Whether you’re an unrepresented person or an attorney representing an accident victim, dealing with insurance companies can be a frustrating process. For the unrepresented accident victim, understanding the insurance process is overwhelming. Delay, Deny and then Defend are the very familiar tactics used by insurance companies in handling injury claims.
Insurance Companies Routinely Delay Payments
Delay is the biggest method utilized to make it seem as if your case has fallen into a bottomless abyss. Why the delay?
First, insurance companies have a statutory period to investigate claims. When the insurance company (the injured person’s and/or the at-fault) receives a claim, they must act diligently and efficiently in investigating the claim. The investigation phase takes the form of recorded statements, phone calls to persons involved and/or their representing attorneys, securing the police report, determining coverage and fault, property damage issues, sending out various forms, and sometimes examinations under oath. To be fair to the insurance company these are necessary steps that must be taken.
However, when investigations drag on for months, the wheels of progress grind to a halt and proactive measures must be taken. If coverage is disputed or denied, Litigation needs to be commenced through a declaratory action to determine coverage. Cooperation or the lack thereof with parties involved is another stumbling block to insurance investigation and can result in unreasonable delay. For unrepresented persons, trying to figure what to say and whom to talk is daunting and frustrating, which is why having a litigation attorney experienced in personal injury managing your case is important. The experienced litigation attorney knows the players, insurance adjusters and defense attorneys, will facilitate the insurance company with its investigation while advocating the damages you should be compensated for.
Aside from coverage investigation, insurance companies tend to delay cases for investigation of injuries. Consider this common scenario: a person gets injured in auto accident and has a prior history of similar accidents with injuries. Insurance companies on both sides will undoubtedly delay the pre-suit settlement process by requesting and awaiting prior medical records to determine pre-existing injuries that could diminish their exposure. Delays of this sort can seemingly drag a case into oblivion. Even once the records are received by the insurance company, delay is inevitable as reviewing the records, whether by the adjuster or a peer review physician, a process that can move at a snail’s pace.
Another common reason for delay is inattentive and inexperienced adjusters who are often overworked and responsible for hundreds of claims. The unfortunate result is a back-log of claims that go unnoticed for quite some time. Even 30-day demand letters can go unnoticed. Experience dictates the most effective way to get your case noticed is to immediately file suit. As a corollary, company hierarchy can bog down the claims process. Often the initial adjuster has limited settlement authority and must seek approval when a demand is made above their limit. Likewise, the transferring of adjusters to existing claims further bogs down the process and creates the feeling of no end in sight.