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Mistakes to Avoid When Pursuing a Bodily Injury Claim

In most states, everyone is required by law to purchase and carry some form of minimum auto insurance. In addition to the minimum required coverage, there are many optional types of coverage that drivers in liability states may choose themselves or may carry because their car note lender requires them to carry it. Because people are all required to carry insurance, car accident victims sometimes make the mistake of thinking that when they get in a wreck, sorting it out should be a simple thing to handle on their own. Unfortunately, this is too often not the case.  Insurance is a contract. They owe you contractual duties and nothing more. If they can find a way to avoid payment under the terms of the contract, they will.  Never forget who wrote the contract—they did.

Do Not Mistake the Other Driver’s Insurance Adjuster for Your Friend

Insurance adjusters for the other driver’s insurance have two jobs—fight for the other driver’s interests and fight to keep the insurance company’s money. The insurance companies train them on various tactics that the unsuspecting bodily injury claimant is unaware of. These tactics are aimed at lowering the value of your claim so that they pay you less money. They include things such as trapping you in a recorded statement, delaying your medical care, failing to advise you of what costs come out of your settlement offer, and settling your claim before you know the full cost of the harm done to you. If you suspect these tactics are being used on you, consult a lawyer who handles bodily injury claims arising from car accidents.

Recorded Statement Traps in Bodily Injury Claims

Recorded statements have been a favorite tool of insurance adjusters to devalue your bodily injury claim for many years. Did you know that in court, they can rarely benefit you and almost exclusively be used against you?  This is true because the recorded statement itself is inadmissible hearsay—a statement made out of court offered to prove the truth of the matter asserted. However, there is an exception to the hearsay rule that allows all or part of a statement to be admitted if it is an admission against interest.  So if you try to offer any part of the statement to support your case, they will object to it as hearsay.  But if they offer any part that hurts your case, it is an admission against interest. Because recorded statements are powerful tools that really only benefit the adverse party, insurance companies spend countless hours training their insurance adjusters on how to ask questions aimed at tricking or trapping you into saying something they can construe against you. In short, do not agree to give a recorded statement pertaining to your car accident or bodily injury claim without the advice of counsel. They often ask you to let them record it so that it seems less like they are tricking you. However, in many States, an adjuster can record your call without consent. So think about what you say and do not make assumptions or guesses anytime you choose to speak to an insurance adjuster.

Delaying Your Medical Care to Devalue Your Bodily Injury Claim

Many adjusters will tell you they are “accepting liability” for the wreck when their insured is obviously at fault. They will then work diligently to get the property damage claim resolved. Do not make the mistake of thinking that this means they will be equally as helpful in getting you the medical care you need. The value of your car’s property damage is pretty much the repair cost or the replacement cost. However, with property damage, the insurance company may be held liable for damages that accumulate such as storage fees and compensation for loss of use of the vehicle. In order to limit these, they often act facts on settling your property damage claim.

 When it comes to the bodily injury claim, however, the other driver’s insurance has no obligation to pay your medical bills as you go nor do they have a duty to help you obtain medical care if you cannot afford it. They typically will assign a separate adjuster who will be much less accommodating. Adjusters will often tell bodily injury claimants to go get medical care and pay for it out of pocket and then they will discuss a lump sum settlement at the end. The problem with this is that the victim is often already financially strapped from the accidents and inability to work. The adjuster knows that if the injured claimant is hard-up for cash due to having had to front the bills for all the medical care, then the claimant may stop going to care or miss appointments because of the costs. This ultimately reduces the settlement value of the case and saves the insurance company money. Furthermore, the claimant will be more desperate to accept whatever low offer the adjuster makes at the end. This issue can be avoided by using your healthcare, filing on your own personal injury protection insurance policy, and/or having a lawyer issue a letter of protection to allow you to treat on credit.

Failing to Advise You of What Must Be Paid Out of Your Settlement

Let’s see, you had an accident, your health insurance paid the hospital bill directly, your chiropractor filed on your auto insurance and got paid, and you only paid $500.00 out of pocket. Now the adjuster offers you $500 plus $4500 for your troubles. Is this a fair settlement offer? Five times your out-of-pocket expenses sure sounds tempting. But hold on. The moment you say to them that you agree to accept $5000 to settle your claims, your case is settled. Texas law says verbal agreements are binding. After you accept that money, you may be in for a rude awakening. That is when the adjuster says “ok now that we have agreed to settle I need to check for liens.” “What liens?” you say.

Hospitals that treat you within 72 hours of an accident have a hospital lien by statute.  Almost all health insurance policies have what is called a subrogation claim or “lien.”  Additionally, Medicare and Medicaid have liens created by statute. What these liens mean is that if you collect any money as a result of an injury that they paid for the medical care you received, then they get reimbursed first out of the proceeds. So, if your health insurance is out $4,000, you are getting that money taken out of the $5,000. Also, if the auto policy portion your chiropractor filed under was a Medical Payments Coverage policy, then you have to reimburse them what they paid.  You could wind up owing more than you are being paid. Lastly, there are other liens that have nothing to do with your case which, by law, must be paid by the insurance company before you receive any of your settlement. These include tax liens and child support liens. Thus, you need to know how to do a county lien check and verify related medical lien amounts before you know whether the offer is fair or not.

Settling Your Bodily Injury Claim Before You Know Your Losses

It is not uncommon for an insurance adjuster to call you up on the day of the accident and say, “Hey let’s agree to settle for the amount of your medical bills plus $500 more for you as compensation.” You may not feel the full effects yet, but if you verbally agree to settle, you are stuck with a settlement for the amount of the medical bills as of the verbal agreement date plus $500.  So if it turns out you need more medical care, that is now your problem to pay, not theirs.

Conclusion

Do not make the mistake of thinking the insurance adjuster is there to help you with your bodily injury claim following an auto accident. Adjusters are there to save the insurance company money, not to treat you fairly.  Talk to an attorney about your bodily injury if you have any concerns that you are being tricked or trapped.

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