The Role of Insurance Companies in Personal Injury Claims

In the aftermath of a car accident or personal injury incident, insurance companies play a crucial role. The insurance company will analyze the circumstances leading to the accident, assess fault/liability, review the coverage provided by the policy, and decide on a settlement amount to offer the victim, if any. However, insurance companies are profit-driven entities, meaning that their primary goal is to minimize settlement payouts on personal injury claims to protect their bottom line. It’s not uncommon for insurance companies to undervalue a claim or deny it outright. It is important to have an experienced personal injury attorney on your side to ensure that you receive a fair settlement or award that accurately and fully reflects your damages and losses. Call Solnick Lawyers today for help with your personal injury case.

How Do Insurance Companies Evaluate Your Claim? 

The claims process of an insurance company is strategic and deliberate. An insurance adjuster is assigned to your case and their primary role is to investigate your claim and try to gather evidence that might support your claim, but also any evidence that they can find to defend or minimize your claim. They will review incident reports, witness statements, medical records, photographs, police reports, and any other evidence associated with your claim and alleged injuries. They also have access to a database identifying prior claims in which you may have been involved.  After a lawsuit is filed, they will also seek to subpoena records from your doctors in an effort to locate information and records that might impact your claim.  The adjuster’s objective is to ascertain the severity of your injuries, the impact on your life, and the circumstances of the incident that caused the injury. This comprehensive evaluation serves two purposes – assessing liability and quantifying damages. It is crucial to remember that the insurance adjuster works on behalf of the insurance company, not you. Their goal is to reduce the company’s financial exposure, which can often result in a lower settlement offer. Even seemingly cooperative and friendly insurance adjusters are tasked with protecting the insurance company’s financial interests above an injured person’s best interests.

Insurance adjusters do not work alone. They are backed by a team of investigators and lawyers who work for the insurance company and help the company navigate complex litigation, defend the interests of the insurance company and its insured, and implement strategies to mitigate financial risk, often at the expense of the claimant / injured victim. As soon as a claim is filed, representatives of the insurance company begin strategizing ways to limit the company’s payout and exposure. They scrutinize every detail of a claim, looking for inconsistencies or potential weaknesses that could downplay the severity of the injury or shift the blame onto the claimant or other parties. Having a personal injury lawyer who will deal with insurance issues on your behalf is vital to advocate for your rights, counter the tactics of the insurance company’s team, and strive to secure a fair settlement for your injury.

Why Your Claim May Get Denied

Insurance companies may deny your claim for several reasons. This can include a lack of evidence to support your claim, the belief that the injured victim was at fault for the incident, notations in medical records that might suggest a less serious injury or discrepancies in your account of the event. If your claim is denied, your attorney may discuss filing a personal injury lawsuit to get full and fair compensation for your injuries.

One of the fastest ways to have your claim denied is to be dishonest about the circumstances of the accident. When you present a claim, you are under a legal obligation to provide truthful, accurate information. Any attempt to exaggerate your injuries, misrepresent the facts, or lie about the circumstances can lead the insurance company to deny your claim on the grounds of fraud or misrepresentation. In more serious situations, this could not only result in the loss of your right to compensation but could also lead to legal consequences for you.

Similarly, if you are found to have contributed to the accident either through negligence or reckless behavior, the insurance company may seek to reduce or deny your claim. Legal principles of comparative negligence provide that when a victim is wholly or partly to blame for their injuries, their compensation is reduced. Under the law in Pennsylvania and New Jersey, if your degree of fault for an accident is greater than that of the other party (or parties), you may be barred from receiving any compensation at all.

How to Handle Negotiations with Insurance Companies

Dealing with insurance companies can be a daunting task. It is important to remember that the insurance company is looking to settle your claim for as little as possible. This is where the experience of personal injury lawyers comes in. They can conduct their own investigation and strategize to present your claim in the best possible light and negotiate on your behalf to ensure you receive the settlement you deserve.

Some important things to remember when dealing with representatives of insurance companies in the following.

1. Do Not Sign Anything or Allow Conversations to be Recorded: It is crucial to only sign documents or permit recorded conversations in the presence of your personal injury lawyer. These documents or recordings can be used against you in the claim process, potentially limiting the compensation to which you are entitled.
2. Provide Truthful and Necessary Information Only: While it is important to be truthful, you should only provide information that is necessary for your claim. Sharing too much information or speculating on the circumstances of your injury or an accident can negatively affect your claim.
3. Do Not Settle Too Quickly: Insurance companies often try to settle claims quickly, potentially offering less compensation than you deserve. It is imperative to resist the urge to settle quickly. Waiting until the full extent of your injuries and other damages are known is key to getting a fair settlement.  Once you agree to settle your claim, you can never go back in the future to seek additional compensation, even if your condition worsens or if previously unknown injuries are discovered.
4. Get an Experienced Personal Injury Lawyer: Retaining a seasoned personal injury lawyer can make a significant difference in your claim. They understand the tactics used by insurance companies, can negotiate effectively on your behalf, and ensure your rights are protected throughout the process. Their expertise can be invaluable in securing the compensation you deserve.

Schedule a Free Consultation With a Pennsylvania Personal Injury Lawyer

If you have been injured and are seeking compensation, don’t navigate the complex landscape of insurance claims alone. Schedule a free consultation with a Pennsylvania personal injury lawyer at Solnick Lawyers. We have the knowledge and experience to advocate for your rights and secure the best possible outcome for your claim. An initial consultation with our personal injury lawyer is free of charge, and if you proceed with your claim, we will take your case on a contingency fee basis, which means that you only pay fees if we get you a settlement or award.  

Solnick Lawyers has been handling personal injury claims in the Greater Philadelphia area, and throughout Pennsylvania and New Jersey, for more than 30 years. We are not intimidated by the tactics of insurance companies. We face them day after day in negotiations and courtrooms to secure justice for our clients, and we will do the same for you. Solnick Lawyers is on your side. Contact us today to schedule your free consultation.