5 Common Insurance Company Tricks to Reduce or Deny Claims | Weir & Kestner Injury Lawyers (2024)

5 Common Insurance Company Tricks to Reduce or Deny Claims | Weir & Kestner Injury Lawyers (1)
When you’re in an accident and suffer an injury, the last thing you want to deal with is a battle with the insurance company. Unfortunately, that’s exactly what many people have to go through—whether it’s their own insurance company or that of the other driver. While insurance companies go to great lengths to tout their trustworthiness, the sad fact is that they only pay claims because they legally have to—not because they want to. They will do whatever they can to pay as little as possible. And they’re not above tricking you into accepting less than you deserve or, worse, denying your claim completely.

Insurance companies are notorious for using a variety of tricks to reduce or deny claims. If you know what these tricks are, you can prepare yourself and make sure that you don’t get taken advantage of. Let’s look at five common tricks insurance companies try to use against claimants.

Trick #1: Delaying the Claims Process

This tactic is quite common. They conveniently fail to return your calls, and when they do talk to you, they may try to confuse you with paperwork or legal jargon. They tell you, “These things take time.” The purpose for dragging their feet here is two-fold. They’re hoping that 1) you’ll get impatient to settle, or that you’ll simply give up; or 2) they’re giving enough time for the bill collectors to start harassing you for payment, so you’re pressured to settle faster. In either case, it’s a manipulation to get you to accept less money.

Trick # 2: Acting Like They Care About You

Don’t be fooled by this one. The insurance agent or adjuster may call you frequently to “check up on you” and express empathy. But make no mistake—this is not a friendly call. They are trying to act like your friend, so you let your guard down and trust them. Once they have gained your trust, they will start asking you questions that are designed to trip you up or get you to say something that they can use against you to reduce your claim.

Trick # 3: Offering a Quick or Simple Settlement

This one is particularly deceiving because it seems like a good thing: the insurance company seems eager to settle, and they’re offering you a quick settlement that seems to be fair. But what they’re really doing here is lowballing you with an offer that’s far below what your claim is worth. If you accept it, you’ll likely end up getting a lot less money than you deserve. The first offer is seldom fair, and you should be highly suspicious of quick offers because it usually means the insurance company knows something you don’t know about how much money you should get—and they’re trying to settle the claim before you find out.

Trick #4: Using Your Words Against You or Out of Context

This trick is particularly underhanded because it’s legal. The insurance company may take statements you made to them out of context or construe them against you in ways you didn’t mean. They may twist your words to make it sound like you’re admitting partial responsibility for the accident as a way of reducing your claim. (This is why you should never talk to the insurance company without an attorney involved.)

Trick #5: Discouraging You From Contacting a Lawyer

“This is a simple case.”

“We’re here to work with you.”

“Why hire an attorney who is just going to charge you more fees?”

“It will only delay the process.”

Beware of these statements—they’re not made in good faith. Insurance companies would rather negotiate with you directly because they believe they can convince you to take less money. The truth is a good lawyer can help you get the most money possible from your claim and can make sure that the insurance company doesn’t take advantage of you. Hiring an attorney usually results in a much higher settlement—one that more than covers any attorney fees you’d incur. (Plus, when the attorney is paid on a contingency basis, you don’t pay them anything unless they win.)

Bonus Trick: The Pressure Tactic

The insurance company seems to hover over injury victims like a dark rain cloud. That is because insurance companies want to make injury victims feel stressed. The easiest way to eliminate this pressured-induced stress is to call an experienced injury lawyer. Once an experienced injury lawyer is involved, the insurance company is no longer in a position to dictate the rules of engagement to you or your family.

Here is an example of the pressure tactic. Before we represented them, some of our clients received letters from the insurance company, stating they would be closing their file if they did not settle within 14 days. As long as the statute of limitations has not expired, the insurance company closing their file has zero impact on the viability of the case. This pressure tactic is designed to cause anxiety and stress in order to force the injury victim into a bad settlement. The insurance company wants injury victims to feel powerless.

Insurance companies know you are in physical and mental pain watching medical bills and lost wages add up. They also know you do not have the expertise to navigate an injury claim. So, the more pressure they apply, the more stress they create. Insurance companies only care about their bottom line. That is why it is so important to know your injury rights.

Are You the Victim of a Personal Injury Accident in Tennessee?

There’s no need to suffer alone due to someone else’s negligence. The experienced legal team atfocus on providing the best possible representation to victims of car accidents.

Contact us onlineor call our office directly at615.220.4180to schedule your free consultation. We’ll arrange a time to meet with you at one of our offices inSmyrna,Nashville,MurfreesboroorChattanooga—whichever location is most convenient for you.

by

Helping personal injury victims win their case and lose their stress.

  • Post A Comment

Do I Have a Case?

At Weir & Kestner Injury Lawyers, we are committed to providing the best possible client experience. Fill out our contact form below to schedule your free consultation today.

RESULTS

Slip and Fall Client Wins Confidential Six-Figure Award

Sideswiped by a Tractor-Trailer on I-40 East in Nashville

Smyrna Car Accident Victim Wins Six Figure Settlement

VIEW ALL +

TESTIMONIAL

"Thankfully I had the help of Weir & Kestner. They made what would’ve been a stressful, scary process so much easier. "

Tori B. | Murfreesboro, TN

"When they negotiated a settlement after filing my case, I was very happy.”

John C. | Smyrna, TN

Previous slide

Next slide

VIEW ALL +

FAQs

  • What should I do if I was seriously injured at a Nashville bachelorette party?
  • Is an autopsy required in a wrongful death claim?
  • What should I do after a Nashville Uber accident?

VIEW ALL +

5 Common Insurance Company Tricks to Reduce or Deny Claims | Weir & Kestner Injury Lawyers (2024)

FAQs

How to successfully appeal an insurance denial letter? ›

Steps to Appeal a Health Insurance Claim Denial
  1. Step 1: Find Out Why Your Claim Was Denied. ...
  2. Step 2: Call Your Insurance Provider. ...
  3. Step 3: Call Your Doctor's Office. ...
  4. Step 4: Collect the Right Paperwork. ...
  5. Step 5: Submit an Internal Appeal. ...
  6. Step 6: Wait For An Answer. ...
  7. Step 7: Submit an External Review. ...
  8. Review Your Plan Coverage.

How to win against insurance? ›

How To Beat Insurance Companies
  1. Take detailed photos of the accident scene, vehicle damage, and injuries.
  2. Gather witness statements and contact information.
  3. Obtain the other party's insurance details and file a police report.
  4. Keep records of medical treatment and preserve relevant documents.
Feb 14, 2024

Do insurance companies use scare tactics? ›

Before digging into what to do to scare an insurance adjuster, it's useful to know a little about how they try to scare those who file a claim. One of the most common scare tactics they use is to delay a decision on your claim. They know that when you're dealing with a severe injury, time is not your friend.

How to negotiate for more from insurance settlement? ›

8 Insurance Settlement Negotiation Tips
  1. Understand the Insurance Company. ...
  2. Initiate the Claim as Soon as Possible. ...
  3. Never Admit Fault for the Accident. ...
  4. Stick to the Facts, Never Speculate. ...
  5. Know the Rough Value of Your Claim. ...
  6. Be Patient, Do Not Accept the First Offer. ...
  7. Get Everything in Writing.

What are the possible solutions to a denied claim? ›

If you believe that the insurance company's decision was incorrect, you can file an appeal. This may involve submitting a written request to the insurance company explaining why you believe the claim should be approved. You may also be able to present your case to an independent review board.

What are not medically necessary examples? ›

Examples of services or treatments a plan may define as not medically necessary include cosmetic procedures, treatments that haven't been proven effective, and treatments more expensive than others that are also effective.

How to get the most from an insurance claim? ›

It's essential to gather all the necessary evidence to demonstrate the extent of the damage and the costs of repair or replacement. To show proof, you should start by taking photos and videos of the damaged property. You can also keep a detailed inventory of damaged items, including their age, condition, and value.

How to mitigate insurance claims? ›

Some common types of property damage mitigation include:
  1. Removing fallen trees or branches from your home.
  2. Covering the damaged area(s) of your home with tarps to prevent further wind or water damage.
  3. Turning off your water and stopping a leak.
  4. Extracting water and drying out your home.

Can you argue with your insurance company? ›

You can ask that your insurance company reconsider its decision. Insurers have to tell you why they've denied your claim or ended your coverage. And they have to let you know how you can dispute their decisions.

What are scare tactics examples? ›

An example of scare tactics is, "If you don't buy this product, you risk injury and death." Scare tactics do not provide evidence. Ignoring evidence, a scare tactician dares you not to believe their conclusion. Someone might use scare tactics because its claims are untrue, quick, and powerful.

What reduces the amount paid in a claims settlement? ›

The insurance company pays up to the policy limits. They also reduce the settlement by the amount of any applicable deductible. Car insurance coverage can limit the amount of a settlement even if the damages are greater than the policy limits.

How to put pressure on an insurance adjuster? ›

You can put an insurance adjuster on edge by proactively letting them know you intend to wait until you are fully healed to settle your claim. Most adjusters will not expect this, and it will show them you have a good working knowledge of the variables to be considered in a fair settlement offer.

How do you ask for more money in a settlement? ›

Get the Adjuster to Justify a Low Injury Settlement Offer

Instead, ask the adjuster to give you specific reasons why the offer is so low, and make notes of what he or she tells you. Then write a brief letter responding to each of the factors the adjuster has mentioned.

How do lawyers negotiate settlements? ›

How do lawyers negotiate settlements? It takes both art and strategy. Utilizing legal knowledge and negotiating skills, lawyers must tackle multiple elements of a case, from liability to company policies, the extent of damages, and the locale in which the case originates.

How do you negotiate a better settlement? ›

Tips On Negotiating A Settlement Agreement
  1. Use a solicitor that knows what they're doing. ...
  2. Consider carefully whether the first offer is reasonable. ...
  3. Be patient with your resignation letter. ...
  4. Listen to what your employer has to say. ...
  5. Be realistic and know your worth. ...
  6. Don't undervalue yourself.
Aug 8, 2023

How to write a letter of appeal for reconsideration? ›

How to write a letter of reconsideration of appeal
  1. Confirm the recipient's information. ...
  2. Consider why you want a reconsideration. ...
  3. Find out why they passed. ...
  4. Support your request. ...
  5. Add a conclusion.
Jul 5, 2023

How do you write a formal appeal letter to an insurance company? ›

My name is [patient] and I am a policyholder of [insurance company]. I wish to file an appeal concerning [insurance company name's] denial of a claim for [procedure name]. I received an Explanation of Benefits dated [provide date] stating [provide denial reason directly from letter].

What are two types of claims denial appeals? ›

The appeal process gives you two options for appealing a denial: an internal appeal and an external appeal.

When a claim is denied, it may usually be appealed within what time period? ›

You must file your internal appeal within 180 days (6 months) of receiving notice that your claim was denied. If you have an urgent health situation, you can ask for an external review at the same time as your internal appeal.

Top Articles
Latest Posts
Article information

Author: Msgr. Benton Quitzon

Last Updated:

Views: 5787

Rating: 4.2 / 5 (63 voted)

Reviews: 86% of readers found this page helpful

Author information

Name: Msgr. Benton Quitzon

Birthday: 2001-08-13

Address: 96487 Kris Cliff, Teresiafurt, WI 95201

Phone: +9418513585781

Job: Senior Designer

Hobby: Calligraphy, Rowing, Vacation, Geocaching, Web surfing, Electronics, Electronics

Introduction: My name is Msgr. Benton Quitzon, I am a comfortable, charming, thankful, happy, adventurous, handsome, precious person who loves writing and wants to share my knowledge and understanding with you.