In the opening text we touched on a form of "perverted logic" that occasionally seems to be an underlying factor when consumers are involved in dealings with the other party's insurance company. That perverted logic manifests itself when the other party's insurance company is rude and indifferent to you . . . almost as though they are trying to drive you to an attorney. Well guess what . . . THEY ARE! Let me take a stab at trying to explain why. First of all, if you take this abuse you will wind up settling cheap and the insurance company saves money. If you go to an unqualified attorney, there is a better than average chance they will be able to force a cheap settlement on you through that attorney. Again, the insurance company saves money. If you get a qualified attorney they will have to pay full value to settle your claim. Even then, there is benefit for the insurance company AND the insurance industry in general. Every couple of years the insurance industry tries to push some type of Insurance Reform Bill through the Legislature. When they do, they point out how many consumers hire attorneys to help them resolve their claims and it is these "greedy" attorneys that are driving up the cost of auto insurance. The insurance industry points their collective finger at personal injury attorneys as being the reason why insurance companies keep raising their auto insurance premium rates. Have you ever noticed that when you are pointing your finger (your index finger) at somebody else . . . you have at least three (3) more fingers pointing right back at YOU! Well, the same rule holds true when insurance companies try to blame rising auto insurance premiums on personal injury attorneys.
When insurance industry lobbyists fund campaigns, vacations and employment opportunities, they can usually find legislators with attentive EARS! Then, when the insurance industry tells their story, Bills start getting submitted to the Legislature. That's when consumers, YOU and I, have a problem! When the insurance industry is pushing for Insurance Reform Legislation, you can bet they're not doing it to benefit consumers.
Now, do you see the logic in having insurance companies "drive" consumers to seek the help of an attorney? We could go on and on discussing the uncontrolled and unwarranted increases in auto insurance premiums and the ways in which the auto insurance industry manipulates the truth in an effort to deprive consumers of their rights, but then, that is a separate matter that we will be addressing later on as this web site grows and expands.
The recorded statement: Most insurance companies have now gone to the practice of having their adjusters tape record their phone conversations with you. By rights, the adjuster should let you know when your conversation is being recorded. There are multiple reasons for recording these conversations:
1. The Adjuster needs to make a record of the facts related to how the loss occurred. This will become a permanent part of their claim file. You will be asked to provide self-identifying information, such as your full name, date-of-birth, place of birth, Driver's License # and Social Security #. With this information, the insurance company will probably order a C.L.U.E. (Claims Loss Underwriting Experience) Report and/or an Index Report. The C.L.U.E. Report will tell the insurance company of any claims you may have submitted to your own insurance company(s) in the past. The Index Report will reveal any prior claims you may have submitted for a Personal Injury Claim. The insurance company wants to know about your prior insurance claims experiences which could impugn your honesty.
2. By asking key questions about the circumstances of the loss, you may admit to something that would allow the insurance company to either deny your claim or substantially reduce the benefits you receive.
3. The insurance company will want you to be as detailed as possible in the recorded statement. Months later, when your memory may have faded, you may be called upon to once again answer the same set of questions. If you do not answer these questions exactly as you did in the recorded statement, the insurance company may try to make you look dishonest.
It is simply not practical to assume you will be able to avoid providing a statement to the insurance company. If you are dealing with your own insurance company, your cooperation is required by the policy. If you are dealing with the other party's insurance company, the Rules of Civil Procedure give them the right to interview and Examine you.
Since you are probably not going to be able to avoid giving a statement, the next best thing is to be prepared for the statement. If you are dealing with the other party's insurance company, as with a Personal Injury Claim, we strongly suggest to provide your statement in the company of (and with the guidance of) your own attorney. If you are providing your statement without counsel, we suggest you review the following guidelines:
1. Answer the questions asked as briefly as possible without going into extemporaneous detail.
2. Unless you are 100% sure of the exactness of your answer, qualify you answer(s) with terms like "about", "approximately", or "as best as I can recall", etc. Or, if you do not know the answer to a questions . . . simply say so!
3. Avoid being specific as it relates to speed, time and distance. It is a simple matter of mathematics to take two of these factors and calculate the third. If you are specific in any of these two factors and you are wrong, then a wrong conclusion could be reached which could work against you. Believe me, insurance companies have "helped" other people shoot themselves in their own foot before. You would not be the first. Even honest people can become entrapped into a compromising position. If your insurance claim involves a "significant loss" - SEEK PROFESSIONAL COUNSEL BEFORE GIVING A STATEMENT !
The Wage and Medical Authorization: If you have a Personal Injury Claim pending with either the other party's insurance company or your own insurance company (Uninsured Motorist, Underinsured Motorist or Med-Pay Coverage), you will probably be asked to sign a "Wage and Medical Authorization" form. As nobody is supposed to be able to access your medical and/or employment records without your permission, it seems reasonable to sign this form. WARNING: By signing this form, you are usually allowing the insurance company to go on a "fishing expedition" in search of any reason to not pay all or any part of your claim. If your claim is with your own insurance company you have an "obligation to cooperate", as specified in your Insurance Policy Contract. However, cooperation can be achieved without giving carte blanche to your insurance company. It is usually better to provide an authorization with limitations as to scope of access. A good Personal Injury Attorney will know how to limit this authorization, so as to protect your rights and limit what records your insurance company can access. If your claim is against the other party's insurance company, you have no obligation to provide a wage and medical authorization to them. You will have to provide them with legitimate information upon which they can base their evaluation of your Personal Injury Claim. However, by having that information come through you or your Personal Injury Attorney, you are able to address any potential problems before they can be distorted and used against you. It is always best to be able to work with the insurance company. It is never prudent to surrender control of your claim to the insurance company. As is often the case, we recommend that you SEEK PROFESSIONAL COUNSEL BEFORE GIVING AN AUTHORIZATION!
This portion of "Understanding Adjusting Techniques" primarily addresses Personal Injury Claims. After all, that is the topic of this page. Other adjusting techniques involving Auto Damage, Rental Reimbursement and Medical Claims are also discussed within this page and within other pages of this Web site. We suggest you take the time to read ALL of the text in ALL the Consumer Tips / FAQs pages. Only good things can come from being an informed consumer!
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