It should not come as a surprise that your insurance company is not your friend when you are seeking compensation for the injuries you sustained in an accident. For the insurer, the accident victim represents a financial cost — one that it will seek to minimize.

This is not to say that claims representatives and insurance adjusters will deliberately delay or deny your claim. However, it is a simple and recognized fact there is a very significant imbalance of power and information between that which the insurer and the accident victim possesses. You, the accident victim or a loved one, simply do not have the time or the resources to be able to effectively advocate for yourself.

So, how do claims adjusters reduce the settlement amount you are owed?

What is a settlement?

A settlement is the resolution of a dispute arising out of contested insurance claims and personal injury lawsuits. Parties to the negotiation typically reach a settlement amount. It can be in the form of payments for a certain number of years to cover medical care and rehabilitation or a lump sum payment.

Just as you seek to receive the settlement amount you are owed, it is the job of insurance professionals to minimize it. Some ways this can be achieved is by:

  • Offering lower lump sum compensation
  • Using a reducing scale for monthly payments
  • Setting strict time limits on coverage
  • Downgrading the classification of your injuries
  • Using pressure tactics to coerce you into accepting reduced compensation

These are just some examples of how your settlement amount can be reduced. In this article we will discuss some tactics insurance companies employ, and mistakes accident victims make that lower their settlement amounts.

1. Being won over by friendliness

You are happiest when the insurance executive you are dealing with is friendly and helpful. After all, your claim is in their hands and you have to keep them happy, right? Interpersonal relationships are a part of processing and resolving insurance claims. However, if your insurer is very happy, that happiness may reflect the fact that the compensation you are being offered for your injuries is less than you deserve. Further, too many victims fear that if the relationship with the insurer sours or becomes contentious, their claim will be denied.

What you need to do: You should speak to a Toronto personal injury lawyer before you start your claim. If you do not know how much you are owed, how can you possibly fight for the ‘right’ amount? A strong legal team will provide you with an informed assessment of what your claim is worth. In addition, your lawyer’s objective is to maximize compensation; he or she is not interested in forming friendships with the insurer.

2. Not being aware of your rights

When accident victims, who are not experienced in or knowledgeable about seeking compensation for their injuries, must deal with insurance professionals, it is not a meeting of equal parties. The insurance representatives are far more experienced and knowledgeable about the process, and they will represent themselves as being authorities on how the process can and should be resolved. Consequently, they are apt to make pronouncements —“This is how it’s done”, “No, that’s not possible”— as matter-of-fact statements that cannot be contested. While the insurers like to give the impression that their views are written in stone, they are not. They are following a script, rather than citing scripture.

What you need to do: You have to ensure your injuries and the gravity of your condition is understood. If you feel the insurer is unfairly representing the nature of your injuries and their impact on your life, there is a high probability that your injuries and their impact are being unfairly assessed and represented. Make sure you have a knowledgeable insurance claim lawyer in Toronto to represent you at all insurance hearings.


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3. Minimizing the severity of your injuries

Unfortunately, all too often claims adjusters classify serious injuries as ‘minor’ and disablement as ‘non-catastrophic.’ The classification of your injuries directly impacts the compensation to which you are entitled, as well as the long-term payments for rehabilitation and medical care. By downgrading the severity of your injuries, the insurer can very easily deny you support for medical expenses and prevent you from receiving the necessary support for your long-term recovery. In fact, insurers are, in some cases, highly aggressive in challenging the legitimacy of victims’ injuries, employing surveillance tactics that involve invading victims’ privacy.

What you need to do: It is essential that your injuries are thoroughly examined, assessed, and documented. Oddly enough, it is not uncommon for pertinent medical reports to be ignored or forgotten when insurance calculations are made. You have to be clear about your injuries with your doctor. Putting on a brave face and bearing pain stoically may seem to be a ‘strong’ and admirable response. However, by doing so, the victim is inadvertently withholding important information that results in the insurers being provided with an incomplete medical record.

4. Requiring information irrelevant to your case

Don’t forget, an insurance claim is often a very contentious process. Insurers will try to minimize the amount of compensation you receive. This can include digging around to find information upon which the insurer will rely on reducing the compensation it pays. For example, the insurance company may duplicitously receive your consent to probe your entire medical history by having you sign innocuous looking insurance forms that provide it with the authority to delve into your personal life and more.

What you need to do: You need to carefully review every single document before you sign it. Consent forms, disclosure of information forms, and even discharge of liability forms can weaken or nullify your claim. Make sure you consult with your lawyers before signing or agreeing to anything from your insurer.

5. Using the promise of a quick settlement

When you or a loved one is in hospital and medical bills are mounting, the lure of a quick insurance settlement may prove to be too attractive to pass up. There have been many instances in which insurers have been able to exploit accident victims’ desperation and settle a claim for much less than what it is worth. Beware! The “quick fix,” that such settlements represent, does not serve your best interests. By settling prematurely, you may end up forfeiting significant sums that you will need to meet your ongoing medial expenses — compensation to which you are entitled.

What you need to do: You need a team of personal injury lawyers in Toronto who will guide you through the insurance process. We help our clients receive the accident benefits they require and to which they are entitled. Those payments will help tide you over in the immediate aftermath of the accident. Subsequently, our insurance claim lawyers will strategize ways to maximize your compensation.

It may be tempting to go for a quick and easy insurance settlement, but remember: doing so may well significantly diminish the compensation to which you are entitled. Wondering what the settlement offer should be that will compensate you adequately? Contact Pace Law Firm to discuss your claim.

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