How Do Insurance Companies Avoid Paying Claims?

Scartelli Olszewski P.C.

People don’t make insurance claims because they want to, but because they need to. They’ve paid their insurance provider on the off chance they may be hurt in an accident. This comes with the expectation that their insurance company will provide for them when they need them. The truth is that insurance companies are likely to try and avoid paying those claims.

Why Do Insurance Companies Avoid Paying Claims?

Insurance companies make their money by people making regular payments to them and then do their best to make sure their clients don’t do anything that requires large insurance payouts. There are small regular services that insurance companies cover so their clients feel they have value, but they never want to pay a big bill. They make their profit when clients don’t need big bills.

Of course, accidents happen, and a big payout will be necessary. If someone else caused the injury to their client, the insurance company will target them and their insurance to get your bills paid. But if there is no one else to blame, if it was purely an accident or you were at fault, your insurance company will do its best to avoid paying any claims you submit. It’s cheaper to avoid paying your bills and leaving you to suffer and lose you as a client than it is to pay your bills.

For this reason, you need to contact a personal injury attorney who will fight to make sure your insurance company covers your bills. You paid for their coverage plans, you deserve the financial protection they promised.

What Tactics Do Insurance Companies Use to Deny Your Claims?

The insurance companies have a list of tactics they use to deny their clients their claims that the attorneys at Scartelli Olszewski, P.C. are familiar with. These tactics can be humiliating and dangerous to you. Make sure to watch for any signs that your insurance company is attempting to use any of these tactics against you.

Blaming You

Many insurance companies will add fine print to their contracts that make it seem like they won’t or don’t have to cover you if an accident is your fault. They can even try to manipulate the language of your contract so they can say what’s your fault and what isn’t later on.

Either way, they’ll do their best to make it seem like your injury is entirely your fault and is solely your financial burden to bear. When it comes to car accidents, Pennsylvania is a no-fault state, so insurance companies can’t use blame to deny your claims. They can behave as if this isn’t the case, considering many people don’t know that Pennsylvania is a no-fault state, so be careful. Pennsylvania’s “no-fault” laws only apply to auto insurance, not other types of insurance.

Drag Out Your Case

Depending on your injury, your healing process can end before a legal case can finish. This will help an insurance company build their defense as to why they denied you your injury claims. If you heal before your case is over, they can use your healed body to argue that you don’t need the repayment or to minimize how bad your injuries and recovery costs were.

You can also potentially die from your injuries and lack of coverage as they drag out court cases. This means that you’re not around to fight for your payments, and your family may not be able to recover enough to win. It’s important to fight back and file a suit as soon as possible so your injuries can’t be used against you.

Ways that they can drag out a case include:

  • Requiring written and recorded statements from your doctor, copies of the accident report, and/or your employer’s reports depending on the type of injury. The more people involved and the more paperwork you have to file, the more time they have to build a case against you and avoid paying you.
  • Ask you to authorize the release of your medical records. Medical records have a lot of protection against them to maintain your privacy, but this can be used against you. The medical record system in the United States is not the most effective and can take some time to release information to your insurance company.

Pressure You Into a Quick Settlement

One of the things an insurance company can do to deny your claims is to see how much your bills will cost with your medical records. Unless you work in medicine, odds are that the insurance company will develop a better idea of how much your injuries will cost than you.

Rather than outright fight you to avoid paying anything, they’ll offer a settlement that’s less than you need, but large enough to look attractive.

They can do this as you begin a lawsuit against them for denying your claim, before you can recover, and/or before you even get the chance to talk to a lawyer. While it’s your decision whether to accept a settlement, consult with a lawyer and doctor to make sure you’re getting all the money you need to recover.

What Should You Do Next?

After you or a loved one are injured, the first thing you should do is go to a hospital and get treated for your injuries. Once you or your loved one are treated, make your insurance claim as soon as possible to see their response. If they don’t respond with coverage or take too long, do not hesitate to contact the attorneys at Scartelli Olszewski, P.C.

We care about our clients and will do everything we can to get you the coverage you need. Contact us today.