What Are The Common Tactics Insurance Companies Use To Fight Injury Claims?

When you file a personal injury claim, you may expect the insurance company to act fairly and cover the expenses for your injuries and damages. However, insurance companies are businesses, and like any business, their goal is to protect their profits. To minimize payouts, insurers often use a variety of tactics that can weaken your claim, resulting in reduced compensation—or even a denial of coverage altogether.

At John J. Malm & Associates, our top-rated Illinois personal injury attorneys help clients navigate the insurance claims process, advocating for fair compensation while protecting them from common pitfalls. Here, we’ll highlight some of the most common insurance tactics used to undermine personal injury claims, and offer tips on how you can safeguard yourself.

1. Quick Settlement Offers

One of the most common tactics insurers use is offering a quick settlement right after an accident. These initial settlement offers are often much lower than the actual value of the claim. The insurer may pressure you to accept this offer by emphasizing the need to resolve the case quickly or by suggesting that you won’t get a better offer if you wait.

Why it’s risky: Accepting a quick settlement can be tempting, especially if you have immediate financial concerns. However, these offers rarely account for the full scope of your medical expenses, ongoing treatment, lost wages, and pain and suffering. Once you accept, you generally waive your right to pursue additional compensation later.

How to protect yourself: Before accepting any settlement, consult with an experienced personal injury attorney who can evaluate the offer and advise you on whether it’s fair. An attorney can help you calculate the full extent of your damages to ensure you aren’t settling for less than you deserve.

2. Disputing Liability

Insurance companies frequently attempt to dispute liability, arguing that their policyholder wasn’t entirely at fault or that you were partially responsible for the accident. In states like Illinois, which follows a modified comparative negligence rule, the amount of compensation you receive can be reduced if you’re found partially responsible. If you are found to be more than 50% at fault, you may lose the right to recover damages entirely.

Why it’s risky: If the insurance company succeeds in shifting blame, it can significantly reduce your compensation. By attributing partial or full fault to you, the insurer limits its financial responsibility, potentially minimizing or eliminating your recovery.

How to protect yourself: Document as much evidence as possible at the scene of the accident. Take photos, gather witness contact information, and request a copy of the police report. Working with an attorney can also be invaluable; they can help establish a clear case showing the other party’s responsibility and counter any claims that you were at fault.

3. Downplaying the Severity of Your Injuries

Insurance companies often downplay the severity of injuries to justify lower settlement offers. They might argue that your injuries are pre-existing, exaggerated, or not as severe as you claim. In some cases, they may ask for a recorded statement or request access to your medical records to find any evidence to support their position.

Why it’s risky: By downplaying your injuries, the insurer can justify offering a lower settlement or rejecting parts of your claim. Insurance companies may use your medical history against you, pointing to pre-existing conditions or unrelated injuries to weaken your case.

How to protect yourself: Seek medical attention immediately after the accident, and follow your doctor’s treatment plan. Avoid discussing your injuries in detail with the insurance adjuster without first consulting your attorney. It’s also wise to limit the release of your medical records, as the insurer may try to access your complete medical history, not just records relevant to the injury.

4. Requesting a Recorded Statement

Insurers may request a recorded statement early in the claims process, claiming that it’s necessary to “understand your side of the story.” While this might seem routine, the real objective is often to gather information they can later use to undermine your case.

Why it’s risky: Insurance adjusters are trained to ask leading questions that might prompt you to downplay your injuries or provide information that can be misinterpreted. Your words can be taken out of context and used to argue that you aren’t as injured as you claim or that your account of the accident is inconsistent.

How to protect yourself: Politely decline to provide a recorded statement without consulting your attorney. You are not legally required to provide a recorded statement, and it’s best to have an attorney present when discussing your case with the insurer.

5. Delaying the Claims Process

Insurance companies sometimes delay processing a claim to frustrate the claimant, hoping they will either settle for a lower amount out of desperation or abandon the claim altogether. Delays might include waiting a long time to respond, requesting unnecessary paperwork, or dragging out the investigation.

Why it’s risky: Delaying the claims process can put a financial strain on claimants who need compensation to cover medical bills, lost wages, and other expenses. If the statute of limitations expires before your claim is resolved, you may lose your right to file a lawsuit altogether.

How to protect yourself: Be proactive and follow up regularly with the insurance company. Document every communication, including emails and phone calls. Having an attorney handle the case can also prevent unnecessary delays, as insurers are often more responsive when a lawyer is involved.

6. Misrepresenting Policy Terms

In some cases, insurers may misrepresent the coverage available under the policy, claiming that certain damages aren’t covered or that coverage limits are lower than they actually are. This tactic can lead claimants to believe they’re not entitled to certain benefits or that they must settle for a lower amount.

Why it’s risky: Misrepresenting policy terms can prevent you from pursuing the full amount of compensation you’re entitled to, particularly if you’re unaware of the policy’s actual coverage.

How to protect yourself: Review your insurance policy carefully, and consult with an attorney if you have questions about coverage. Attorneys experienced in Illinois personal injury law can interpret policy language accurately and ensure you’re aware of all available benefits.

7. Using Surveillance to Challenge Your Claim

Insurance companies sometimes conduct surveillance to investigate claimants. They may hire private investigators or use social media to look for evidence that contradicts your claims about your injuries.

Why it’s risky: If you’re seen engaging in any physical activity that appears inconsistent with your reported injuries, the insurer may use this to question your credibility or dispute the severity of your injuries.

How to protect yourself: Be cautious about what you post on social media, and avoid discussing your case online. Limit activities that could be misinterpreted as inconsistent with your injuries, and follow your doctor’s restrictions closely.

8. Offering Lowball Settlements for Future Medical Costs

Insurers often attempt to settle claims by offering compensation that covers current medical expenses but doesn’t adequately account for future treatment. This can be particularly problematic in serious injury cases where ongoing medical care is likely.

Why it’s risky: Accepting an offer that doesn’t account for future medical needs can leave you responsible for covering significant medical expenses down the road.

How to protect yourself: Consult with medical professionals and an attorney to understand the full extent of your injury and potential future costs. An attorney can help you pursue fair compensation that considers both current and future medical needs.

9. Questioning the Necessity of Certain Treatments

Insurance adjusters may argue that certain treatments or procedures are unnecessary, particularly if they are costly or long-term. They may deny coverage for some of your medical expenses, claiming that they are not essential or directly related to the accident.

Why it’s risky: Denying coverage for necessary treatment can delay your recovery and increase out-of-pocket expenses, impacting both your health and financial stability.

How to protect yourself: Have your medical provider document the necessity of all treatments and procedures. An attorney can help you challenge these denials and seek coverage for legitimate medical needs.

10. Using Comparative Fault to Reduce Compensation

In Illinois, the concept of comparative fault allows the insurer to reduce the compensation if they can show you were partially at fault for the accident. They may claim you contributed to the accident in some way, which would reduce your overall compensation.

Why it’s risky: If you’re found partially responsible, your compensation can be reduced in proportion to your degree of fault, and if you’re over 50% at fault, you may be barred from recovering damages.

How to protect yourself: Work with an attorney to gather evidence that clearly establishes the other party’s responsibility. An attorney can help counter any assertions of comparative fault and protect your right to fair compensation.

How the Illinois Personal Injury Attorneys at John J. Malm & Associates Can Help

Insurance companies use a variety of tactics to minimize payouts on personal injury claims, and navigating these tactics can be challenging. At John J. Malm & Associates, our team of Illinois personal injury lawyers is committed to standing up to these insurance tactics and advocating for our clients’ rights. If you or a loved one has been injured and are dealing with an insurance company, contact us for a free consultation. We’ll help you understand your options, negotiate on your behalf, and work to secure the compensation you deserve.