"Most people assume that they are protected when they file a personal injury claim with their insurance company. This is frequently not the truth," declared Nejat Ahmed, a well-respected personal injury lawyer in the Dallas area. "The largest insurance companies in the United States are well aware that the easiest and fastest way to boost profits is to deny an insurance claim or underpay the insured person. Corporate executives in the insurance industry receive promotions and multi-million dollar salaries with the production of more profits every year. The injured party receives too little or nothing for their injury claim that is a profit-booster for these corporations."
Examples Of Insurance Companies Denying Personal Injury Claims
Deny The Claim and Challenge The Policyholder's Injuries
- a man is sitting in his car at a stoplight and is rear-ended by a drunk driver. He suffers a serious brain injury. The at-fault driver has minimal insurance that will not cover the medical expenses of the injured driver. The personal injury lawyer for the injured driver then submits a claim to the insurance company of the injured driver. The injured driver had purchased extra coverage under his policy. However, the injured driver's insurance company denies the claim stating that he is not as injured as his doctor stated. Then the injured driver's insurance company hires lawyers to challenge his injuries in court. It costs many thousands of dollars and over a year to prepare for the trial, but the injured driver won his personal injury lawsuit against his insurance company. His insurance company was NOT "on his side."
Deny The Claim
- a 60-year-old woman was seriously injured and in a coma after a multi-vehicle accident. Her insurance company denied her injury claim based on their decision that the at-fault driver had acted intentionally and an intentional act is not an accident.
Insurance Companies Have Plenty Of Money To Pay Personal Injury Claims
All of the major insurance companies in this country are very profitable, and they have plenty of money in the bank. They can and should properly compensate their policyholders who have been injured. Leading the list of profitable companies in 2019 (pre-pandemic) was State Farm with $5.6 billion in profits. Most of the large insurance companies in America made over a billion dollars in profits in 2019. The CEOs of the insurance industry lead all industries in CEO cash compensation with an annual median salary of $1.6 million per year. Critics claim insurance companies use unfair and questionable tactics to deprive legitimate claimants and injured victims of a fair settlement. Critics have also written about insurance companies that award portable fridges to adjusters who deny the most claims and pizza parties to shred documents.
Some Of The Insurance Tactics Used To Lower Personal Injury Settlements
- Discourage the claimant from hiring a personal injury lawyer by claiming the legal fees will reduce the net amount received by the claimant. Not true. The legal research on this topic is very clear - claimants that are represented by a personal injury lawyer walk away with significantly better settlement amounts than those not represented by an attorney.
- Low-ball offers far below the legitimate value of the claim.
- Delay. Delay. Delay. While the injured party has medical and other bills to pay, he or she is feeling financial pressure. Insurance companies delay payouts in an effort to get the claimant to accept a low-ball offer.
- Broad requests of claimant's medical history to find any detail that can be called a "preexisting condition" and therefore deny the claim.
- Misrepresenting Policyholders' Rights - This is an intentional and devious tactic to cheat the claimant. Usually, this takes the form of stating that a particular claim or injury does not qualify for insurance benefits when the opposite is true.
- Confusing language in the policy suggests policyholders have coverage when they do not.
- Insurance Company lawyers use questionable and distasteful tactics in discovery and other legal settings.
- Research the social media accounts of the injured party to find any detail that can be used to minimize or deny a claim.
- Pressuring the injured party to provide a recorded statement; Do NOT do this without a personal injury lawyer present. Insurance company representatives are experienced and trained to ask questions that are designed to affect the injured party's claim negatively. These can be leading questions that attempt to get the claimant to admit some degree of fault. Or questions designed to minimize the injuries received.
How A Personal Injury Attorney Can Protect An Insurance Claim
- All communication will go to the personal injury lawyer, who will protect the client's rights.
- Determine who is responsible for the injury
- File a claim against the responsible parties
- Review the insurance policy of the injured party
- Gathering all necessary documentation
- Evaluating and estimating all losses of the injured party
- Negotiate for a fair personal injury settlement
- File a personal injury lawsuit if settlement negotiation fails
Nejat Ahmed is a founding member of LeMaster & Ahmed PLLC based in the Dallas metro area and Houston metro area. Her practice is focused on personal injury cases, litigation of complex insurance coverage issues, and first-party bad faith disputes involving commercial and residential property claims.
