Psst!  Wanna know a secret? Insurance companies are not your friend!

When physically injured in an auto accident, you must consider whether to file an insurance claim with your insurance, the at-fault party’s insurance, or both.  To get the best results and protect your own interests on all fronts, be sure to get legal advice right away. Your attorney will help you navigate your insurance claim and arrive at a settlement.

Adjuster Goals

An insurance adjuster’s main goal revolves around saving their company money. Keep this in the forefront of your mind as you negotiate your personal injury claim. Insurance companies want to pay the least amount possible while still fulfilling the general requirements of the insurance policy.  Don’t think this just pertains to the other party’s insurance company and adjuster.  Your insurance company’s staff most likely has the same mindset.

PIP versus Bodily Injury Liability

In several states, you are required to carry personal injury protection coverage (PIP) on your auto insurance.  For example, in Florida, the state requires you to carry $10,000 in PIP coverage.  You may also have a deductible.  This coverage allows you to receive the immediate medical treatment that you need, regardless of fault.  Some states mandate that you seek treatment within a certain number of days following the accident to be covered.  In Florida, it is 14 days. If you only see a chiropractor without consulting a medical doctor, your PIP coverage may be lowered.  In Florida, it is limited to $2500 without a medical doctor certifying that more treatment is necessary, which can be done at a later date.

When another vehicle causes your accident, that driver’s bodily injury liability coverage may cover your additional medical expenses. However, it isn’t cut and dry.  You will likely need to get treated using your regular health insurance once your PIP coverage is exhausted.  Then, your health insurance and the PIP insurance will go after the at-fault driver’s insurance to recover the money they spent on your treatment. This process is called subrogation.

Payment for Lost Wages and Suffering

When you’re hurt due to the negligence of another driver, you may be able to recover your lost wages, potential loss of earning capacity, out of pocket expenses, and pain and suffering.  In order to get fully compensated, your attorney may suggest waiting until you’re finished treating or are at your maximum improvement.  Jumping the gun could short-change yourself and your case. For example, if you resolve the claim before done treating, later you could discover an injury you’ll suffer from for the remainder of your life.

Bodily injury adjusters often encourage injured parties to settle quickly.  They may offer you a small amount, with the goal to get your signature on a release before you get a lawyer or know the extent of your injuries.  Often, the full extent of your injuries shows up over time and via additional testing.  If you sign a bodily injury release or a general release of all claims, you will not be able to collect any more money for medical bills or pain and suffering from that company. Don’t sign a release for a quick $500, even for what you think was a minor accident. Make sure you treat your injuries and begin healing first.

Wage and Medical Authorizations

Don’t immediately sign wage and medical authorizations for the other driver’s insurance adjuster.  If you do, they can request all of your designated medical records. They will be quick to point out prior injuries and procedures.  For example, years ago you mentioned to your doctor that your back hurt due to extensive yard work the previous weekend. The adjuster may use this medical history as a defense, arguing that your injuries were pre-existing.

Don’t Consider the Adjuster Your Friend

Bodily injury adjusters may act very friendly to put you at ease so you trust them.  It’s easy to give away too much information in this situation.  For example, you may disclose previous personal injury information that the adjuster can use against you later. Discuss what you should and should not disclose with your attorney.

If you meet the adjuster in person to go over the repairs to your vehicle, the adjuster may try to get photos of you they can use against you in your bodily injury claim. The adjuster may ask you to hold the measuring stick or bend over to point out areas of damage, so they can get a picture of you bending over. They may even try to catch you smiling in a photo.  They then argue that you can’t possibly be hurt, or you wouldn’t be smiling.

The insurance company may order surveillance on you if it appears your injury claim is significant.  While they may not be permitted to film inside your residence, they might try to catch you taking out the trash.  Incidentally, a normal person does that chore, so the argument doesn’t hold water. However, if you say you have a back injury and go jet skiing, you may have a problem.

Using Computer Records & Programs Against You

A computer program used by the major insurers to evaluate claims may be manipulated to value your injury claim lower than it actually should be valued.  The program will allow the bodily injury adjuster to ignore medical bills, such as chiropractic treatment, in determining the settlement amount well below what you deserve.

Question Insurance Adjusters

Other secrets about bodily injury claims relate to how adjusters present offers and information. Your adjuster may only have limited authority to settle your injury claim. This may be due to lack of experience or training. Many adjusters must obtain permission from supervisors in order to extend offers, even low ones.

Did they really extend their top offer? An adjuster may say that an offer is final, even if there’s potential for more. Be sure to provide hard evidence and a thoughtful argument to the adjuster so a higher number can be reached.

Keep in mind these secrets about personal injury claims.  In short, the bodily injury adjuster and insurance company look for ways to not pay claims rather than finding ways to pay claims.

To learn the secrets regarding property damage claims, read part 1 of the series:  https://www.downtimeclaims.com/secrectsinsuranceclaims1/.

This article was reviewed for accuracy by attorney Tom Normandeau prior to publication.