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The Truth About Insurance Adjuster Claims for Car Accidents

By Keith Stachowiak on November 2, 2020 // Leave a Comment

Not everything insurance adjusters say is false, however, the attorneys at Murphy & Prachthauser want you to remember that it’s the insurance adjuster’s job to pay as little as possible—or even no money at all—on your car accident case. Insurance adjusters do not have the same end-goal as you and it’s important to keep this in mind when you are in contact with them. Oftentimes, when it seems as though someone is trying to help you and they make a bold statement such as “we have a right to all of your medical records,” you tend to believe them.

The truth behind their statements may be surprising. The claims that insurance adjusters may say to you can be partly or even completely false. Here are common sayings that you may hear from an insurance adjuster and why they aren’t true.

A man sitting on a couch with his injured leg in a cast raised up as he scrolls through messages from his insurance adjuster on his phone


False Notion 1: “You have to provide a recorded statement”

Unless you are dealing with an uninsured or underinsured motorist claim against your company or the company insuring a vehicle you are in, you do not have to do this and we suggest that you do not. Although their questions may seem harmless, there is a specific reason why they ask each one. For example, if a car accident insurance adjuster asks you, “how are you doing?” and you reply with “good”, which is a normal everyday response, this could be interpreted that you don’t need any more medical care. Most people are poor at estimating time and distance, and may guess at answers they think they should know but don’t.

These situations may seem bizarre, but they can be a real risk and happen quite frequently. Never agree to have a conversation recorded unless you are dealing with an uninsured or underinsured motorist claim. Then do so after consulting an attorney. Even if the insurance adjuster claims that they need the recording for training purposes, this is not always true and we would encourage you to not allow it to happen.

False Notion 2: “Your case is accepted as compensable”

This statement can lead you to believe that everything is set and good to go. However, this decision to accept your case as compensable doesn’t mean the insurance company will pay for all of your losses. There can be large differences of opinion on what fair and reasonable compensation is. There can be policy limits that cut off compensation at a set point. People often realize this has happened when it's too late, such as when you settle the case and discover unpaid medical bills.

woman on the phone with insurance adjusters as they claim that her case is not compensable Adjusters could tell you to get treatment for your medical injuries and that they will take care of the bill. Unfortunately, what can happen is once your treatment is complete and you submit the medical bills, the insurance company can now say that they will only cover a small portion of the costs, that the limits of medical payments have been exhausted. And at this point, hiring a lawyer might be out of the question in terms of time and you’re now in serious debt.

False Notion 3: “Your case is under investigation”

This often means, “we are going to hold off as long as possible to tell you that we are going to deny your case for little-to-no reason.” They may wait as long as possible to exhaust you in an effort that you will accept the insurance adjuster’s small settlement offer.

The longer it takes for a claim to settle, the more likely it is that you accept less money. It’s important to watch out for adjusters trying to push a claim past the statute of limitations. If the statute expires, you are legally barred from conducting a lawsuit and they will then completely deny your claim.

What can you do to speed up this process and make sure this doesn’t happen to you? Talk to an experienced personal injury attorney, today. Murphy & Prachthauser is here to help you get what you deserve.

False Notion 4: “Medical treatment isn’t necessary”

The attempt to dispute how severe your injuries are will almost always happen in every personal injury case. Insurance adjusters are not doctors and they shouldn’t give you medical advice. Listen to your medical professional (ideally your primary care doctor, who can recommend specialists if necessary). If your physicians recommend a treatment that your insurance company is disputing, you should absolutely contact a personal injury lawyer right away. You need to listen to your doctors, not an adjuster, on what to do for medical treatment.

False Notion 5: “Your policy doesn’t cover this”

On occasion, an adjuster may tell you that certain benefits aren’t available when they really are. Insurance adjusters often use misleading interpretations of your policy just to deny your claim. They might even fail to tell you the full limits of your coverage, and hope you won’t find out—and most of the time, people don’t because they don’t know any better. It’s important to read the policy thoroughly. The adjuster will even use out-of-date information or technical jargon to make it difficult to understand for anyone other than an experienced lawyer.

False Notion 6: “We have a right to all of your medical records”

Woman with injured leg raised while reviewing medical records and on the phone with insurance adjusters who claim they have a right to all of her medical recordsThe only medical records that your insurance company has the right to access are records that are reasonably related to your injury and records of medical care to the related body part. However, they do not have the right or deserve access to all of your medical records. Typically, records going back five years are warranted, for doctors who may have treated you for the same or related body part before your vehicle accident. Dermatology records, OB-GYN records for instance, typically have no relevance to a car crash injury.

The insurance company is looking for other things to blame your injury on. For instance, do you engage in recreational activities that could cause this? Or employment that may be physical? This is an attempt to fault your injury on a pre-existing condition or activity. All they have to do is ask you to sign a general medical authorization form and they will have access to all of your medical records. You are not obligated to release all of your medical treatment information to the insurance company and we highly suggest you not to sign the general release form. Make it limited to time and appropriate medical providers

False Notion 7: “We can’t pay you until you sign a release form”

If you are told to sign a document that says, “Release” on it, this can be used to release all claims for medical bills, repair bills, etc., and remove your right to receive any further compensation. Some insurance companies are sending out unsolicited $500 checks to people involved in an accident along with a release, and signing that release and cashing the check is giving away your rights to make a claim if the injuries are more serious than they first appear. Some insurance companies are recording phone calls shortly after a crash to get your agreement to settle your case.

Never sign anything or agree to anything pertaining to a vehicle accident you are involved in without a having an attorney review it first. This could be the difference of your claim getting taken care of and you getting what you deserve and not receiving any compensation for your accident.

woman with neck brace on looking at phone confused as to why insurance adjusters won't pay her compensation until she signs release forms

False Notion 8: “You must accept this settlement within ‘X’ days or it will expire”

Insurance adjusters will say this to create panic and fear, causing you to agree with a bad offer before you have a chance to even calculate your physical or material damages. As difficult as it may be to ignore a deadline provided by an insurance company, this settlement expiration date is arbitrary. The only true deadline is the statute of limitations, typically 3 years after the accident, but sometimes much shorter if a death is involved or a government vehicle is involved.

It’s important to remember that you should never enter a contract until you have fully completed medical treatment.

This statement is simply a negotiating tactic for almost all scenarios involving settlements expiring. Offers usually only expire when new facts are found, which does not happen very often. Most settlements will not expire after 30 days.

Why Choose Murphy & Prachthauser?

If you suspect your insurance adjuster isn’t being honest, you may be right.

The attorneys at Murphy & Prachthauser have decades of experience with car accident cases. At Murphy & Prachthauser, we practice personal injury law the way it should be practiced—motivated and equipped to do our best for you. We take pride in being good lawyers who help people.

If you have a case you would like to speak to a lawyer about, get a free case evaluation now or call us today, and get an experienced team of lawyers working on your behalf.