Negotiating Personal Injury Claims With the Insurance Company: A Four-Part Guide
Every year, countless individuals and their loved ones throughout Colorado are impacted by car accidents and other personal injuries. These accidents result in grueling recovery processes, expensive medical bills, and a variety of other hardships, What’s worse, though, is that the insurance companies involved in these situations seem to be of no help to you. In fact, they often engage in bad-faith tactics designed to pay out the least amount of money possible. It’s natural for victims to feel frustrated or even completely overwhelmed.
Whether you were involved in a car crash, motorcycle accident, dog bite, or a trip-and-fall on someone else’s property, you don't deserve this kind of treatment.
At Landry Law, P.C., our attorney is committed to offering skilled representation and detailed guidance through the entire personal injury claims process. If you live in Lone Tree, Trinidad, or anywhere else in Colorado, set up a consultation with Landry Law, P.C., for reliable legal assistance.
Part One: What You Need to Know Before Talking to an Insurance Adjuster
After you report an auto accident to your insurance company, the next time your phone rings, it may well be a representative of the company known as a claims adjuster.
A claims adjuster is a highly trained professional employed by the insurance company to protect its bottom line. In other words, it is their task to get you to say or do something that they can use to either lowball or deny your claim.
The point is: Don’t let them take advantage of you. Get on top of things from the beginning. Or better yet, while you’re injured and recovering at home, let a skilled attorney take over the task while you take the time to recover.
Dealing With Insurance Adjusters
Unless your accident was only a fender-bender and your injury just the loss of a sense of safety, you may not even want to deal with your insurance company’s adjusters on your own. If you do decide to do so, here are some valuable points to consider:
When dealing with insurers — yours or the other party’s — don’t let emotions dictate how you act or what you say. Remain calm and objective.
Set limitations. Don’t agree to have the conversation recorded. They have to get your consent, so respectfully decline. They can later use anything you say against you to diminish or deny your claim, and if it’s recorded, it’s hard to refute or correct a previous statement.
Don’t volunteer information. Stick to the basics — where, when, who, the type of accident, etc. Say the accident is still under investigation and you’ll get back to them. If they ask about your injuries, don’t be specific. You can say you’re still being examined and treated. Most importantly, don’t admit guilt or fault in anything.
They also may attempt to mail, email, or fax you a medical release form. Don’t sign it until it’s reviewed and approved by an attorney.
If they offer you a settlement, rest assured that the first offer is going to be the lowest they can justify. Don’t accept the first offer. In fact, don’t accept any offer unless your attorney reviews and approves it.
Negotiating a Settlement
Remember that the first settlement offer is invariably going to be on the low end. The insurer can increase the offer to make it more tempting, but if you’re injured, your treatment may not end with the issuance of a check. Always keep in mind that a settlement is final. If your injury worsens or resurfaces, you cannot go back and ask for more once you’ve settled.
You need to work with your attorney on drafting a demand letter that spells out the compensation you feel is justified to cover all medical and associated expenses now and into the future, as well as any income lost due to missed work while recovering.
If you attempt to deal with insurance adjusters on your own, you can never be sure if they’re treating you fairly or cheating you out of what’s really due you in terms of compensation.
Part Two: Understanding Insurance Bad Faith Tactics
According to a Lawyers.com survey, personal injury victims who accepted the first settlement offer received nearly $31,000 less than those who negotiated. When an individual files an injury claim, all insurers are required to investigate, negotiate, and settle the claims in good faith.
Unfortunately, some of these insurance providers use bad faith tactics such as lowballing, denying valid claims, misrepresenting the law, or offering significantly low first settlement offers.
Common Bad Faith Tactics
Any kind of accident can feel overwhelming. This is made worse when the insurance company engages in dishonest or unfair practices—otherwise known as bad faith tactics. Some common bad-faith tactics include:
Long or Unreasonable Delays
Colorado law stipulates that a valid injury claim should be accepted or denied within 60 days. Some insurance companies may cause unreasonable delays by failing to respond to communications or not investigating the claims. These unnecessary delay tactics are often employed to see whether the policyholder will stop pursuing the claims.
Failing to Conduct a Thorough Investigation
Insurance companies are required to carry out prompt and thorough investigations once a policyholder files an injury claim. Failing to conduct a thorough investigation is an act of bad faith.
Furthermore, Colorado is a modified comparative negligence state. This means that if the injured party is determined to have been 50 percent or more liable for the accident, then they forfeit the right to receive compensation for their injuries. Claiming liability requires a thorough and comprehensive investigation that insurance companies often fail to perform. They will often try to cite modified comparative negligence as a means of avoiding paying for injuries.
Misrepresentation of the Law
The insurance provider may intentionally misrepresent the policy’s coverage or interpret policy language against the plaintiff. As part of their duty of good faith and fair dealing, they must be truthful and honest in their statements about the insurance policy and the law.
Making Threatening Statements
Insurance companies are required to treat policyholders in a professional and respectful manner. Making threatening statements to policyholders or third parties who make injury claims is an act of bad faith.
Lowball First Offers
Offering lower than the real worth of an injury claim is an act of bad faith. Insurers know that most people will take the first offer they receive because they are feeling pressured for money to pay bills for damages to their vehicle and for injuries.
Part Three: Why You Shouldn’t Always Take the First Offer From the Insurance Company
If you have been injured due to someone else’s negligence, the first thing you want to know is whether that person has insurance to cover the damages. If there is an insurance policy you can file a claim against, you may be relieved — however, that is merely the beginning of what could be a long fight for fair compensation.
Most victims who are pursuing a settlement often ask themselves, how much is enough? Invariably, the first offer you receive from the insurance company will not be their best offer. If you are pursuing a claim, you should understand why, exactly, that first offer often misses the mark.
How Will an Insurance Company Respond if I File an Accident Claim?
When you first file a claim, the insurance company is usually pretty quick to assign your claim with a case number and a claims representative. This may lead you to believe the process will move quickly, however, you may hear nothing from them for a number of days or weeks. When you attempt to reach the claims representative, you may get their voicemail. You may leave message after message, inquiring about the status of your claim — but receive no response. Avoidance is a tactic often used by insurance companies in the hopes that you will simply give up and stop pursuing a claim.
If you are persistent, the insurer will eventually submit an offer to you, along with a Full Release of All Claims for you to sign. Once you sign it, you are finished. There is no going back for more. You release the insurance company and their insured party from any more responsibility related to the accident or your claim.
Why Should I Refuse the First Offer?
If you have not already, by the time you receive the insurer’s initial offer in full settlement of all claims, you should immediately talk to a Colorado personal injury attorney. The claims process may be new to you, but not to an experienced attorney.
In some cases, that first offer could even come quickly. However, accepting an early offer could prove to be shortsighted, as you may not know the full extent of your injuries for months. Remember, if you settle and sign the Full Release, you cannot seek any additional compensation, even if your medical expenses, lost wages, or pain and suffering increase.
No matter what, it’s vital to reach out to a personal injury attorney to help you understand your next steps.
Part Four: How Insurance Companies Evaluate the Value of a Claim
Pursuing a personal injury case is an overwhelming process, especially if you’re also addressing injuries sustained from the accident. When filing a claim with a provider, many clients want to know, “How much can I recover after my accident?” And, if they discover that filing a lawsuit is the only way to gain adequate compensation, they’ll ask, “How much is my personal injury case worth?” These are important questions because the answers will affect how your lawyer approaches your case and focuses their investigation.
Not All Claims Are Equal
When you meet with your attorney, they’ll listen carefully to the details of the incident and look at all available evidence to estimate how much you’re likely to get from a settlement. No two cases are alike. An insurance adjuster will look closely to determine their odds of winning if you file a personal injury lawsuit or the odds that a jury will side with you and base their next steps on these calculations. For example, if they think you have a high probability of winning in court, they may make a larger offer upfront hoping you’ll accept so they can avoid litigation.
On the other hand, if they think their chances of winning are higher, they may try to lowball you. For instance, if they believe you played a significant role in causing the accident, they may use the comparative fault law to their benefit by trying to prove you held over 50% responsibility for the accident and should therefore lose your right to seek any damages.
Factors That May Be Considered
A settlement includes payments for any damages that occurred because of the accident, and this is typically broken up into three categories: economic, non-economic, and punitive. Economic damages cover medical costs, property damage, lost wages, or other out-of-pocket expenses. Non-economic damages compensate you for non-tangible things like pain and suffering or loss of consortium. Finally, only in the most extreme cases of negligence will punitive damages be considered, which are designed to punish the guilty party.
Your Actions Factor In
We mentioned the comparative fault rule above, but it’s important you fully understand this. An insurance company will look closely at each driver’s role in the accident and evaluate how much your actions played in it (if at all).
In Colorado, fault can be shared by two parties, and your total compensation will be reduced by your share of liability. However, if it’s proven you were over 50% responsible, you’re no longer able to seek any damages. Additionally, they’ll also look at your actions after the accident. For example, if you failed to notify the police or waited a long time to get medical treatment or get an estimate for damages, your inaction could be seen as evidence you weren't seriously affected and therefore don’t need a large settlement.
Steps You Can Take to Maximize Compensation
The first thing to do to maximize your compensation is to hire an attorney. A skilled attorney can dramatically increase the likelihood you’ll reach a favorable settlement. Second, you should always seek medical attention and retain all documentation from doctors, even if you feel your injuries are minor. Start documenting everything, including the days you’ve had to miss work, time away from your family, or any way the accident has inconvenienced you. Lastly, it’s worth restating: never accept the first offer from the insurance company. This will almost always be less than you need and won’t include all the expenses you may yet incur.
Experienced Legal Counsel: Landry Law, P.C.
Navigating personal injury claims with an insurance company is a complex process. However, you don’t have to face these issues alone. At Landry Law, P.C., we know how to document personal injury claims, craft demands, and negotiate with insurance companies. We’ll stand by your side every step of the way as you strive to pursue the financial compensation you deserve.
When you’re ready to get started, we’re ready to help. Set up a one-on-one consultation today.