After an accident, you may expect the insurance company to review what happened, consider your injuries and losses, and make a reasonable settlement offer. Unfortunately, the claims process is not always that straightforward.
Insurance companies are businesses, and controlling the amount they pay in claims is part of protecting their financial interests. An adjuster may be professional, friendly, and responsive, but their job is ultimately to evaluate the claim on behalf of the insurance company.
For someone recovering from an injury, understanding how insurers approach personal injury claims can make a significant difference. At Woolsey Morcom, our Florida personal injury attorneys help injured individuals understand the claims process, recognize potential insurance tactics, and protect their rights throughout a personal injury case.
COMMON WAYS INSURANCE COMPANIES MAY REDUCE PERSONAL INJURY CLAIMS
Insurance companies have several strategies they may use when evaluating and negotiating personal injury claims. Some begin almost immediately after an accident, often before an injured person understands the full extent of their injuries.
ASKING FOR A RECORDED STATEMENT
An insurance adjuster may contact you shortly after an accident and ask you to provide a recorded statement about what happened.
The request may seem routine. You might be asked how the accident occurred, what you remember, or how you are feeling. The problem is that these conversations can happen before all the facts are known or before your injuries have been fully evaluated.
Something said casually can later become part of the insurer’s assessment of your claim. For example, saying you are “doing fine” during a conversation could potentially be used to question the seriousness or duration of your injuries.
For this reason, injured individuals should understand the purpose of a recorded statement and their rights before providing one.
QUESTIONING THE EXTENT OF YOUR INJURIES
Another way an insurer may attempt to reduce the value of a claim is by challenging whether injuries are as serious as they appear.
An insurance company may question whether a particular injury was caused by the accident, argue that a condition existed beforehand, or dispute whether certain medical treatment was necessary. Your medical history and treatment timeline can become particularly important. Delaying medical treatment, missing appointments, or failing to follow a doctor’s recommendations may give an insurer an opportunity to argue that your injuries were not as severe as claimed.
That is one reason consistent medical documentation can play such an important role in a personal injury case.
SLOWING DOWN THE CLAIM
Personal injury claims can take time, but unnecessary delays can create additional pressure for someone who is already dealing with medical expenses, missed work, and other financial obligations. An insurance company may repeatedly request additional information, take extended periods to respond, or transfer a claim between adjusters. These delays can make an already difficult situation more frustrating.
Deadlines also matter. Florida law places time limits on bringing personal injury lawsuits. Allowing the applicable statute of limitations to expire can prevent an injured person from pursuing a claim in court. Understanding the deadlines that apply to your case is essential, regardless of how long settlement negotiations continue.
DISPUTING WHO WAS RESPONSIBLE
Even when another party appears to be responsible for an accident, an insurance company may investigate whether the injured person contributed to what happened. Florida’s comparative negligence laws can affect the amount of compensation available in certain personal injury cases. As a result, establishing how an accident occurred and preserving evidence of fault can become an important part of the claim.
Insurers may review accident reports, photographs, witness statements, video footage, and statements made by the people involved when determining liability. The stronger the evidence surrounding the accident, the more difficult it may be to dispute what actually happened.
MAKING AN EARLY SETTLEMENT OFFER
Receiving a settlement offer shortly after an accident can feel like good news, particularly when medical bills and other expenses are beginning to accumulate.
However, an early offer may arrive before doctors know whether additional treatment, rehabilitation, surgery, or other care will be necessary. The long-term effect of an injury may also be unclear. Accepting a settlement generally requires signing a release that ends the claim. If additional complications develop afterward, you typically cannot return to the insurance company and request more money for the same claim.
Before accepting an offer, it is important to understand both your current losses and the potential future consequences of your injuries.
RELYING ON POLICY LIMITS, EXCLUSIONS, AND COVERAGE LANGUAGE
Insurance policies contain detailed provisions governing what is covered, how much coverage is available, and when exclusions may apply.
An insurance company may rely on policy language to dispute certain damages or limit the amount it believes should be paid. There may also be multiple insurance policies or sources of coverage involved in a serious accident. Determining available coverage can therefore be an important part of evaluating a personal injury claim.
HOW DO INSURANCE COMPANIES DETERMINE WHAT A PERSONAL INJURY CLAIM IS WORTH?
There is no single formula that determines the value of every personal injury claim.
Insurance companies typically evaluate several factors, including liability, available insurance coverage, medical expenses, lost income, the nature and severity of the injuries, and the likelihood of future treatment. Damages generally include both economic and non-economic losses.
Economic damages may include medical bills, rehabilitation expenses, lost wages, reduced earning capacity, and other measurable financial losses associated with an injury. Non-economic damages can include pain and suffering and the ways an injury affects a person’s daily activities and quality of life.
Insurance companies may use internal systems, formulas, prior claim data, and other methods when evaluating these losses. Those calculations, however, may not fully reflect the individual circumstances of an injured person’s life.
Understanding the complete impact of an injury is an important part of determining what compensation may be appropriate.
HOW CAN YOU PROTECT YOUR PERSONAL INJURY CLAIM?
What you do following an accident can affect both your recovery and your personal injury claim. Taking several basic steps can help preserve important evidence and reduce opportunities for an insurance company to challenge your case.
GET MEDICAL CARE AND FOLLOW YOUR TREATMENT PLAN
Seeking appropriate medical attention after an accident helps protect your health and creates documentation connecting your injuries and treatment to the incident. Follow your healthcare provider’s recommendations and attend scheduled appointments whenever possible. If treatment is interrupted, document the reason. Medical records can become some of the most important evidence in establishing the nature, extent, and duration of an injury.
USE CAUTION WHEN SPEAKING WITH INSURANCE COMPANIES
You should assume that statements made to an insurance company could become part of the claim file. Stick to the facts and avoid guessing about what happened, assigning fault without sufficient information, or minimizing symptoms that have not yet been fully evaluated.
You also do not have to navigate every conversation with an insurance company on your own. An attorney can communicate with insurers and adjusters on your behalf.
KEEP RECORDS OF EVERYTHING
Documentation can be critical in a personal injury case.
Keep copies of medical records, bills, prescriptions, receipts, insurance correspondence, employment records related to missed work, and other documents connected to the accident.
Photographs and videos of the accident scene, property damage, and visible injuries may also help preserve evidence that could otherwise disappear over time.
It can also be helpful to document how your injuries affect everyday activities, work, sleep, mobility, hobbies, and other aspects of your life.
THINK CAREFULLY BEFORE ACCEPTING A SETTLEMENT
The first offer is not necessarily the final value of a claim.
Before accepting a settlement, consider whether your medical treatment is complete, whether additional care may be necessary, whether you have missed or may continue to miss work, and whether your injuries could have lasting consequences.
A settlement should be evaluated based on the complete circumstances of the claim, not simply the immediate expenses following an accident.
KNOW WHAT YOUR CLAIM MAY INCLUDE
A personal injury claim can involve significantly more than medical bills.
Depending on the circumstances, compensation may address lost wages, diminished earning ability, future medical care, pain and suffering, and other losses resulting from an accident.
Understanding the different categories of damages that may apply can make it easier to evaluate whether an insurance company’s settlement offer reflects the full scope of the claim.
WHEN SHOULD YOU SPEAK WITH A PERSONAL INJURY ATTORNEY?
Not every insurance claim develops into a dispute, but some become complicated quickly.
An attorney may be particularly helpful when injuries are serious, responsibility for the accident is disputed, multiple parties or insurance policies are involved, an insurer denies coverage, settlement negotiations stall, or an important legal deadline is approaching.
A personal injury attorney can investigate the accident, preserve evidence, review insurance coverage, calculate damages, communicate with insurers, negotiate a potential resolution, and, when necessary, pursue the case through litigation.
TALK TO WOOLSEY MORCOM ABOUT YOUR PERSONAL INJURY CLAIM
If you have been injured in an accident and believe an insurance company is undervaluing, delaying, or disputing your claim, Woolsey Morcom can help you understand your options.
Our personal injury team represents injured individuals throughout Florida and works to hold insurance companies and responsible parties accountable for the losses their clients have suffered.
Every case is different. We take the time to understand what happened, how the injury has affected your life, and what may be necessary to pursue the compensation available under Florida law.
Contact Woolsey Morcom today to schedule a consultation and learn more about your legal options.
