Five Misconceptions About Insurance Companies in Personal Injury and Workers’ Compensation Cases
“Why is the insurance company messing with me?”
We often hear these words from frustrated and surprised people when they contact us for help with a personal injury or workers’ compensation claim. Insurance companies are supposed to protect you from financial ruin and help you recover from a major disruption to your life. But with personal injury or workers’ compensation cases, insurance companies can become formidable adversaries.
To manage your own expectations, understand that insurance companies have agendas, and their agendas are often at odds with yours when it comes to fairly compensating you for personal injury lawsuits and workers’ compensation claims. To help you understand the role and impact of insurance companies, we’ve identified five common misconceptions about them.
Misconception 1: insurance companies are on your side
You can take it to the bank: insurance companies will try to pay you as little as possible for a personal injury action or workers’ compensation claim, including denying liability completely. It’s their job to maximize profits and minimize the cost of a claim.
If an insurance adjuster can find a reason to deny a claim, they will. If they can find a reason to reduce a payment for a medical expense related to a workers’ compensation claim or personal injury, they will. If they can slow down the process of managing your case in order to delay having to pay a claim, they will.
With personal liability cases, the insurance adjuster may claim their client is not liable even if evidence shows otherwise. With workers’ compensation cases, they will actively look for reasons why your injury was not work-related.
Bottom line: they are going to do everything in their power either not to pay or to pay as little as possible, or present you with enough roadblocks in order to discourage you from pressing forward.
Misconception 2: insurance companies will act with reasonable speed
Get ready for a marathon. Even under the best circumstances, the process of managing a personal injury or workers’ compensation claim can be time-consuming. Insurance adjusters handle many, many cases at once. Yours is going to be just one to-do on their list regardless of how urgent your problem is.
For instance, let’s say you’ve suffered a work injury. An insurance adjuster may take weeks or months to even authorize an MRI. The delay may put you in a painful bind while you wait for authorization. During this time, your recourses are going to be limited – either you contact your insurance adjuster persistently (which may not be easy to do) or you get treatment and pay for the MRI out of your own insurance. It’s best to follow up with the claim adjuster until you get results – but if you are in serious pain, you need to take care of your health first.
Misconception 3: insurance companies will have only limited involvement in my case
Insurance companies will remain closely involved in your case all the way through – so be prepared to be proactive with them the entire time.
For instance, with a workers’ compensation claim, even after you get approval to get an MRI and treatment with a primary care physician, the insurance company will still have a say in what happens next. If your physician recommends surgery, your insurance adjuster still needs to approve the recommendation, which they may not do. And if surgery is approved, the adjuster will remain involved to approve any rehab you need and determine the amount of money you are entitled to receive for the time you miss from work during recovery.
After you return to work, the insurance adjuster will remain involved to settle for permanent partial disability (PPD) you’ve suffered. Here, the insurance company might try to deny you disability, perhaps claiming that your injury does not have as much of an impact on your performance as you believe it does. The adversarial relationship will simply continue until a settlement is made.
The adjuster may work against you throughout the entire process. For example, your adjuster may dispute how much work you’ve lost and therefore are entitled to be compensated for – so it’s important you document everything going on, including keeping records of work slips and correspondences.
With personal injury cases, insurance companies will remain involved throughout as well, from determining liability to settling for damages. But they are more entrenched in workers’ compensation claims owing to their complexity.
Misconception 4: insurance companies will involve me in the process
Your insurance adjuster will likely keep you in the dark while they go about their business. You’ll be lucky if you can contact them on the phone. Be prepared for them to be unresponsive and inaccessible. But they will respond if you are persistent. So Insist on getting as much contact information as you can, and simply reach out to them as often as you can.
Misconception 5: If I fight hard enough, insurance companies will pay up
Yes and no. Getting legal leverage against an insurance company should secure a more equitable settlement for you. But insurance companies do not have limitless funds. In fact, they cannot exceed the payments allowed by the policies they manage. Your own settlement will be limited by the amount of insurance that is carried by the other party in a personal injury lawsuit. This is not to say that you should accept unfair treatment by an insurance company, though. You should always take action if you are being wronged and denied a fair settlement.
Tips for Success
Yes, dealing with insurance companies can be exasperating, frustrating, and time-consuming. But you can achieve results if you follow these tips:
- Be prepared for a marathon. As noted, even under the best circumstance, insurance adjusters are busy people, and they have every motivation to delay the process.
- Stay after them.
- Document everything. If you are in an accident, document the entire scene. Get photographs. Get information from the other party. Don’t assume an insurance company will properly investigate the scene or that their investigation will be favorable even if liability seems clear to you. Be prepared to support your case with evidence.
- Keep a record of everything that happens with your case. If you’ve been injured at work, document how many days you missed, when you returned, and every action you’ve taken to get proper treatment.
- Never give a recorded statement to an adjuster. At that point, there is nothing you can say that will help you.
- Stay off social media. Your insurance company will monitor what you post on social media and look for reasons to deny your claim or dispute your level of pain and suffering.
- If you need to hire an attorney, work with your counsel every step of the way. Hiring an attorney does not mean your job is done. You need to keep your attorney informed of your medical progress and share all the records you are sharing with your employer, the other party in a lawsuit, or the insurance company.
- Above all, take care of yourself. Get the proper medical help you need if you are in pain. Don’t let the process of working with an insurance adjustor prevent you from doing what’s right for you.
Finally, remember that you are not alone. If your insurance company has denied your workers’ compensation claim, denied liability in the case of a personal injury, or is simply leaving you out in the cold, you can get instant leverage by getting legal counsel.
Call Capron & Avgerinos
Call Capron & Avgerinos now at (800) 535-4542 if you need help with a personal injury or workers’ compensation case in Illinois or Iowa. We are ready to assist you over the phone or in person. We perform our cases on a contingent fee basis, which means we are not paid unless you recover compensation for your claim. Call Capron & Avgerinos at (800) 535-4542 – let us show how we can deliver results for you.