Tips for Insurance Company | Commonwealth Law Group (2024)

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In a recent blog, we explored the perils of giving a statement to an insurance company that isn't your own, which you are never legally obligated to do and we generally advise against, since the information you give can be used to hurt your case against them.

However, when you've been hurt in an accident or had extensive property damage to your home through no fault of your own, it's possible that your own insurance company will want you to provide a recorded statement. This is a similar but different situation, since your signed insurance policy may state that you must cooperate with the insurance company's request for a statement.

If you are required by your own insurance company to give a statement, there are certain best practices that you and your attorney should discuss before you provide that statement. Below are some best practices to consider:

  1. Contact a lawyer. Your attorney will act in the best interest of your case and can help you prepare for the type of questions an insurance adjuster might ask and how best to answer them. The personal injury attorneys of Commonwealth Law Group have years of experience dealing with insurance adjusters and claims agents and can advise you on how best to proceed.
  2. Keep in mind that despite the friendliness of the person taking your statement, that person is not your friend. It's in the insurance company's best interest to minimize claim payouts, and this person works for that insurance company. Therefore, they are not your friend. Be wary of them; keep your guard up.
  3. Ask specifically that your statement not be recorded. If the statement is recorded, your exact words will be used to compare with other statements you may have given, such as your police statement. Any discrepancies, no matter how small or unintentional, can cause problems for your case.
  4. Give brief answers. Try to answer each question in as few words as possible. Don't explain. If you are specifically asked to explain, do so in as few words and with as little detail as possible.
  5. Don't volunteer information. Even if you think it will help your case. Let your lawyer handle anything that is left unsaid.
  6. Answer only the question asked. Think deeply about the exact question the agent asked, and only provide that specific information.
  7. Never admit to fault. Never admit to even being partially at fault.
  8. Never admit that you are uninjured. When you're in an accident, your body releases adrenaline, a powerful hormone that can mask injuries and pain to get us through stressful or traumatic situations. Because of this, it can take several days for an injury to surface after an accident. Yet if you speak to your insurance agent within 24 hours of an accident and say that you aren't feeling any injuries, it could negatively impact your potential compensation for your injuries.
  9. If you're unsure what you're being asked, refuse to answer. Don't offer an ambiguous reply such as "maybe" or "I guess so" – simply refuse to answer.
  10. Similarly, if you don't know the answer to a question, state firmly, "I don't know."
  11. Avoid discussing your injuries or your medical prognosis. Both are ongoing and subject to change as time passes. Your lawyer will do that for you.
  12. Stick to the basics. If you're asked about the specifics of the accident, simply let the agent know where your vehicle is so they can assess damages themselves. If they press you for details about the accident, refer them to the police report, since you have already given the police a detailed recollection of the accident.
  13. Don't sign any document from the insurance company without consulting your lawyer. This includes both the insurance company transcript of your statement and also any medical records release form.
  14. Don't let the insurance agent rush you into a settlement. Even though you might need the settlement to pay for repairs or medical bills, don't let them rush you into taking a settlement that could be far too low for the situation at hand.
  15. Don't assume that your insurance agent is on your side. Statements made to insurance companies are not protected by attorney-client privilege. Because of this, they can be subpoenaed into evidence in the event you move forward with a lawsuit and the opposing insurance company would then have access to your statement. In addition, there are circ*mstances where your own insurance company may not hold your best interests. For example, if the at-fault driver in a car accident is uninsured or loses coverage, your insurer may have to pay the claim on his or her behalf. In this case, your insurance company is at odds with your best interests and anything you said in your statement could hurt your case.

Always be honest when making a statement, but keep your best interests at the forefront of your mind by consulting with your attorney before the statement interview. Call us now to learn more.

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Tips for Insurance Company | Commonwealth Law Group (2024)

FAQs

What insurance company denies the most claims? ›

Claim denial rates by insurance company
CompanyClaim denials
UnitedHealthcare32%
Anthem23%
Aetna20%
CareSource20%
1 more row
Apr 24, 2024

Should I accept the first compensation offer? ›

If you have already accepted a compensation settlement, you cannot claim for more money, even if your injuries are later discovered to be more serious. For this reason, you should not accept an early offer of compensation before a full medical exam has been carried out.

Do insurance companies try to avoid lawsuits? ›

Fair Settlements Aren't Easy

So when an insurer gets an accident claim, they will look for ways to reduce what they pay. They'll also do what they can to avoid a court case. This is why most insurers will try to settle before going to court.

How to argue with your insurance company? ›

Contact your insurance agent. Write to an executive at the insurance company. Ask a third party such as an ombudsman to help with your dispute. File a complaint with your state department of insurance, which regulates insurance activity and insurer compliance with state laws and regulations.

What insurance company has the most complaints? ›

United Automobile Insurance

What are 5 reasons a claim may be denied? ›

Six common reasons for denied claims
  • Timely filing. Each payer defines its own time frame during which a claim must be submitted to be considered for payment. ...
  • Invalid subscriber identification. ...
  • Noncovered services. ...
  • Bundled services. ...
  • Incorrect use of modifiers. ...
  • Data discrepancies.

How to counter offer an insurance settlement? ›

Rather, ask why the adjuster has provided this extremely low figure. You should then write a formal letter of response in which you state that you don't find the initial low settlement offer acceptable, listing the reasons why and concluding with a demand for a higher settlement offer.

What is the Part 36 offer? ›

[See rule 47.20.] 5. In summary, Part 36 provides that: - A party making a defendant's offer is offering something to settle their opponent's claim, counterclaim, additional claim, appeal, cross-appeal or costs assessment proceedings and to accept a liability to pay costs.

How to negotiate claim settlement? ›

8 Insurance Settlement Negotiation Tips
  1. Understand the Insurance Company. ...
  2. Initiate the Claim as Soon as Possible. ...
  3. Never Admit Fault for the Accident. ...
  4. Stick to the Facts, Never Speculate. ...
  5. Know the Rough Value of Your Claim. ...
  6. Be Patient, Do Not Accept the First Offer. ...
  7. Get Everything in Writing.

Why do insurance companies drag out settlements? ›

Dragging Out a Case

The insurance company knows that you need money. It might want to wear you down by delaying settlement so that you give up and accept a lower offer so that you can get money in your pocket. The other reason for delaying a case might be to create a statute of limitations defense.

Why would an insurance company not want to settle? ›

The entire goal is to pay as little as possible and limit their liabilities so that they can walk away unharmed. Therefore, the biggest reason insurers refuse to settle is because they want to try to minimize how much they pay or work in a way to pay nothing. Insurance companies try to delay first.

How long before an insurance company offers a settlement? ›

Negotiating a Settlement Check

Insurance companies do not like to pay out much on injury claims, so it might take time to negotiate. Most of the time, settlement negotiation takes a few weeks or months after getting the first offer. Again, the exact timeline will depend on each case.

What is it called when an insurance company refuses to pay a claim? ›

Bad faith insurance refers to the tactics insurance companies employ to avoid their contractual obligations to their policyholders. Examples of insurers acting in bad faith include misrepresentation of contract terms and language and nondisclosure of policy provisions, exclusions, and terms to avoid paying claims.

What to do when an insurance company ignores you? ›

What to Do if the Insurer Does Not Respond
  1. Keeping an open line of communication and continuing to reach out to the insurance company at least once every week.
  2. Contacting your insurance adjuster supervisor.
  3. Mentioning to the insurance adjuster that you have concerns they are handling your claim in bad faith.

How do I make a successful insurance claim? ›

You'll need to include copies of all paperwork that will help your claim, including receipts or medical certificates. You should also keep copies of the originals in case your claim is queried or refused. Your insurer may ask if you have other insurance that may cover the claim.

What's the worst medical insurance company? ›

Here are what some consider to be the ten worst insurance companies in the United States:
  • UnitedHealth. ...
  • State Farm. ...
  • Elevance Health (formerly Anthem) ...
  • Unum. ...
  • Federal Employee Benefits. ...
  • Farmers. ...
  • Liberty Mutual. ...
  • USAA. USAA started in 1922, and like Farmers, it's one of the country's biggest homeowner's insurance companies.

What is the biggest insurance company to fail? ›

Executive Life Insurance Company (1991) - One of the largest life insurance companies in the US, it went bankrupt due to investment losses in junk bonds.

Which medical insurance has best claim settlement? ›

Best Health Insurance Companies in India
CompanyCLAIM SETTLEMENT RATIO (avg. of last 3 years)Gross Written Premium (2020-21)
Care90.75%₹2,559.75 Cr
Niva Bupa (erstwhile Max Bupa)90.66%₹1,750.78 Cr
Bajaj Allianz94.04%₹2,301.74 Cr
ICICI Lombard85.53%₹3,021.35 Cr
1 more row

What are the odds of winning an insurance appeal? ›

Nationally, although 94 percent of insurance deni`als are never appealed, approximately 70 percent of health insurance appeals are granted. Insurers are counting on you giving up after receiving a denial, but making the effort to appeal can pay off.

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