10 Reasons to Never Trust an Insurance Company

Filing an Insurance Claim? Don’t Automatically Trust Insurers to Explain Your Rights, Look Out for You, or Honor Your Policy

As for-profit businesses, insurance companies make money when they don’t pay claims in full or at all. That may sound like common sense, but it can be easy to forget when an adjuster seems sympathetic or helpful as you file a claim.

The reality is that, however, that insurance companies are under no obligation to explain or protect your rights. In fact, it’s not uncommon for them to use tricky, unethical, or potentially illegal tactics to reduce or prevent payouts.

How Insurers Can Sabotage Your Claim: 10 Tactics

Being aware of these tactics can help you stay on your guard and avoid the mistake of trusting insurance companies when it’s time to file a claim.

1.  Insurance companies may push you to provide an “official” statement.

Official is usually “code” for recorded. When you give an official statement, your words can be used against you. So, if you make a mistake or misstate anything, you could give insurers room to try undercut or deny your claim.

TIP: Don’t agree to give an official statement until you are completely ready. When you do provide this statement, stick to the facts—and never admit or accept blame for the accident or incident associated with your claim.

2. They may use “gaps” in reporting or treatment against you.

For some coverage and policies, like car insurance, there may be strict deadlines for reporting car accidents. Missing that reporting window may give insurers reason to deny a claim.

Similarly, waiting to get medical attention—or skipping necessary treatments—can open up a window for insurers to allege that:

• You were not injured by the event associated with your claim.
• You caused your injuries to get worse by not getting treatment ASAP or as needed.
• Your injuries aren’t as bad as you claim because you would have gotten immediate or more treatment if so.

TIP: Call your insurance company as soon as you can when you know you need to file a claim. Also, make sure you see a doctor and follow through all recommended medical treatments.

3. They may prolong the claims process.

Insurance companies know that people often depend on compensation from claims to cover medical bills and/or get by while they’re out of work and recovering from accidents and injuries. When insurers drag out claims, they’re trying to intensify that financial pressure. The end game is to get people to accept less than they deserve.

By Texas law, however, insurers are required to:

• Acknowledge claims within 15 days of receiving notice of them and request any additional information needed at that time
• Approve or deny your claim within 15 days of receiving all requested information
• Notify you if the deadline needs to be extended and explain why

TIP: When you feel like you’re getting the runaround from an insurance company, call a lawyer. You can get free answers about your rights and what to do to protect them.   

4. Insurers may blame you for the event associated with the claim.

If they can make an argument that you caused or contributed to the accident or event related to your claim, they will.

Why? 

That can give them room to reduce or deny your claim.

TIP: Don’t let the insurance company play the blame game. An attorney can help you diffuse this tactic by presenting the right counterargument and evidence to protect your claim.

5. They may minimize the injuries and/or losses associated with the claim.

Insurance companies may try to claim that the injuries or damage pre-existed the incident associated with your claim. They may also allege that events after the incident contributed to the injuries or damage. All of this is just another effort to minimize or avoid paying compensation.

TIP: Take pictures and/or videos of the accident scene and damage. Also, keep all records you have related to your injuries. This type of evidence can go a long way towards proving just how much compensation you may deserve.

6. They may use standardized formulas to calculate payouts.

How do you know if they plugged in the right numbers? How do you know if they’re using a fair equation?

You can’t be sure of these things. So, you can’t automatically trust the offers insurance companies may throw out—especially first offers.

TIP: Never accept an offer without understanding the details. All too often, initial and subsequent offers fall short of providing the full compensation a claimant deserves.

7. Insurers may ask you to see a specific doctor.

This is generally a one-time visit to assess or verify your injuries. Don’t expect confidentiality with this doctor. Instead, expect that the doctor has a relationship—and aligned interests—with the insurance company.

TIP: Be truthful when speaking to this doctor, and don’t say anything you wouldn’t want to be shared with the insurance company. Also, try to bring someone you trust with you to this appointment. This person can be an important witness later if there’s a discrepancy about anything.

8. They may surveil you.

An insurance investigator may follow you around and record your activities. This surveillance is done to verify whether your statements to the insurer were true. It may also be done to try to catch people doing things that could be used to subvert their claims.

For example, lifting something heavy when your claim involves back injuries could be used to argue that you misrepresented or overstated your injuries. Therefore, insurers may say, you don’t deserve as much or any compensation for your claim.

TIP: Expect to be surveilled and keep a lookout for anything out of the ordinary after you file a claim. Also, take special care to follow doctor’s orders, and don’t do anything you shouldn’t be doing, given any physical limitations you may have.

9. They may send you a check with a release of all claims.

They want you to cash it and sign the release. Then, medical bills keep coming that you were not even aware existed.  If you do sign off and take the money, you could be “agreeing” to accept that check as the full compensation, closing your claim and leaving you with the medical bills to pay.

TIP: Don’t automatically cash any check from an insurance company. Talk to a lawyer if you need help figuring out whether the check adequately compensates you for your claim.

10. Insurance companies may bring in their own lawyers to fight you.

When disputes arise, insurance company attorneys will be ready to go to battle against you. These lawyers only defend insurance companies. That means they have extensive experience fighting claims.

TIP: Don’t fight insurance company lawyers alone. Make sure you have an attorney on your side who knows how to stand up to insurers.

Trust an Attorney When You Need to Deal with Insurance Companies

When it’s time to file a claim with an insurance company, you may have limited time, and making mistakes could compromise your recovery. To make sure you take the right steps—and to set your claim up for success—work with an experienced attorney.  More importantly, never trust an insurance company.