What Is Your Experience With Representing People Who Are Going Up Against Insurance Companies And Claims Adjusters To Get A Fair Settlement?
I’ve been a practicing attorney, representing plaintiffs in personal injury cases for 42 years. Those cases include traffic collisions, slip and falls, trip and falls on dangerous conditions of property, defective products, fires, burns, electrocutions, animal attacks, construction site injuries and medical negligence. In virtually every case, an insurance company or claims representative is there to protect and defend the person, business, or governmental entity that is at fault. I have represented thousands of people who’ve been harmed by the carelessness of someone else. That someone else is always seeking to minimize or avoid the consequences of their negligence or conduct – sometimes even their intentional dangerous conduct. The insurance companies and their representative’s job is to pay as little as possible to you. Insurance companies and claims representatives are not there to help you. They’re not there to make your life better, or to make sure that you are well cared for. Their job is to look out for themselves. It would be a mistake for any injured person to think or assume that the people they’re dealing with on the other side are interested in their wellbeing.
Representing people who are injured and seeking fair compensation is an adversarial and frequently hostile endeavor. Fair settlements are possible, but you have to understand that the best settlements come from overcoming the challenges and obstacles placed in your way by an insurance company and its representatives. In fact, the term claims adjuster isn’t even accurate when describing people that you deal with on a day-to-day basis with an insurance company. A claims adjuster is a person whose job is to adjust a claim. That means their job is to consider and evaluate the facts and evidence in the damages claim, and reach a resolution with you. These days, you deal with an insurance claims representative, not an adjuster. You’re dealing with people who do not have authority to evaluate the claim. They get their limited authority from their bosses, a claims manager, or sometimes a vice president of claims. They are told what to offer, where to start, and how high they can go. They have no independent decision-making authority to negotiate with you beyond the authority they are given.
If you believe that your claim has a value higher than what they are offering, or higher than what their authority is, they have no power to resolve the claim with you. All a claims representative can do is carry your response back to his or her boss. The bosses then tell them what to say in response to your demand. You never get the direct person to person direct interaction with the decision-makers. That’s true not just of the layperson who handles their own claims, but also of lawyers. Insurance companies perceive that it is to their advantage to insulate the decision-makers. That way, they don’t have to confront the facts in a case. It is just easier for them to delay, deny, and defend claims.
The system that the insurance companies have set up makes it easy for them to deny claims. Therefore, you have to be better at it to beat them at their own game. That’s where 42 years of experience comes in very handy.
When Someone Has Been Injured And They Realize They Need To File A Personal Injury Claim, What Are Some Of The Biggest Challenges That They’re Going To Be Facing In The Claims Process?
The biggest challenge you will face in a personal injury claims is to prove your case. You have to prove who is at fault. You have to overcome claims made by the insurance company blaming you for not avoiding the accident. You have to demonstrate why the insurance company must pay you, the nature of your harms and losses, the extent of those harms and losses, and how they’ve affected you in your day-to-day life. You have to prove your medical expenses to treat your injuries were reasonable in amount and that the treatment itself was necessary. In addition, it will be a challenge to persuade the insurance company that it is in their best interest to pay you quickly and fairly and that there will be a consequence to them if they do not. That requires that you understand your power and leverage to move an insurance company in the direction that you want them to move. So, how do we do that?
Number one, I call it assume nothing, document everything, or proof equals truth. Now, while it’s probably obvious to you that you’re not at fault, that you’re suffering a lot of pain, need medical care, and you are incurring medical bills, none of that is obvious to the claims representative. They don’t assume that you were injured, no matter how bad a collision is, nor do they assume that you needed medical care, treatment, surgery or that you were unable to work and are incurring a loss of income.
Therefore, you need to be careful, diligent, and detailed in documenting the facts and the reasons why the other party is at fault and how and why you became injured. When you’re injured and dealing with your changed medical status and coping with all of the other responsibilities that you may have in your life, documenting everything you need to convince an insurance company to pay what they owe is challenging. However, it must be done – and it must be done well. You must continue to do it as long as you continue to suffer from your injuries. You can’t just go to an emergency room once and expect that the insurance company will pay for six months of pain, suffering and impairment in your ability to work. Your medical records over the period of time when you needed medical care are your proof. If you cannot work, you can’t just not go to work and expect the insurance company to pay your lost earnings. You must have a doctor state that because of your injuries, you need to take time off of work to heal up. Without that, you don’t have to proof you need to prove you claim for loss of earnings. These are just two simple examples of what it takes to get a good result in a personal injury case.
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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