4 Tactics Insurance Companies Use to Deny Claims, and What to Do About Them

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Whether you or a loved one are injured in a slip-and-fall on someone’s property, in a car accident or attacked by your neighbour’s dog, you will have to deal with insurance company investigators and claims adjusters to be compensated. Chances are the person you speak to at the insurance company about your claim will be friendly, engaging and appear to be sympathetic toward your plight, but the person’s primary goal is to protect and safeguard the interests of the insurance company for which he or she works.

People pay insurance premiums believing they will be treated fairly and have their claims paid without delay. After all, insurance companies are in business to help people in times of tragedy. If that’s what you believe, then read on to learn more about the business side of insurance and the four tactics companies use to avoid paying claims.

Tactic 1: We’re on your side, so you don’t need a lawyer

After an accident, one of the first people you might hear from is a claims adjuster. Acting quickly allows an insurance company representative to befriend you at a time when you are probably still reeling from the shock of what has just happened and searching to find someone with answers to your many questions.

Along comes a claims adjuster or investigator offering to help you and suggesting how you can save money by not retaining a lawyer. “We want to see you get back on your feet as quickly as you do, so let’s work together on getting this claim resolved” is the usual banter. The truth is that your lawyer is the only one working on your behalf against the party who caused you to suffer injuries and the insurance company that wants to save money by paying you as little as possible to settle the claim.

Tactic 2: Tricking you into giving a statement they can use against you later

Never talk to an adjuster or anyone else from an insurance company without first speaking to your lawyer. The true nature and extent of the injuries you suffer might not be apparent in the first day or two following an accident, so a recorded telephone conversation within the first 24 hours of you telling an adjuster you feel fine could be used later to deny your claim or minimize the severity of your injuries.

Tactic 3: Please sign this medical release so we can begin working on your claim

A general medical authorization allows an insurance company to request records from any doctor who has ever treated you. This information can be used to deny the claim or minimize your injuries as pre-existing conditions. Refuse to sign anything related to the accident or the injuries you suffered unless it is reviewed and approved by your lawyer.

Tactic 4: Denying liability to delay paying claims

Injuries suffered in an accident can make it impossible for you to work while you undergo treatment and rehabilitation. Some insurance companies look for ways to delay resolution of your claim in the hope that financial pressures will force you to accept a reduced settlement amount. One way of delaying is to place all or part of the blame for causing the accident on you.

A lawyer working on your behalf can use the courts to move your claim along and force it to trial or settlement. Where it can be shown an insurance company acted in bad faith, punitive damages might be available.

Get sound and trusted legal advice

The personal injury lawyers at Diamond and Diamond have experience obtaining compensation for individuals throughout Ontario who have been injured due to the negligence of others. We work for you to obtain maximum compensation from insurance companies. Contact our 24/7 injury hotline at 1-800-567-HURT or visit our website to speak to someone now about your right to compensation. Consultations are free, and we have offices conveniently located throughout Ontario.