Four Excuses Insurance Adjusters Use To Not Pay

Four Excuses Insurance Adjusters Use To Not Pay

“Insurance companies don’t want to pay claims. The business model of an insurance company is simple: take in more money than they pay out.  So they hire people called adjusters that are rewarded for finding reasons not to pay claims. These reasons usually make no sense in the real world. However, the insurance world is so large, and the insurance companies are so big, that they can literally shape the way people think about personal injury lawsuits and claims. Here are some examples of excuses that insurance adjusters use:

1.  Gap in Treatment – Insurance companies constantly measure how long it takes to get to a doctor, or how long between visits to a doctor, and have created a term of their own, called “gap in treatment.”  Adjusters will say “there was a gap in treatment, so we reduced our valuation.” The thought process here is that if you were really hurt, you’d be sitting in a doctor’s office all day every day. Which brings us to our next example:

2.  Overtreatment – Even if a doctor recommends physical therapy for a certain amount of time, adjusters will still consider more than x number of weeks of treatment to be “overtreatment.” No matter how different we all are, no matter how old or young, regardless of our medical history, adjusters typically apply some sort of “one size fits all” approach to medical treatment based on the next example:

3.  Low Property Damage – This is mostly based on what the adjuster sees in a picture. If you have a lot of damage to your car, then they will just ignore it and look for other excuses. If your car held up pretty well despite the wreck, then that’s all the adjuster will talk about. Things like, “well property damage was minimal, we feel you overtreated, so we reduced our offer” are often said when the car only has a dent in the bumper.  

4.  Not Accepting 100% Liability – when all else fails, then the adjuster will find something that you did wrong to be able to reduce the offer. Even if the other guy ran a red light and t-boned you when you had a green light, the adjuster will say, “you had a duty to enter the intersection cautiously, so we only accepted 90%.”  What this means is they will offer 90% of whatever they decided the claim is worth.

Fight them! Fight them at every turn.  Don’t give an inch. Call them out on their hypocrisy!  And if they don’t budge, file suit! Insurance companies ultimately don’t decide cases – juries do. And juries are made up of regular people. People that know we all put off going to the doctor even when we are in pain. People that know we do what our doctor tells us because we want to get better. People that know you can be fine when the car is demolished, and hurt when the car has a few dents. People that know running a red light or rear-ending another person is negligent! The answer is to fight.” 

Call 214-414-3808 today if you need an insurance claim attorney in Dallas to fight for you. Attorney Zach Herbert is a Marine Veteran who loves fighting for his clients. Don’t hesitate to schedule a consultation with Herbert & Eberstein LLC to discuss your case.” Source


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Dallas Insurance Claims Lawyer Zachary Herbert

(T): 214-414-3808