What Are The Common Delay Tactics That You See Insurance Companies Make To Sabotage A Personal Injury Case?
In the legal arena, the delay tactics that insurance companies use are generally known as the 3Ds: Delay, Deny and Defend. If an insurance company can buy out of a claim very cheaply, they will do so. That is why they may come to you and offer a small amount of money right away. To them, it’s a nuisance. It saves them the time and expense of investigating. It allows them to free up claims personnel to deal with other claims. However, if they can’t buy out very cheaply right away, then they take the position that they will pay if they are convinced that you can and are willing to prove your claim and your damages. They place the burden on you to pursue and prove your claim, and that’s the way it is under the law. As the claimant, you have the burden to prove what you are claiming. They assume nothing about your case. They do not assume that it’s their insured’s fault. Once they accept fault, they do not assume that you’re injured. Once they agree that you may have been injured, they do not assume that you required all of the medical care that you incurred or that your medical bills are reasonable. They will deny that you required all your medical care or that you needed to take time off from work and lost income.
They scrutinize the doctor’s medical bills; they will say that that doctor overcharged you. They will compare your bills to perhaps an out-of-state market and say, “Well, your doctor charged you $115 a visit when we think that $80 a visit is fair.” They will pick your claim apart and raise any issue that they can. They will challenge any act that you did or did not take.
Among other delay tactics, they ask for information multiple times, even though they already have it. They change claims representatives and force you to explain your case over and over. They delay making offers to settle until the statute of limitations forces you to settle for less or file a lawsuit.
They deny issues and facts that they should admit. They sometimes deny things that even their own insured would admit. They deny issues that they know are true, just to see if you are willing and able to challenge them on those issues. These are only a few of the tactics insurance companies like to employ to run down claimants and delay payment of legitimate claims.
Does The Insurance Company Have The Right To Use Private Investigators To Follow Me? What Is Their Purpose In The Hopes Of Doing That?
Insurance companies may hire private investigators to follow you. It is called a sub-rosa investigation. However, they’re not going to do that until very far down the line. They don’t send out investigators right away after a claim is made. They don’t do it in every case. If you have a very significant injury claim, an injury that is permanent, or an injury that prevents you from working or engaging in important activities of daily life, they may at some point, after a lawsuit is filed, send investigators to secretly follow your and record your activities on video or take photographs of you. They will park across the street from where you live in a van or SUV, and video you coming and going. I’ve seen plenty of sub-rosa videos and pictures of clients going out on their driveway in the morning and bending over to pick up a newspaper or following a client to a grocery store and video then carrying bags out to their car. They use that to suggest that injured claimants are not being truthful.
They’re looking for impeachment. They want to get video evidence of you doing things that they can compare to your complaints and medical records. It’s a horrible thing to do. It is usually unsuccessful. Unless the video is extremely compelling and clearly contradicts a claimant’s claims, juries do not like sub rosa video. It can sometimes be kept out of evidence, or it can have the opposite effect of making the defendant look bad by spying on and invading the privacy of injured claimants. We ask for ALL of the surveillance video and often we find that the insurance company lawyers excluded video that helps prove our client’s case.
What Are The Most Common Reasons Why Insurance Companies Will Deny Claims Altogether?
First of all, insurance companies must support their insured. If their insured lies to them, which happens all the time, they are going to support them in those lies until their insured is proven to have lied. Any nonsense story, false story, or lie that an insured tells the insurance company to avoid being held responsible will be supported by the insurance company until it is proven to be false. As a tactic, a claims representative may immediately say, “Look, our insured says black is white or white is black, and we accept that.” So, number one, they’re going to deny fault based upon what their insured says to them.
Second, they’re going to do an investigation. The insurance company has the right and duty to do gather fact, interview witnesses and obtain documents and reports . They’re going to look for evidence to see if the evidence supports what you’re claiming. So, a reasonable investigation takes some time so that a proper evaluation of the claim can be made.
In California, we have comparative liability. That means that a claim may not be an all or nothing proposition. The insurance company may not be looking to deny your claim in its entirety, but if they can make an argument that you are partly at fault, or that their insured is not entirely at fault, or that someone else is at fault, they will do that and seek to reduce what they owe you. They may say, “Look, we think it’s your fault too, so we’ll pay you half,” or, “We think it’s 75% your fault, so we’ll pay you 25% of the value of your claim.” So an insurance company denial may not be a denial of the entire claim.
Insurance companies may take your medical records and their bills, and send them out to doctors they hire. They pay the doctors to review your medical records, reports, and bills and criticize your care and treatment and your bills. With 20/20 hindsight, they say that you didn’t need a certain test or procedure or a specific course of care after a certain date, or that the bills are too high. Then, they send you or your lawyer a report from their so-called doctor saying, “Well, here’s our justification, so we’re denying your claim, denying a certain amount of your care, or reducing what we want to pay.”
Insurance companies will interview witnesses to see if they say anything that supports the insurance company position. If you file a lawsuit, the insurance company will hire lawyers to defend their insured. The answer to the lawsuit always results in a denial of your claim. It’s a fight all the way down the line until they run out of arguments or until you make it clear to them that you’re not going to go away. You have to show them that you do not accept their false arguments and evidence. You demonstrate to them that their choice is to pay you something fair or you and your lawyer will go to court in front of a jury and have the jury decide what’s fair to pay. The demonstration of your willingness to do what’s necessary to overcome their defenses is how you wind up with a good result.
For more information on Personal Injury Insurance Laws In California, a personalized consultation is your next best step. Get the information and legal answers you are seeking by calling (818) 530-1770 today.
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