everything

Top 8 Secrets About An Insurance Companies
Top 8 Secrets About An Insurance Companies

1. The Reserve Amount

The reserve is an amount of money when you make a personal injury claim that the insurance company sets aside to pay your claim. Generally speaking, the higher the reserve amount, the higher the amount of money, that the insurance company will ultimately pay you in a case, or has the authority to ultimately pay you in a claim. You may be dealing with an insurance adjuster, a claims representative of the insurance company, and think he's extremely nice but, just to get a good idea of how much you think you're going to get paid? Or how willing you think the insurance company is to pay you? 

Ask the adjuster what is the reserve, what have you reserved my claim at? 95 out of 100 times you're going to get the adjuster to say "I can't tell you that, it's privileged information." Occasionally you may get an adjuster who says I've reserved your claim at X. Now X could be $5,000, $40,000, and a $100000, whatever. Even if the insurance adjuster tells you the reserve, you have to assume that it's not really the reserve. Why? If he told you the reserve he would be showing you all his cards.

An example of a claim that I had where the adjuster told me one reserve that was totally incorrect. And much lower than the actual value of the claim, and settlement value was, I had a case I settled for $445,000.00. After my client was released from the hospital, I made a claim against the truck driver, who caused the accident. And I sent the adjuster some medical bills and records, and the adjuster told me that when I asked him I said: "What do you have the claim reserved at?" He told me "$100,000." From that point forward not much changed with the case. The case ended up settling for $445,000. Even if the insurance adjuster does tell you what the reserve is, take what he tells you with a grain of salt.

2. Low First Offer Doesn’t Mean Law Case Value

A low first offer does not mean the case is not worth that much money. I have had many cases. too many to go over right now, where my client, or we, received a low first offer and the claim ended up settling for multiples of that offer. One example was where my client was offered by Travelers Insurance company $20,000 for a wrist fracture and the surgery as a result of falling from a booth at a restaurant. 

The adjuster told me "$20,000 "Is all that I'm allowed, "All the authority I have to offer you." But we ended up filing a lawsuit and just a few months later, not a whole lot of time later, but after hard-fought litigation, we settled the case for $210,000.The moral of the story is, just because you get an initial low offer, don't think your case is not worth that much. On the other hand, there are some cases where the insurance adjuster will offer you $4,000, $5,000, $7,000, whatever, and he really only has the authority to increase his offer a few thousand dollars or more than that. But just because he only has the authority to offer a few thousand more, doesn't mean your case is not worth a lot more.

3. Denying Liability Doesn’t Bad Care

Don't expect the insurance company to tell you that you may have a case even if they deny liability. From time to time, it claims that I represent people in, where they're hurt and someone else is at fault, the insurance company will deny liability. One of the big secrets out there to people who don't handle these claims routinely is that just because an insurance company denies liability, essentially saying we did nothing, their client, they are insured, did nothing wrong, that doesn't mean that you don't have a fantastic claim. Let me give you an example.

I represented a gentleman who slipped and fell in a supermarket in Miami, Florida. Prior to the slip and fall, he had hurt his Achilles tendon, but the fall made it much worse and he had to have a couple of skin revisions. The insurance company, actually it was the supermarket themselves, initially denied liability. They said, they even sent a copy of the surveillance video showing the fall, they said: "Look at it, we did nothing wrong." Well, I ultimately filed a lawsuit and we settled for $300,000 sometime later after hard-fought litigation. But the point of the story is, just because an insurance company denies liability and says our client, or our insured, did nothing wrong, it doesn't mean you don't have a fantastic claim. On the other hand, there are times where an insurance company does deny liability, and you really may have a terrible claim.

4. Whether There Is Other Available Insurance

Don't expect the insurance company to tell you if there's any more available insurance out there, many adjusters will not do it. Let's say you're in an auto accident and you have a claim against the driver. The insurance company tells you that the driver has $10,000 of insurance, or you send a letter to them requesting that they tell you what the insurance limits are, sworn under oath, they say $10,000. They say on the response that there's no other available insurance that they're aware of. They're not always right. Sometimes the adjuster does not take the time to ask his insured, the person who caused your accident.

Sir, mister, do you have any other umbrella insurance that would apply for this accident that covers you above the bodily injury liability?

Were you working for an employer at the time of the accident?

Were you driving a car for Uber or Lift, or were you volunteering?

Do you live with a resident relative, whose insurance may cover you for this accident?

Bottom line is, insurance adjusters are loaded up with claims. They may not take the time to research and speak with their insured and really find out if there's additional insurance that applies to the claim. You need to do the work, you need to investigate it, you need to send the proper letters, and you need to demand that they give you an answer. Don't expect them to do the work for you.

5. Suing May Get A Higher Offer

Don't expect the insurance company to tell you that suing their insured will get you a higher offer they're just not going to do it. Occasionally an adjuster will say hey, if you want to get more money, you have to sue us, meaning their client. Overall don't expect them to tell you this. I heard years ago that one particular insurance company when a lawsuit is filed against them, they double their settlement reserves, their reserves to pay the claim. One of the reasons that using them may get a higher offer is because a lot of insurance companies have to then hire outside attorneys to defend the case. They have to pay them hourly fees which can really add up very quickly. Also, when you file a lawsuit the insurance company may switch the adjuster. The new adjuster may have more settlement authority, money, to pay your claim.

Top 8 Secrets About An Insurance Companies
Top 8 Secrets About An Insurance Companies

6. You May Not Have To Give Recoded Statements

One of the best-kept secrets in the insurance business is doing not expect the insurance adjuster to tell you that you do not have to give a recorded statement. In many cases, you do not have to give a recorded statement. There are some cases where you do have to give the recorded statement.

For example: If you're making a claim against your own auto insurer, there's a very high probability that you have to give a recorded statement. But generally, if you're injured on someone else's premises, you never have to give a recorded statement. If you're making a claim against a driver, someone who was careless, or an owner of a vehicle, who caused your injury, you generally never have to give a recorded statement. The recorded statement will later be used against you and the insurance company will try to point out things, such as you saying that you were not in pain when you gave the statement, and you're telling the insurance company, how bad your life has been damaged because of the accident. 

The recorded statement can generally only favor an insurance company. The same is true with the non-recorded statement, just a regular informal statement. If it's to your own insurance company you generally have to give it. If you're making a claim against someone else's insurance company for damage that they caused to you in an accident, you generally never have to give a recorded statement.

7. Not Going To The Hospital (Gap In Treatment) Lower The Case Value

Don't expect an insurance company to tell you, that you should go to the hospital or get medical treatment. If you don't go to the hospital or get medical treatment, expect them to, later on, offer you less to settle your personal injury claim. But don't expect an insurance adjuster to tell you, to say to you, hey I just wanted to point out you haven't gotten medical treatment in a while, you should go to the doctor, it's going to help your case.

8. Their Bad Facts

The number eight secret that the insurance company for the careless party likely will not tell you are bad facts that hurt their insured's claim. Essentially, facts that make your claim better. What are examples of that? If their insured calls the insurance company and tells them that the insured was speeding, the careless driver was speeding. If it's a slip and fall for example in a supermarket, and they know that the liquid was on the floor for a long time before your fall, which makes your case easier to prove. If the insured was on a cell phone at the time of the crash and many, many, many more bad facts that can hurt the other side's claim.

Do not expect the insurance company to tell you bad facts for them. I have had cases where the insurance adjuster has told me bad facts that hurt the other side's claim. Or, defenses against your claim such as I had a client who was injured when shower glass broke and sliced him, the insurance adjuster told me, she says in that same hotel they have had past instances of glass breaking. She said they didn't happen in the shower, but they happened in other areas in the bathroom. 

Now, that helped my claim because it allowed me to show that the hotel was on notice, or arguably was on notice, that there was a problem with the glass. And again, I've had many other cases where the insurance adjuster has shared with me bad facts that make it easier for us to prove liability that their insured was negligent, although it's the exception to the rule and it rarely happens. I hope you got a lot out of these secrets that insurance companies likely will not tell you in an accident case.

Thank you for reading this article. I hope you get the benefit from the points given in it. If you like this article, then share it and you can subscribe to our website via email.

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