Insurance – something that none of us particularly like very much (paying premiums is not pleasant), but also something we just cannot do without. Nearly every client I have ever had asks the same question: Why won’t the insurance company just pay my claim? And like I have said here dozens of times: because paying out claims is really not the essence of their business model.
The frustration of clients who have experienced injury from an accident
is completely understandable. After all, they imagine, why on earth can’t the insurance carrier empathize with their suffering and their loss? How could the insurance carrier withhold compensation when they (those who were injured) were blameless?
Once again, I remind my readers that insurance carriers, although
they happily collect premiums from millions of Americans, are not working to pay out compensation. Rather, they work for their shareholders. They are in business to make money with the purpose of investing that money only to make more money.
Why Do They Take So Long?
For insurance carriers, it’s all about taking their time; delaying conversations, decisions, and payments. The longer they hold onto “their” money, the more profits they will earn from investments. They routinely delay or deny claims for a multitude of justifications: some outright wrong, some difficult to prove or disprove, and others plain petty. Short of blaming the injured party instead of their own customer, insurance carriers often use excuses such as:
- The accident was caused by someone or something other than the individual they insure.
- The injured person stopped short or did not stop quickly enough.
- The accident was avoidable.
- The injury is not really serious or debilitating.
- The injured person was not transported to the hospital by ambulance.
- There was a delay in medical care.
- The injured person’s diagnostics are interpreted differently by their insurance doctors.
- The injured person did not miss enough time at work to be credible.
- There were pre-existing conditions that are causing symptoms.
- The injured person is asking for too much money.
Insurance carriers have many other reasons (excuses) for denying payment, but you get the idea. In other words, they always have many reasons to deny and too few reasons to approve. But that should never deter an injured individual from seeking knowledgeable legal counsel. Although some of these “defenses” may contain a shred of of legitimacy, a skilled personal injury attorney can successfully oppose or mitigate most of them. That means he or she will need to obtain all relevant information and documentation on your case. You cannot leave out one detail.
But you are not or should not be a passive participant in your own personal injury case. As the injured party, you also must do due diligence and avoid making mistakes.
For instance, as I’ve discussed many times before, make sure to get the medical care you need right after the accident and long after the accident. To the best of your ability, try to get the contact information from witnesses. Do not take advice from non-professionals. Closely follow the advice of your treating doctors. Always be truthful. And above all, do not have discussions with the insurance carrier or the individual who is responsible for your injury. They are not your friends, no matter how friendly they sound. Make sure you have your own personal injury attorney handle it for you.
No personal injury case is a slam-dunk win. Most are complicated and require patience. That is why the best you can do is follow your doctor’s advice and listen to your attorney. He or she has your best interests at heart.
