Insurance companies employ a variety of tricks and schemes to avoid or reduce payments owed to an injured person. It is impossible to list or fully explain each and every one of their tactics. The intention of the following list, however, is to provide you with some warning when you see the following schemes being implemented in your case.
1. A TELEPHONE CALL WITH THE INSURANCE COMPANY IN WHICH THEY INFORM YOU THAT THE CALL IS BEING MONITORED FOR SO-CALLED “TRAINING OR QUALITY CONTROL PURPOSES”. This is nothing more than a clever way to violate your privacy rights and they are in fact recording your phone call. The law requires that you consent to the recording of the call, however, they get around this requirement by informing you of the “monitoring” and if you do not object, they will claim that you impliedly consented to the recording. Why are they recording your phone call? They alleged reason is to train or maintain “quality control”, but the actual reason is that in these phone calls they will often ask you what appear to be innocent questions, but in fact are designed to trap you into making a mistake which they can exploit in defending your claim. When they ask you to describe the accident, it is not to educate them concerning the facts of the case. They have contact with their insured, and if there has been a police report, they have the report to review. What information are you going to add to make them pay a claim that they would other wise deny? If their insured has admitted fault to them, the only reason that they would want a statement from you is to see if you say something inadvertently that can allow them to evade payment. If their insured has not admitted responsibility, it is rather naive to expect that your different version is going to encourage the insurance company to pay a claim which their insured has conveniently given them an excuse to deny. In summary, there is no advantage to you whatsoever to give any recorded statements to any insurance company, unless you are represented by counsel at the time of the recording. It should also be pointed out that having recorded your statement, they will almost always refuse to provide you with a copy of the statement. They will certainly refuse to provide you with a copy of their insured’s statement. Since you do not have access to the statement, you should also consider the possibility that your statement, since it is completely within the control of the company that owes you payment, can be altered and/or edited, or perhaps conveniently “lost”, in the event that it is to their advantage. Never give a recorded statement when you do not have simultaneous access to the recording to guarantee that it is not altered or edited to your disadvantage.
2. THE INSURANCE COMPANY SPECIFICALLY ASKS YOU TO DESCRIBE THE ACCIDENT AND GIVE THEM A TAPE RECORDED STATEMENT. Item number one is where they are surreptitiously recording you and most people do not recognize that such is taking place. This is a different situation, i.e., the insurance company is specifically informing you that they “need” to take a recorded statement. They like to use the word “need” or sometimes tell you that a statement is “required”. This is absolutely untrue. You are under no obligation nor legally required to provide a recorded statement to an insurance company. Most significantly, though, the fact that they are formally requesting a statement from you is the clearest possible indication to you that they are looking for a way to get out of paying your claim. There is really nothing you can say that’s going to make an insurance company change its mind and go against its insureds, or its belief that it can get out of paying your claim. The request for the statement is actually part of the implementation of a plan or decision to not pay your claim. It is a clear warning sign that you are looking at future problems to obtain the fair payment of your claim from the insurance company. Giving the statement can hurt your case and the chances of it providing any help are almost non-existent.
3. THE POLICE REFUSED TO RESPOND TO THE ACCIDENT AND WOULD NOT MAKE A POLICE REPORT. If you have been in an accident and the police refuse to come out and prepare a report, you are at substantial risk of having the insurance company for the party that caused the accident delay the processing of your claim and eventually deny payment. Without a properly prepared police report, insurance companies will often work with their insureds to create a situation of it being your word against the word of their insured. Even if the other party apologized and admitted fault for the accident, with no police report an insurance company will often work with their insured to later deny such statements, and then contend that you, or someone other than their insured, is responsible for the accident, thereby evading the payment to you which is due. This is sadly a very common occurrence, and in this office alone we will review in a years time literally dozens of cases in which this takes place. IF THE POLICE DID NOT MAKE A REPORT FOR YOUR ACCIDENT IT IS IMPERATIVE THAT YOU SEEK LEGAL COUNSEL IMMEDIATELY AND DO NOT DELAY OR WAIT FOR THE OTHER INSURANCE CARRIER TO ACT!
4. THE INSURANCE COMPANY ASKED YOU TO DISCLOSE YOUR SOCIAL SECURITY NUMBER EVEN THOUGH YOU ARE NOT A MEDICARE BENEFICIARY. Many insurance companies are openly lying to people and telling them that because of a recent change in the Medicare law they are required to obtain Social Security Numbers from all accident victims. This is absolutely untrue! The recent change to the Medicare law only requires you to disclose your Social Security Number in the event that you are, or have been, a Medicare beneficiary. There is a specific form for this disclosure published by the Center for Medicare and Medicaid Services which specifically states that you are not required to provide your Social Security Number if you are not now, or have never been a Medicare beneficiary. Incredibly, many insurance companies are altering this form to delete this information, and are instead fraudulently obtaining Social Security Numbers to which they are not entitled. You should only disclose your Social Security Number to an insurance company after you have consulted with counsel and made an informed decision concerning such. In this age of identity theft it can be very risky to disclose your Social Security Number, especially to a company that has made no guarantees regarding the safeguarding of that information, nor specified what use they will make of that information.
5. YOU HAVE BEEN TOLD THAT THE INSURANCE COMPANY IS “INVESTIGATING” YOUR CLAIM. This is not really a warning sign, rather, it is a direct statement that they are actively seeking to find ways to not pay you the compensation you are due. If you are verbally told or receive a letter stating that they are still investigating your claim, you should immediately seek the advice of counsel.
6. AS PART OF THE PROCESSING OF YOUR PROPERTY DAMAGE CLAIM THE INSURANCE COMPANY IS WORKING WITH THE BODY SHOP TO USE REPLACEMENT PARTS WHICH ARE NOT MANUFACTURED BY YOUR SPECIFIC CAR MANUFACTURER, AND INSTEAD, THEY ARE USING SO-CALLED “AFTER MARKET” PARTS. The use of such parts on your automobile will not be warrantied by the automobile manufacturer and they often do not meet manufacturer specifications. Accordingly, the part can fail at some time in the future, and you will have little or no practical recourse against the insurance company or the body shop, and frequently the after market manufacturer’s warranty is of such a short duration that it is practically meaningless. If you are dealing with an insurance company that cuts corners by using such parts, it is an obvious warning that they will do everything they can to minimize your bodily injury claim, as well.
7. IF YOUR CAR WAS A TOTAL LOSS AND INSTEAD OF USING THE KELLY BLUE BOOK TO DETERMINE VALUE, THE INSURANCE COMPANY USED A SO-CALLED “INDEPENDENT” APPRAISAL COMPANY TO DETERMINE THE VALUE OF YOUR CAR. THIS IS A CLEAR INDICATION THAT YOU ARE DEALING WITH AN INSURANCE COMPANY THAT IS WILLING TO ENGAGE IN QUESTIONABLE PRACTICES. These so-called “independent” appraisal companies are not as independent as they may appear. First of all, these “independent” appraisal companies only provide services to insurance companies. The services that they provide involve telling the insurance company how much money they owe you for your car. Their motivation is obviously to provide their client, the insurance company, the lowest possible valuation on your vehicle so as to give the insurance company the excuse to under pay you for your vehicle. If the appraisal on you car was done, or is going to be done, by one of these so-called “independent” appraisal companies, you should regard this as a clear indication that they will use similar tricks to deny or minimize the payment they owe you for your injuries. An experienced lawyer can often look at these appraisals and show you some of the short cuts and tricks that were used to undervalue your vehicle, and most personal injury lawyers will perform this service for you free of charge when you are consulting them on your injury case.
8. IS THE INSURANCE COMPANY GOING TO USE A COMPUTER TO CALCULATE THE AMOUNT THEY OWE YOU FOR YOUR INJURIES? If the answer to this question is yes, it is a very clear indication that the insurance company is looking to minimize the payment of your claim. If you ask the insurance company if a computer is being used to value your claim, they may well lie and tell you “no”, or they may provide an evasive answer. In order to pin down the insurance company you need to get a clear, unequivocal statement from them, in writing, that a computer is not being used in any fashion to calculate any portion of what is owed, even in an advisory capacity. Some insurance companies, in order to avoid potential legal problems, will state that they only use a computer as part of an advisory process, or as some sort of a tool, as part of an over all evaluation. This is a complete evasion of the truth, and you should not deal with any insurance company once you have any suspicion that instead of a complete evaluation of your individual situation, they will be submitting it in any fashion to a computer. The obvious problem with having a computer being used in the valuation of your claim is that the insurance company then has complete control over the payment. They can program their computer to produce any valuation or advice that the corporate higherarchy wants, thereby controlling the payment that is offered on your claim, even though the individuals controlling such payment have never specifically reviewed or considered your information. This is a despicable practice, yet it is very common, and any use of the computer in your claims process by the insurance company other than to store information is a clear warning sign that you have an insurance company that is willing to engage in a very nefarious practice and should not be trusted.
9. YOU HAVE BEEN ASKED TO SIGN FORMS AUTHORIZING THE INSURANCE COMPANY TO OBTAIN YOUR PRIVATE MEDICAL RECORDS, EMPLOYMENT INFORMATION, OR OTHER PRIVATE RECORDS. Insurance companies often offer to obtain this information, or they claim to have a “need” for it. Such a request should be viewed by you at all times with suspicion. First of all, you should in detail read exactly what you are authorizing them to obtain from your personal, private records. Often the so-called simple authorization and information requests by the insurance company are in fact carefully crafted, lengthy documents designed by the insurance company’s corporate lawyers to delve into areas of your life in which they have no business, but which they might later hope to utilize against you. Even if they tell you verbally what they are going to use the documents for, it is the documents themselves which control their usage, and there is no guarantee that they will not use the documents in any fashion that they think may help their cause. It is very important to know what time period you are authorizing them to utilize these documents, and are they able to use the documents to obtain information from your past to which they are not entitled, and/or how far into the future are they allowed to use the documents. In summary, if the insurance company sends you documents authorizing them to obtain information you should be very careful and suspicious, and understand that signing those documents and returning them to the insurance company may be a serious mistake. Insurance companies are not entitled to invade your privacy, unless you give them permission. These documents are designed by the insurance company’s lawyers to let them invade your privacy, all under the guise that you have given them permission to do so. It is very dangerous to sign these pre-printed authorizations from the insurance company without being certain that you understand what they mean, what their effect is, and what is the scope and duration of their usage. Any reputable personal injury attorney will examine these documents and give you advice concerning their usage as part of an initial consultation with you concerning your claim. There should be no charge for this consultation.
10. HAS THE INSURANCE COMPANY REFUSED TO ISSUE AN ADVANCE PAYMENT FOR YOUR MEDICAL BILLS AND/OR LOST WAGES? If the insurance company refuses to issue an immediate check to pay for a medical bill that you have already incurred, or lost wages that you have already suffered, this is a very clear sign that they intend to look for ways to avoid paying your claim. If you offer to give them the medical billing, but they refuse to send you a check to pay for that billing, what this can suggest is that they are in the process of preparing to fight the payment of that bill, and potentially other bills. Additionally, if you have lost time from work and they will not give you prompt payment for those lost wages, you should certainly interpret this to mean that you are going to have your wage loss questioned in the future. If there is going to be a problem concerning payment for your bills, it is important that you seek legal counsel immediately because there are certain tricks that insurance companies use to avoid paying medical bills and lost wages and an experienced attorney can often stop these tactics before the insurance company has a chance to implement them. It is important to note that some insurance companies will tell you that they are “not allowed” to pay for medical bills or lost wages in advance. They may provide you with some suggestion that the law does not permit it. Others may tell you that it is against policy (meaning the insurance company’s own internal policy), or that they “need” or “require” something before payment can be issued. The idea that they “need” or “require” something other than the medical billing or wage loss verification before issuing payment, to the extent that it suggests that there is such a legal requirement is absolutely false. There is no law that prohibits an insurance company from immediately paying your medical bill and/or compensating you for your lost wages. If the insurance company has a “policy” where it will not issue such payment, or you get the run around that they “need” or “require” some additional information or documentation, this is nothing more than an excuse to delay, and perhaps eventually deny payment to you. They do not “need” or “require” anything once you have shown them your medical bill or paystub or similar document showing your lost wages. What they really mean by “need” or “require” is that they “want” something else, and this want is part of an ongoing strategy of delaying payment so that they may retain the money as long as possible, drawing interest and income off of it at your expense. If the insurance company refuses to issue any advance payment to you, it is an immediate warning sign that you need to consult with an attorney, and depending upon what is determined in your consultation with that attorney, you may need to immediately retain a lawyer.
11. HAS THE INSURANCE COMPANY REFUSED TO IMMEDIATELY APPROVE MEDICAL TREATMENT FOR YOU, AND CONTACT YOUR TREATING DOCTOR TO SET UP A DIRECT BILLING AND PAYMENT SYSTEM TO THE DOCTOR? If the insurance company will not contact your doctor and set up an agreement whereby the doctor may bill them directly, and have your doctor receive immediate payment upon such billing during the course of your treatment, this is yet another warning sign that the insurance company is looking for a way to delay, deny, or minimize the compensation due you. There is no law that prevents an insurance company from setting up a direct billing and payment with an injured victim’s hospital and/or doctors. If they tell you that they cannot do that, or it is against the rules to do that, or it is against their policy to do that, they are not accurately stating to you any law. The law prevents no such thing. They are really just telling you what their company rule is, which should inform you that such a company is in the business of avoiding payment of claims to injured victims to whom it knows it owes payment. This is another warning sign that you should at least consult with an attorney concerning your particular situation, and then you can decide whether or not to retain a lawyer at that time.
12. BE VERY CAREFUL IF YOU CHOOSE 2TO GET A RENTAL CAR! There are a number of ways and schemes that insurance companies use to avoid paying all or part of your rental car charges. Furthermore, many insurance companies enter into agreements with rental car companies which are designed to allow the insurance company to avoid payment of everything that is owed to you, yet the rental car company will still look to you and obtain payment from you for the rental car. There are also issues concerning what insurance coverage you may need to have if you rent a vehicle. All of these problems still exist, even if the insurance company is supposedly on a direct billing from the rental car company! Even in cases where the rental car company is directly billing the insurance company, there are situations in which you may be forced into paying the rental car bill. Every case has to be individually analyzed and it is impossible in this forum to provide the individualized advice that you need to know concerning renting a car following a motor vehicle accident. Our law firm, and most law firms, will provide a free legal analysis of your rental car situation at the time of your free consultation concerning your bodily injury claim. Often times, even if you are already in the midst of driving a rental car the situation can be fixed by the attorney, and the insurance company’s schemes stopped if it is handled promptly and before fully implemented. The rental car companies get a lot of business referred to them by insurance companies so they are very willing to work with the insurance companies to the disadvantage of you, their one time customer. The watch word is to be very careful in dealing with both the insurance company and the rental car company.
ADDITIONAL WARNING SIGNS. The foregoing list of warning signs that an insurance company is potentially in the midst of a scheme to deny payment to you for what you are owed is not a complete list. It is impossible to list all of the many tactics and schemes that insurance companies have learned and implemented over the years in the training of their adjusters. You may well be subjected to a scheme that is not described in the foregoing list. If you have already been cheated we would appreciate knowing your story, and if it is a scheme that we have not seen over the years you can help other consumers by telling us about it, and letting it be added to the list. If the insurance company is in the midst of a scheme with you presently, it is possible that simply consulting with an attorney will raise an alert to the attorney about the problem and sometimes the attorney can fix the problem or stop the scheme. Again, any reputable attorney will provide you with a free consultation for your bodily injury claim and as part of that consultation should be more than willing to discuss with you any other issues that are part of your injury claim.