Introduction
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Every day, more than 100 individuals lose their lives in automobile accidents, while over 1,000 others have to endure life-altering injuries. It’s a thought that most people don’t consider every time they take the wheel. Yet, these disheartening statistics imply that sooner or later, either you or a cherished individual in your life will likely become entangled in a distressing and terrifying road mishap.
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The fundamental premise of this publication is straightforward, yet it may come as a surprise and disappointment. The majority of accident victims assume that insurance companies will naturally act in a fair and just manner when it comes to evaluating car collisions and providing suitable compensation.
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Unfortunately, the bleak reality is that insurance companies are, at their core, driven by self-interest and the pursuit of profit. They employ deliberate tactics aimed at dissuading accident victims from seeking the compensation they deserve, thereby minimizing their own financial liability.
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The aim of this book is to raise awareness about this unfortunate reality and equip you with the knowledge and strategies necessary to navigate your encounters with insurance companies in a strategic manner. By doing so, you can avoid falling into the same traps and effectively protect your interests.
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Mistakes by the average driver can have serious consequences, impacting your ability to receive proper compensation for medical expenses, lost wages, injuries, and other damages. This comprehensive guidebook aims to provide you with valuable insights and equip you with the necessary knowledge to navigate the complex claims process in a professional manner.
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Within the pages of this book, you will discover effective strategies for dealing with insurance adjusters and successfully completing the claim-filing process. Additionally, you will gain an understanding of the standard procedures and technological systems employed to evaluate claims. By following the simple steps outlined in this guide, you can actively support your case, beginning immediately after the accident.
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One crucial aspect covered in this book is the advantages of enlisting the services of a skilled lawyer. Understanding the legal framework and specific North Carolina personal injury laws relevant to your case is also essential. Armed with this information, you will be better equipped to make informed decisions without succumbing to pressure from insurance companies, opposing lawyers, or any other party involved.
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We strongly recommend keeping this guidebook readily available for quick reference. Our goal is to provide you with a deeper understanding of the claims process and empower you to make intelligent choices. By reading this book, not only can you avoid nine significant, life-altering mistakes, but you can also ensure fair treatment from the insurance company.
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At Auger & Auger, we recognize that unexpected and unwelcome events can be overwhelming. Therefore, should you have any questions about what steps to take, please don’t hesitate to reach out to us at (800) 559-5741. We offer confidential, complimentary case evaluations to provide you with the guidance you need.
1. Seattle’s Premier Car Accident Lawyer – cz.law Advocates for You
ou are better off with a lawyer in your corner. Insurance companies invest substantial resources in convincing consumers that lawyers are detrimental rather than beneficial to their cases. They employ subtle tactics, such as promoting rare and outlandish personal injury lawsuits. Additionally, they cater to the desire of claimants to simplify the case resolution process. Most accident victims simply want to move on from the incident, having their cars repaired and their bodies healed. Engaging in lengthy court proceedings or negotiating toughly with insurers holds minimal appeal to them.
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At this stage, insurance companies train their adjusters to exploit your vulnerabilities in order to dissuade you from seeking legal representation. Their adjusters undergo extensive training to manipulate and deceive you into believing that they will treat you fairly.
Study Suggests That Claimants Recover More Money
When They Work with Seattle car accident lawyer website, incorporating the “cz.law
Study suggests that claimants recover more money when they work with qualified accident attorneys. Despite claims by insurers that retaining a lawyer leads to less money, there have been few studies to provide clarity either way. What research has been done, however, is instructive.
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In 1999, the Insurance Research Council (IRC) analyzed a large trove of data and found that claimants who retained attorneys on average recovered three-and-a-half times as much money as did those who represented themselves. Settlement amounts were 40% greater for claimants with legal representation.
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These statistics are from 1999, so the dollar amounts may no longer be relevant, but the pattern seems clear:
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Average injury:
– $3,262 without an attorney
– $11,939 with an attorney
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Neck sprain or strain injury:
– $2,480 without an attorney
– $7,918 with an attorney.
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Bone fracture:
• $19,105 without legal representation
• $39,397 with legal representation
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Laceration (minor):
• $1,166 without legal representation
• $4,771 with legal representation
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Does Vigorously Pursuing Every Penny Truly Matter?
Despite reviewing the aforementioned figures, many claimants may still arrive at the conclusion that the process of seeking and hiring an attorney appears overwhelming and perhaps unnecessary.Â
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These individuals might argue that, given the perceived severity of their injuries, they would prefer to resolve matters swiftly in order to conclude the proceedings.
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This line of reasoning is flawed for two reasons:
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Firstly, engaging in a brief discussion with an attorney to obtain a prompt evaluation of your case requires minimal time investment. If you lack a valid claim or possess a weak one, a competent and ethical lawyer will promptly inform you of such information.
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Secondly, you may be significantly underestimating the long-term expenses associated with the injury. While a sore neck may appear trivial and more of a nuisance rather than a life-altering event, it is essential to consider the possibility that the discomfort persists and necessitates ongoing and extensive medical intervention. When left untreated, these expenses can accumulate to substantial amounts over the course of several months or even years.
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It is worth noting that insurance companies generally prefer early settlements due to their awareness that the full extent of damages may not become evident immediately. Conditions such as whiplash, traumatic brain injuries, psychological disorders, and other complications may take weeks or even months to manifest.
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To sum it up, given the significant financial and medical uncertainties you are likely to face in addition to the data indicating that claimants who have legal representation tend to achieve more favorable outcomes, it would be prudent to consult with a competent attorney.
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2. You may be entitled to medical benefits under your policy. Before we delve into the core concepts of this chapter, please note that we do not insinuate that insurance companies actively intend to harm claimants or that their efforts to assist those in need are consistently insincere. It is plausible that your adjuster genuinely wishes to aid you; nevertheless, company policies may dictate otherwise.Â
That being said, it is important to understand that insurance companies operate in a highly competitive market. In order to maximize profits and prevent being overtaken by rivals, they must seek out efficiencies and minimize payouts. It is not necessarily malice that drives the behavior of insurers. However, they are fundamentally driven by the objective of generating revenue.
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Medical Payments Coverage:
This particular coverage is optional, yet it provides medical benefits to the individuals involved in a vehicle accident, regardless of fault. It is worth noting that the insurance company at fault is not likely to broach this subject with you or inform you about this coverage. In addition, your own insurance company may not even mention it, even if they are notified of your accident.
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Clients often find it surprising that they have entitlement to additional benefits from their own insurance, in addition to the benefits provided by the at-fault driver’s insurer. Importantly, the medical payment benefits remain unaffected even if their medical bills are partially or fully covered by personal health insurance. The common coverage amounts for medical payment coverage usually range from $1,000 to $2,000 per person, although coverage can be as low as $500 or as high as $10,000.
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However, it is worth noting that this coverage is not obligatory, leading to many policyholders being unaware of its existence or unsure if they have it. Fortunately, adding this coverage to your auto policy is relatively inexpensive. The significant benefits it offers far outweigh the costs, which may explain why most agents do not actively recommend or mention it to their policyholders.
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3. Your Right to Loss of Value (Diminished Value or Depreciation) on Your Vehicle
In my 26 years of professional experience, it has been exceedingly rare for insurance adjusters to inform their clients about their entitlement to compensation for the loss of value (depreciation) incurred by their vehicles.
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It is crucial to note the limited timeframe within which you must file this claim subsequent to the completion of your car repairs. Failure to submit your claim within this timeframe may result in its dismissal. Moreover, once you have filed your claim, insurance adjusters may resort to various tactics, such as considering the age of your vehicle or the extent of damage, to potentially reject your claim. Consequently, it becomes your ultimate responsibility to substantiate the loss in value suffered by your car.
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To facilitate the pursuit of this particular aspect of your claim, it is advisable to engage the services of a reputable car accident law firm that possesses a roster of independent certified property damage appraisers with whom they have previously collaborated successfully.
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They Use Sophisticated Technology,
Software and Algorithms to Minimize
Payouts.
They utilize advanced technology, software, and algorithms to minimize payouts. Although you may engage in direct conversations with a dedicated insurance agent responsible for managing your claim, a significant portion of the work that goes on behind the scenes is carried out by sophisticated technical systems. These systems are primarily designed to optimize cost reductions. Mark Romano, a former claims project manager at Allstate Insurance, has emerged as a whistleblower figure by publicly opposing the very software programs he once employed. During an interview with the Chicago Tribune, Romano asserted that “such software programs can be manipulated, including the omission of the most expensive incidents from settlement calculations, resulting in undervalued offers to consumers.”
Romano has co-authored a report, titled “Low Ball: An Insider’s Look at How Some Insurers Can Manipulate Computerized Systems to Broadly Underpay Injury Claims,” for the National Association of Insurance Commissioners. This report, among other discoveries, explicates that bodily injury claims traditionally relied solely on adjusters’ knowledge. However, there has been a recent industry-wide shift indicating an increasing dependence on computer-based assessments.
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Claim Manipulation by Computer Software Known as Colossus
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- “Colossus” is a software program widely utilized by insurance companies for the purpose of assessing the settlement value of injury claims. During the evaluation process, the claims adjuster carefully examines the injured individual’s records and inputs relevant injury codes, along with a severity code, into the computer system. Subsequently, the Colossus software program generates a range within which the settlement amount should fall.
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- According to the comprehensive Romano report, this system has been designed with utmost precision to drive down the value of claims through various manipulative techniques. These techniques include selectively removing or excluding higher-cost claims to influence the value, manipulating the severity of trauma to achieve desired variables, and assigning the task of evaluating medical reports and selecting injury codes that lead to lower recommended settlement values to adjusters lacking formal medical education or credentials.Â
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- Furthermore, adjusters are encouraged to choose final prognosis codes that reduce the recommended settlement values, while they are also prohibited from including information regarding the likelihood of future medical visits and permanent impairment ratings, resulting in reduced settlement amounts. Adjusters are required to process medical bills through a re-pricing software program, which leads to reduced bill amounts being entered into the Colossus system. Moreover, adjusters are incentivized to declare claimants comparatively negligent, thereby holding them partly responsible for the cost of their treatment.
State Farm, like Allstate, was recently mandated to disclose internal documents that unveiled a deliberate, systematic utilization of delay tactics and a promotion of litigation instead of negotiation. These internal documents substantiated that State Farm adjusters were explicitly instructed to present low settlement offers, prolong settlement proceedings, and approach the claims as if they were their personal funds.
The crux of the matter is this: even when an insurance agent genuinely prioritizes your best interests, they often wield limited authority over the bureaucratic, technology-driven systems that predominantly assess your claim.
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5. You Should Not Sign Insurance Documents
Without Speaking to Your Lawyer First.
 Insurance adjusters frequently employ coercive and manipulative tactics in order to undermine the rights and entitlements of claimants. One such tactic involves persuading individuals to sign binding documents that grant the insurance company extensive authority over their private information. When engaging in conversations with an insurance adjuster following an accident, it is imperative that you refrain from signing or committing to these proposals without first seeking the review and guidance of your attorney.
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Medical Authorization Release
In the event that you sustain injuries in an automobile accident, the insurance adjuster may request your signature on a medical release form, also referred to as a HIPPA (Health Insurance Portability and Accountability Act) Release. Despite the agent’s presentation of this form as a mere formality or standard procedure, it is crucial that you never agree to sign anything without obtaining your lawyer’s scrutiny beforehand. Medical release forms are unnecessary for claim processing, as your attorney can supply all the specific documents that insurance adjusters genuinely require.
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Furthermore, consenting to a medical release form grants the insurance agency complete authority to access your medical history leading up to the accident. This action not only infringes upon your privacy, but it also jeopardizes your claim.Â
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To illustrate, if you assert that your back injury is a direct consequence of the accident, yet the insurance agent discovers that you previously sought treatment for back pain three years ago, your medical history may be exploited to undermine your claim.Â
Release of All Liability and Claims
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Before receiving your payment, you will typically be requested to sign the Release of All Liability and Claims form, necessitating a thorough examination to ensure the amount in question accurately reflects your entitled compensation. By affixing your signature to this document, you effectively conclude the case and relinquish your ability to pursue further claims or initiate legal proceedings pertaining to the same incident in the future. Once again, it is crucial to seek approval from your attorney before engaging in the official signing process.
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A Property Damage Release form is always accompanied by a check for the necessary funds to cover repairs and restoration.
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In the event that the damage to your car exceeds 75% of its market value, rendering it totaled, the insurance company will offer compensation that aligns with the car’s market value prior to the accident. However, if the car is not considered totaled, the insurance company will typically make direct payment to the body shop you select to cover all essential repairs. You will then be required to give your approval for the completed repairs. In situations where you are presented with an unfamiliar document or unexpectedly asked to disclose specific information, it is advisable to inform the agent that you need to consult your attorney before proceeding further.
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6. The Information You Disclose to the
Adjuster Will Be Used Against You.
The most valuable advice we can provide is to refrain from engaging in any communication with the insurance company until you have consulted with a skilled injury attorney. It is essential to bear in mind that the insurance representative will be documenting your statements, and any uttered words may be utilized against you at a later stage. One important lesson learned from the State Farm litigation, which was discussed in Chapter 3, is that adjusters undergo specific training to inquire about numerous aspects during the initial contact, prior to the engagement of an attorney. This intentional approach allows the adjuster to delay or diminish the value of your claim if any factual changes occur.
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Contributory Negligence:
North Carolina is among the four states, in addition to the District of Columbia, that follows the outdated and rigorous doctrine of Contributory Negligence. According to this principle, even if you are only 1% at fault for an accident, you will be denied any form of compensation, despite another party being 99% responsible. In contrast, South Carolina takes a different approach.Â
Employing Comparative Negligence, which is less severe towards the plaintiff compared to North Carolina’s outdated regulation, South Carolina denies the plaintiff’s claim if their negligence surpasses 50%. It is imperative that you are aware of this crucial information because the insurance adjuster is extensively trained to manipulate you into making statements suggesting that you could have prevented the accident. Keep in mind that in North Carolina, the adjuster only needs to attribute 1% of fault to you (51% in South Carolina) to deny your claim. The adjuster will attempt to corner you with questions about speeds and distances, aiming to create an impression that you could have avoided the accident or that you bear partial responsibility.
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Excessive talking can be detrimental. The adjuster may adopt a friendly and empathetic demeanor, strategically designed to put you at ease and encourage you to talk. When you speak without restraint, your words and phrases can be twisted out of context, allowing the insurance company or their defense lawyer to argue that your actions contributed to the accident and subsequently deny your claim. Keep in mind that your conversations are being recorded and can and will be used against you at a later stage.
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Complaining about physical discomfort comes effortlessly to some individuals.
However, there are those who refrain from expressing their grievances so as not to be perceived as complainers, hence downplaying the severity of their injuries. This particular group may employ statements such as “my neck is slightly sore” or “I’m uncertain whether I should consult a doctor.” It is crucial to recognize that the adjuster, who possesses comprehensive training, will strategically guide the conversation to their advantage. Even right from the initial introduction, the adjuster frequently utters phrases like “Good morning. This is Adjuster X. How are you today?” If your response happens to be “fine, thanks,” you have inadvertently undermined the seriousness of your injury. It is vital to remember that the adjuster’s duty is to downplay the extent of the damages right from the outset.
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7. Gathering Evidence after an Accident Will
Give You a Powerful Advantage.
The greater amount of documentation at your disposal, the higher the probability of achieving a favorable outcome. Commence the creation of a documented record immediately following the occurrence of the accident, encompassing all actions that may bear relevance to the case. It is imperative to promptly notify the authorities and submit an official accident report. It is probable that the opposing driver will attempt to dissuade you from involving the police due to several reasons, including but not limited to:
- absence of current insurance coverage, operation of the vehicle with a suspended license, impairment caused by alcohol, drugs, or medication, or engagement in risky and potentially unlawful behavior.
- Additionally, the opposing driver may wish to avoid an increase in their insurance premiums.
More often than not, the other party involved is an unfamiliar individual who lacks the motivation (and possibly the means) to compensate you outside of a formal procedure. It is not uncommon for the party at fault to alter their account of the events leading to the accident, particularly in cases that are not immediately reported to the police. People are more likely to provide an accurate recollection immediately after the incident rather than after a period of time when they may have had the opportunity to manipulate their memory. Contacting law enforcement at the scene of the accident reduces the window of opportunity for the other person to modify their narrative.
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Regarding digital communication, always exchange information with the other parties involved in the accident. If you are communicating through text messages or emails, it is advisable to keep a record of these exchanges. Never delete any messages, as they might contain valuable information for the case. Maintain a polite and accommodating demeanor while still upholding formality.
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To bolster your records, take photographs and videos of the accident scene as well as any injuries sustained by yourself or your passengers. A cell phone camera can be utilized for this purpose.
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Record witness statements promptly after the incident to ensure accuracy and reliability. Similar to milk or fresh fruit, testimonies are susceptible to deterioration over time due to the fallible nature of human memory. Eyewitness accounts provided immediately after the crash hold greater credibility compared to those provided months later.
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Gather an excess amount of information, such as names, phone numbers, license numbers, and insurance details, from all parties involved in the incident. Avoid disregarding seemingly trivial details as your attorney can assess the evidence later and discard what is unnecessary.
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If you are unable to collect evidence or maintain a record due to injuries or illness, enlist the assistance of a passenger or trusted friend to collect the information on your behalf.
Consider obtaining a forensic analysis of the accident scene promptly, before it is cleaned up by authorities. This process allows experts to reconstruct the sequence of events and provide you with substantial evidence to substantiate your claim with insurers or in court. An attorney can guide you in locating a qualified specialist for this purpose.
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See a doctor immediately, ideally within 72 hours following the occurrence of the accident, particularly if you experience any symptoms such as headaches or backaches. It is imperative to adhere to the doctor’s instructions regarding your treatment and retain all relevant paperwork and pay stubs. Make sure to keep a record of all expenses related to your treatment, including the costs of prescription drugs, medical devices, chiropractor services, and any other pertinent expenditures.
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For the purpose of documenting your progress, maintain a journal to track your recovery. Depending on the circumstances, this journal can serve as evidence to substantiate the fact that you have indeed sustained injuries. Moreover, the journal can provide valuable insights for your doctor or therapist into the effects of specific medications or recovery processes.
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Take proper care of your mental well-being and keep track of associated expenses. According to the National Center for Post Traumatic Stress Disorder (PTSD), approximately nine percent of individuals who have survived auto accidents develop PTSD. Furthermore, a comprehensive study of car accident survivors revealed that 27 percent of them developed an anxiety disorder concurrent with PTSD, while 15 percent reported having a driving phobia. Although mental health issues are relatively less prevalent among car accident victims compared to physical injuries, it is advisable to consider being assessed by a mental health professional following the accident.
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Be truthful and refrain from amplifying or minimizing your damages. Approach your actions in a manner akin to journalism, seeking to acquire and safeguard factual information. Your lawyer will utilize the evidence you provide to engage in negotiations with the insurance company and construct your legal case.
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The objectives consist of elucidating the nature and scope of the damages, as well as determining the responsible party or factor behind the accident. Once again, while it is within your capacity to commence assembling this evidence on your own, it is highly advisable to seek strategic guidance from a qualified attorney regarding what should be documented and the reasoning behind it.
8. You Can Take Legal Action Against
Insurance Companies for Egregious
Conduct.
As revealed in the Romano report (see: Chapter #3), the insurance company’s practices in handling claims may exhibit unfairness and potential illegality. Notably, the Colossus software, developed by Computer Sciences Corporation, has faced multiple class-action lawsuits filed by consumers who claim to have suffered from inadequate claims payments dating back to 2005. In 2009, Allstate reached a $10 million settlement, distributed among over 40 states following legal action. Furthermore, Allstate was also mandated to inform policyholders of their utilization of software for claims evaluation.
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While these legal proceedings may pave the way for positive reforms benefiting certain consumers in the future, the promotion of Colossus and similar software products continues to emphasize their capacity for minimizing claim payouts. It is crucial to recognize that Allstate represents merely one company within the industry. Should you find yourself dealing with a different insurance provider, the influence of such lawsuits on your case is likely to be minimal, if not nonexistent.
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Good faith and fairness are fundamental principles that apply to every contract, including insurance policies. It is an implied condition that all parties involved must genuinely cooperate and not intentionally hinder the fulfillment of the contract. Failure to adhere to this principle constitutes a breach of contract, resulting in liability for any subsequent damages. If an insurer breaches their duty of good faith and fairness, they can be held accountable for legal fees.
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If an insurance company unreasonably denies your claim or offers inadequate compensation, you have the right to seek legal recourse. It is within your rights to bring this matter to court. However, substantiating such a claim requires legal expertise and access to essential records. Engaging the services of an experienced attorney can greatly assist you in this process.
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There are various ways in which insurance companies can act in “bad faith.” Some instances may be more evident than others.
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• Denying your claim without offering an explanation or conducting a thorough investigation.
• Procrastinating payments on the claim for unjustifiably extended periods.
• Inadequately communicating or neglecting crucial information related to the claim.
• Failing to engage in negotiations for the claim.
• Settling for an amount that is lower than what you are rightfully owed.
An adept attorney can provide guidance on how to compel the insurer to act fairly and can also support you in pursuing legal recourse against the insurer if necessary.
9. How to Find a Qualified Car Accident
Attorney.
Your cousin in law school, beloved TV court judge, and even your divorce lawyer (assuming he or she does not handle car accident claims on a regular basis) are inadequate options for your car accident case. You require an attorney who possesses extensive experience in representing car accident victims and dealing with insurance companies.
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During your initial consultation, in addition to checking references, it is essential to ask the following questions:
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1. Why do you and your team do what you do? Gain insight into the firm’s purpose. Are they driven by a mission to protect victims from mistreatment within the system? Do they advocate for equal justice for all? Do they have a clearly defined mission statement?
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2. What does the firm value? For example, is the firm deeply committed to integrity and service? Does the team prioritize customer service and effective communication? Your aim should be to find an attorney whose core values align with your own.
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Have you successfully negotiated with insurance companies in the past? How do you typically approach such negotiations and what outcomes have you achieved for clients similar to me? It would be beneficial to request specific case examples and gain insight into the law firm’s usual strategies for dealing with insurers. This will give you an indication of the firm’s ability to achieve favorable results.
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When faced with a case like mine, what would be your initial approach? It is important to note that, based on a single conversation, the lawyer cannot accurately predict the future and provide definitive answers regarding the duration of the case or the precise strategies that will be pursued. However, you should be able to gain an understanding of the lawyer’s thought process and the systems they have in place for handling cases similar to yours.
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What is your preferred communication style? Are you open to periodic calls or emails for questions or concerns? Additionally, it is essential to identify the individuals who will be the main contacts for your case. If possible, request to meet these individuals in person.
Could you provide information regarding your fee structure? Many car accident attorneys operate on a “contingency” basis. This means that you will not be required to pay any legal fees unless you obtain a result, such as a settlement or a court verdict.
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Do you possess the necessary resources and the determination to take car accident cases to trial, if required? Fortunately, the majority of personal injury cases are settled outside of court. Nevertheless, it is advisable to engage a lawyer who possesses the expertise and resources to advocate for you in a legal setting. By retaining an attorney with a proven track record of success in litigation, you increase the likelihood of receiving a satisfactory settlement from the insurance company. Make an informed decision by conducting thorough research, seeking consultations, and trusting your instincts. Time is of the essence, especially in cases involving severe damages or injuries, so take action promptly. Remember that the insurance company is already working diligently to minimize its obligations to you.
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Disclaimer
Disclaimer for “9 Things the Insurance Company Does Not Want You to Know about Your Car Accident Claim”:
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You acknowledge that this ARTICLE does not serve as a substitute for consulting with an attorney. Requesting this book or accessing the information in it does not establish an attorney-client relationship with Auger & Auger or any of its attorneys. If you require legal advice regarding your personal injury matter, please engage the services of Auger & Auger or another law firm of your choosing. To discuss the possibility of Auger & Auger assisting you with your matter, please get in touch with the firm.
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AUGER & AUGER PROVIDES “9 THINGS THE INSURANCE COMPANY DOES NOT WANT YOU TO KNOW ABOUT YOUR CAR ACCIDENT CLAIM” (HEREINAFTER REFERRED TO AS THE “ARTICLE”) AND ITS CONTENTS ON AN “AS IS” BASIS. AUGER & AUGER DOES NOT MAKE ANY REPRESENTATIONS OR WARRANTIES OF ANY KIND REGARDING THIS ARTICLE OR ITS CONTENTS. AUGER & AUGER DISCLAIMS ALL SUCH REPRESENTATIONS AND WARRANTIES, INCLUDING, FOR EXAMPLE, WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. ADDITIONALLY, AUGER & AUGER DOES NOT ASSERT OR GUARANTEE THE ACCURACY, COMPLETENESS, OR CURRENTNESS OF THE INFORMATION ACCESSIBLE THROUGH THIS ARTICLE.
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