Traps the Insurance Companies Hope You Fall into

Attorney Robert Edens Does Not Want You to Fall for These

An insurance company is a business and just like any other business, their main goal is to make a profit. The bigger the profit, the better the company performs. Simply put, they have to take in more money than they pay out and ultimately this is what determines just how big their profits will be. While there is nothing wrong with this premise from their standpoint, it does leave you, and your future, vulnerable to their greed. In an effort to achieve their profits, I have noticed FIVE primary traps insurance companies and their adjusters say, and do, hoping that you fall into them.

Trap 1: Believing the insurance adjuster is on your side and is going to treat you fairly.

If you are fortunate enough to have substantial insurance coverage available, after your accident the insurance adjuster who calls you will be pleasant, friendly, and will just want you to answer a few questions so they can help you. Customarily, they will tell you that your medical bills and lost wages are covered and may even offer to pay them as soon as you send them copies. Once received, they will give you one reason or another why the claim cannot be paid and they can’t pay your lost wages. This is the first of many false promises and the first of many excuses you will hear.  The goal is to get to a quick settlement and prevent you from retaining an attorney.

In other cases, they may not want to settle at all.  Initially, the problem may appear to be something that can easily be remedied by a few actions. Either they will request something else from you or they will state that they need to take care of something additional on their end. However, their primary reason is to stall as long as possible. The longer they can stall you, the more likely the Statute of Limitations will run out and you will never be able to recoup your medical bills and other expenses for your injury.

Trap 2: Believing that you have to give a recorded statement.

When it comes to recorded statements with the at-fault driver’s insurance adjuster, a good rule of thumb is “anything you say can and will be used against you.”  Most people who have been in an accident are eager to tell their side of the story, even to the at-fault driver’s insurance adjuster. This is one of the biggest traps they hope you fall into. Once they have your version of events they can start building a case against you. If you were hit from behind, maybe you stopped too fast? If you were hit from the side, maybe you were speeding through an intersection or not keeping a lookout.

You should not give a recorded statement. As stated in the prior chapter, the adjuster will make you believe that your claim can’t be processed until you provide a recorded statement. They will also try to convince you that it is just part of their procedures or policy. There is no law or rule that requires you to give a recorded statement.  The insurance company may have this “policy,” but it does not mean you are bound by their “policy” or that it is even enforceable.

Besides being held to a specific version of events, the adjuster has been trained to ask you very specific questions in a very specific way and, most likely, in a very specific order. The same question phrased slightly differently can result in two completely different responses.  For example, when asked: Do you drink and drive?  Your response would most likely be a resounding no. However, if you are asked:  Have you ever gone out to dinner and had a glass of wine (or a beer) before driving home?  You would most likely answer yes without much hesitation. If it was followed by the question “how often” you may give a “socially acceptable” response such as, occasionally or only a couple of times. Not only have you just admitted to drinking and driving, but you have also just admitted to doing it on multiple occasions.  Although this may seem to be an extreme example, I have seen adjusters ask injury victims questions much like this.

I would highly suggest you don’t, but the decision to give a recorded statement is entirely up to you. If you do decide to give a statement there are things I suggest you do:

If you are caught off guard with a call from the adjuster or asked to make a recorded statement before you have had an opportunity to prepare or speak to an attorney, simply tell the adjuster that he/she caught you at a bad time and suggest an alternate time that allows you to properly respond. Do not be pressured into making an appointment before you are ready, as it will not get your claim resolved any quicker.  On the contrary, it will only ruin your chance of being compensated fairly.

Just like you wouldn’t take a test without preparing, you should prepare for this statement. I want to be clear.   This is not about deception.  This is about taking the time to think through the actual events that led up to your accident, the accident itself, what happened directly after the accident, and what has happened since.

Before agreeing to give a recorded statement, I suggest you ask several questions of your own first.

 i.      Ask if their insured gave them a recorded statement and if so, can you obtain a copy of the statement?

They will likely deny taking a statement.  If they admit to taking one, I guarantee they will not provide you with a copy.  They may say this, that, or the other thing, but the bottom line is that you will not get a copy.  Most likely they will tell you that it is their “policy” not to turn them over or that the law doesn’t require them to: Funny how when the table is turned, you will not get their insured’s statement.

ii. What is their client’s policy limit?

The reason you want this information is to see if their client has enough insurance to cover your injuries or damages.  In most instances, you will be denied this information too.  They are not required to provide the information until certain conditions are met.  You may have a general answer like there is sufficient coverage.  However, ask how much that is.  This is a very important question that has nothing to do with their insured’s fault or your injuries.  Why not provide the information?   Their whole function is to get you to settle your case for less than it’s worth and certainly less than their potential risk. Why should you answer any of their questions and why would you after that?

If your statement is related to a car accident, ask the following questions:

iii. Do they have pictures or damage estimates of the cars that were involved in the accident that they can give you? 

Before the insurance company will pay any property damages related to an automobile accident they will obtain damage estimates and take photos of the car.  Since they are going to ask you about the damage to your car, shouldn’t they provide you with the damage estimates on all the other cars involved?

iv. Did the other driver have a valid driver’s license?

They are likely going to ask you detailed questions about your driving history and, in particular, was your license valid and has it ever been suspended.  Shouldn’t they have to provide the same information about the other driver?

v.  Was the other driver taking any medications or consuming any alcohol at the time of the accident?

These are the same questions that will be asked of you. If they are unwilling to answer the same questions they are about to ask of you, why would you agree to their request for a recorded statement? Again, only you can decide whether or not to abide by their request.

I believe that the above questions in themselves make it clear why you shouldn’t give a recorded statement.  If not, I am sure the adjuster’s answers to them will make it clear why not.

By the time a person realizes they need an attorney, they may have already given their statement. Again, my clients are usually shocked to discover that they didn’t have to give a recorded statement, to begin with. Additionally, it was never explained to them that the recorded statement could be used against them in the processing of their claim, or in a court of law, at a later date. The insurance company knows that if they told you this beforehand, you would likely have declined their request.

So what do you do if you have already given a recorded statement? Don’t panic. A large number of my clients have given a recorded statement before coming to my office. Contact the insurance company and ask them for a copy of the transcript taken from your recorded statement for your file. You do not need to give them any further explanation or answer any other questions about your request.

If your claim is not settled with the defendant’s insurance carrier and a lawsuit is filed, at that time you will be required by law to give a deposition. This is a sworn statement, given under oath, transcribed by a court reporter, with questions being asked by the opposing counsel. This is similar to a recorded statement except that if you hire me, I will prepare you for the questions ahead of time and I will be right next to you while you are answering their questions. Then, you will know what to expect and have an opportunity to discuss any questions or concerns of your own prior to giving your deposition.

Trap 3 : Believing that you have to sign a medical or wage loss authorization.

Just as with the recorded statement, the insurance adjuster will likely tell you they need you to sign a medical authorization form in order to process your claim. Again, you need not and should not sign a medical authorization that allows the insurance carrier full access to all of your medical records.  This authorization will give the carrier unlimited access to records relating to prior injuries, pre-existing conditions unrelated to your injuries, illnesses, surgeries, hospitalizations, and all other medication history.

Some authorizations even give the defendant’s insurance carrier access to your complete educational records or worse; blanket authority to obtain any and all records that can be used against you. The insurance company may attempt to use these records to frighten or embarrass you into not filing a lawsuit or settling for less than you deserve. They are preying upon your fear that this information will be made public. Please know, that they will take every opportunity to exploit any and all information obtained to avoid paying the damages you deserve.

Similarly, they usually want you to sign a wage loss authorization that may allow the insurance company blanket access to all your employment records, past and present, including salary, bonuses, any disciplinary actions, reviews, paid time off, and disability information. They will use this information to reduce your claim for lost wages. If your injury was caused at work, obviously they may already have some of this information.

Finally, DO NOT sign a check from the insurance company that says “Final Payment” or “Final Settlement.” The insurance companies know if you fall for this trick, it will be nearly impossible to file a lawsuit at a later date.

Trap 4: Believing the insurance company will tell you the truth.

I have already stated that insurance companies are in business to make money. Recently, Fortune Magazine named insurance companies as one of the top 50 most profitable businesses. Most insurance companies are publicly held. The better they perform, the more valuable their stock becomes, and the larger and more powerful they become.

Don’t be fooled into thinking an insurance company, or their agents, and adjusters will tell you the correct answers to your questions. Don’t believe they will tell you the defendant’s liability limits.  Don’t believe they will give an honest estimate of what your injuries are really worth. Finally, don’t believe the insurance company is not going to give you what you ask for your injuries if they can pay you less.

Trap 5: Believing the insurance company would not intentionally delay your case, hoping the statute of limitation runs out.

As you begin the claims process, you may find yourself facing delay, after delay, after delay.  I am often quoted as saying an insurance adjuster’s middle name is “deny” or “delay”.  The excuses can vary but the insurance company’s goal is the same.   Each day they delay paying your claim is another day they get the interest on “your money” so to speak. Time is money to the insurance industry.  This interest far exceeds their interest in satisfying your claim.

In addition, when they delay your claim they are hoping for two outcomes. The first outcome is that your mounting medical bills, co-pays, lost wages, and other financial obligations will cause you to become so desperate that you are willing to settle your case for whatever they are offering. The second outcome they are hoping for is that the strict time frame to file your case will expire and they won’t be obligated to pay you anything at all!

I cannot stress this enough…there are rigid deadlines that will dictate when you can no longer sue or file a claim.  These deadlines vary depending on your claim, the defendant, and many factors.  Failure to act within these deadlines will permanently prevent you from recovering compensation for your injuries.

Furthermore, the longer your claim is delayed, the more obstacles arise preventing a successful outcome. Witnesses move and their recollection fades. Their eagerness to help can diminish greatly the more time that passes.  Some evidence can be lost in only days and weeks after the accident.  Therefore, in many cases, it is imperative that you act immediately to secure evidence.  Do not let this happen to you. Protect your rights to be fairly compensated for your accident.