Three Ways Insurance Companies Avoid Paying Fair Amounts For Claims

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Despite what its marketing department wants you to think, your auto insurance provider is not on your side. As a for-profit company, its goal is to make money for shareholders. Thus, when you're involved in an auto accident, you can expect the company to try one of these three things to avoid paying the true value of your claim.

Using Step-Down Clauses

Auto insurance policies are full of clauses that attempt to limit your rights and the amount of compensation you're entitled to when you file a claim. One of the more egregious ones is the step-down clause. Essentially, this clause forces family members hurt in accidents to accept the minimum amount of coverage mandated by the state.

For instance, you and your spouse are T-boned at an intersection. Your spouse files a claim with your insurance provider. However, although you have $100,000 worth of coverage, the adjuster informs your spouse they would only be entitled to the state-mandated minimum, which can be as low as $10,000 depending on where you live, due to your policy's step-down clause.

As you can imagine, you could end up getting far less than you need to pay medical bills and to repair property damage. Unfortunately, it can be difficult getting around this type of clause because it's part of your insurance contract, the terms of which you agreed to when you obtained coverage.

It still may be possible to force your insurance provider's hand, but you'll need the help of an attorney to do so. If you find yourself up against a step-down clause, it's best to contact a local auto accident attorney for advice and assistance dealing with it.

Holding Your Medical Problems Against You

If you have preexisting medical issues, your insurance provider may attempt to use those to justify paying you less for your healthcare bills. It's not unusual for adjusters to try to tie the injuries you suffer in an auto accident to health problems you suffered from previously or are still currently dealing with.

For instance, you could have back pain caused by an injury you suffered on the job. The injury has been mostly healed but was aggravated by the accident and requires treatment. Your insurance company could try to say your back injury was a pre-existing condition that's ineligible for coverage even though the new injury had nothing to do with the old.

That's why it's important to be careful about how you respond to medical questions the adjuster may ask. Additionally, do not sign a general medical release or similar paperwork that would let the insurance company access your medical records. The adjuster is not above sifting through your entire health history to find anything they can use to deny your claim or, at least, justify paying you less than what you're owed.

Try to Manipulate an At-Fault Confession

Some adjusters take a somewhat more aggressive, and questionably ethical, approach and try to get claimants to admit to partial fault in the accident. If they can coerce the person filing the claim to say they contributed to the auto collision in some way, then they can justify offering a fraction of what the claimant is really owed.

They do this by asking leading questions. For instance, if it was raining the day the accident occurred, the adjuster may ask you whether you were driving at the right speed for the weather or how hard you hit the brakes. Since all conversations with the adjuster are recorded, any answer you give could potentially be used against you.

Avoid speaking to the adjuster on the phone. Instead, ask them to submit their questions to you in writing so you can go over them with your attorney. Your lawyer can help you respond in a way that prevents you from inadvertently incriminating yourself.

For assistance managing your auto accident claim, contact a local car accident attorney.