After an accident, an insurance company may not offer the full amount an injured person expects. Insurers often use different strategies to limit what they pay, such as questioning fault, disputing the seriousness of injuries, or pointing to gaps in medical treatment.
Understanding these tactics can help accident victims make informed decisions before accepting a settlement. A personal injury law firm can also help review the insurer’s offer and identify issues that may affect the value of a claim.
Insurance companies are businesses, and their claims adjusters generally look for ways to evaluate and control claim costs. An initial settlement offer may not account for every expense or loss connected to an injury. Medical bills, lost income, future treatment, pain and suffering, and other damages may need to be considered when determining a claim’s value.
Questioning Who Was at Fault
One common approach is to dispute liability. An insurer may argue that the injured person was partly responsible for the accident. In some states, comparative negligence rules can reduce compensation based on a person’s share of fault.
For example, under Arizona Revised Statutes § 12-2505, a claimant’s damages can be reduced according to the percentage of fault assigned to that claimant. Because fault can directly affect compensation, evidence such as photographs, witness statements, police reports, and other records can be important.
Challenging the Severity of Injuries
Insurance companies may also question whether an injury is as serious as claimed. They may examine medical records, treatment history, diagnostic reports, and statements made by the injured person.
If someone delays seeing a doctor after an accident, an insurer could argue that the injury was not caused by the accident or was less serious than reported. This does not automatically mean the claim is invalid, but it can create an issue that needs to be addressed with medical evidence.
Pointing to Pre-Existing Conditions
Another tactic involves focusing on health conditions that existed before the accident. An insurer may argue that some symptoms were caused by a previous condition rather than the accident.
However, a pre-existing condition does not necessarily mean an injured person cannot recover compensation. Medical evidence may help establish whether the accident aggravated or worsened an existing condition.
Using Gaps in Medical Treatment
Gaps between medical appointments can become another point of dispute. An insurer may suggest that someone who stops treatment for several weeks was not seriously injured or had already recovered.
There can be many legitimate reasons for a treatment gap, including cost, transportation problems, work responsibilities, or difficulty scheduling appointments. Keeping records and following medical recommendations can help create a clearer record of the injury and recovery process.
Offering a Quick Settlement
An insurer may make a settlement offer soon after an accident, sometimes before the full extent of an injury is known. Accepting money may seem helpful when medical bills and other expenses are mounting.
However, signing a settlement agreement generally means giving up the ability to seek additional compensation for the same claim. Before accepting an offer, an injured person should understand what damages are included and whether future medical needs have been considered.
Asking for Statements
Claims adjusters may ask injured people questions about the accident, their injuries, or their daily activities. Statements made during the claims process can later be reviewed when evaluating the claim.
It is important to answer questions truthfully, but injured people should also understand what they are being asked and avoid guessing about facts they do not know. Keeping communication accurate and consistent can reduce unnecessary disputes.
Key Takeaways
- Insurance companies may question fault, injuries, medical treatment, or pre-existing conditions.
- Gaps in medical care can become a point of dispute during claim negotiations.
- A quick settlement offer may not reflect future medical expenses or other losses.
- Statements made to an insurer should be accurate and carefully considered.
- Medical records, accident reports, photographs, and other evidence can help support an injury claim.
- Understanding how insurers evaluate claims can help injured people make informed decisions about settlement offers.
