Tactics Insurance Companies Use to Deny Claims

You’re involved in an accident. Someone else is at least partially to blame for your injuries and damaged property. Medical bills are piling up and because of the extent of your injuries, you’ve experienced a temporary loss of income. Recovering compensation from the at-fault party’s insurance company should be straightforward, right? If you’ve ever had to file an insurance claim, you know the frustration that seems baked into the maze of endless forms and confusing small print.

Insurance companies aren’t interested in helping you get the money you deserve after an accident. They’ll use many different tactics to deny claims or limit your payout. Evidence of their shams is chronicled in the book Delay, Deny, Defend: Why Insurance Companies Don’t Pay Claims and What You Can Do About It by distinguished Rutgers law professor Jay Feinman. Not surprisingly, insurance companies are recording astronomical profits as a result. Here are the secret tactics insurance companies use to deny claims:

Tactic #1: Dispute the Accident
Were you seriously injured? Not according to insurance companies. Some companies will outright dispute if an accident even occurred. Shockingly, some will even offer gifts and bonuses to employees who deny claims and keep payments to a minimum. Arbitrary rules will crop up, often referencing provisions that do not exist or that contradict a previous statement. The tactic here is that denial after denial will defeat and deflate claimants, making them feel they have no choice but to throw in the towel.

Tactic #2: Delay Payment … Even Until Death
The insurance company has agreed to pay the claim. So, you can rest easy, right? Think again. Another tactic used to boost profits and deny claims is to delay the payment for as long as possible. They might send out incorrect forms and then blame claimants for the error or set short time limits on when a claim can be filed. In cases involving elderly or gravely ill claimants, some insurance companies have even delayed payments in hopes that the customer dies before they have to pay.

Tactic #3: Use Fear to Intimidate
Insurance companies know that many of their customers may be afraid or unwilling to hire a lawyer. They use that fear to intimidate claimants that a court battle would only end in an insurance company victory. Billions of dollars in profits and thousands of high-priced lawyers on the payroll mean they are always ready for a trial to defend their questionable tactics in court.

What can David do against these insurance-company Goliaths? Here are some tips on what to do before, during, and after filing a claim with an insurance company:

  • Avoid the worst companies: It pays to do a little homework before signing on the dotted line. Good neighbor? Friendly Flo? Good hands? Start with this list of the 11 worst insurance companies from The National Law Journal.
  • Know your policy: You should know precisely what is covered and what you need for an appeal if your claim is denied.
  • Double- and triple-check forms: An incorrectly filled-out form or simple errors can be used by an insurance company to deny or delay claims. Be thorough and honest on every form you fill out.
  • Do not cash the check right away: Insurance companies will send checks with lowball offers or pay premium refunds if they rescind your coverage. Cashing these checks can be legally interpreted as accepting an offer.
  • Get everything in writing: If you need to fight your insurance company, you may need to produce every bill, form, and piece of correspondence.
  • Reach out for help: An experienced plaintiff’s lawyer can guide you through your claims process and provide the firepower necessary to challenge the insurance company in court.

If you were involved in an accident, or wish to discuss specifics of your case in a free consultation with an experienced Tucson personal injury lawyer, please contact us today.