If you have health insurance coverage, consider yourself fortunate, but, be warned that you may be in for some unpleasant surprises should you ever need to file a claim for health benefits. Insurance companies have been known to refuse to pay on claims for a long enough time that the injured person gets too tired to continue, can’t afford to continue, and in some cases, passes away. Unfortunately, the same holds true for car insurance. Typically, people who are injured in car crashes or car accidents have to make a claim against an insurance company to cover their medical bills, pain and suffering, lost wages from work. If you have to make a claim against your own insurance company (called a UM (uninsured motorist) claim or a UIM (underinsured motorist) claim) or even a claim against the other driver’s insurance company, be prepared. If you do not know your rights, you may be taken advantage of.

Many people shy away from seeking the help of an attorney, don’t understand the process or simply don’t know what to do. But the importance of a knowledgeable attorney who is good at representing the injured will help get you past these delay tactics. Delay tactics that the insurance companies have put up in the hopes that you are afraid, confused and eventually do give up.

Some of America’s most well-known insurance companies have been known to deny claims, delay payments and confuse consumers with insurance-speak.

Delay, Deny and Defend

In 2008, the American Association for Justice (AAJ) released a report titled: “Tricks of the Trade: How Insurance Companies Deny, Delay, Confuse and Refuse,” which described some of the most egregious ways the insurance industry puts profits over people.

Delay – Many claimants are ill or elderly and to delay is to deny. According to the AAJ, insurance companies have locked up the paperwork indefinitely. The result, the person gives up or dies.

Deny – Big insurers such as State Farm and Allstate deny claims to consumers while rewarding employees for denying the claims. The result people will just let it go out of frustration, confusion or illness.

Defend – The insurance company forces the insured to go to court to defend their case and things get dragged out while expenses surge. This is really just another way they are denying and delaying the claim. But don’t give up!

What You Can Do

Start by carefully reviewing your insurance policy. Be sure to understand what is and what isn’t covered. They are counting on consumers to be confused and many times when they are, they fail to act. If you don’t understand, don’t be afraid to ask questions.

If it is a health insurance claim, know the appeal process (or contact someone who does) if you are denied.

Regarding your own car insurance, check and double check all information contained on your insurance forms is correct. A simple error may serve as basis for the insurer to cancel the policy. Don’t make it that easy for them.

If you’ve been canceled and receive a check, don’t cash it. Doing so may send the message that you are accepting of their offer.

Keep records of all correspondence and bills. Everything should be documented including the name of the company representative, the date and what was discussed.

If you get stuck, call your state insurance department. While they can’t represent you in a private matter, they can still assist you and point you in the right direction.

Lastly and most importantly, don’t give up! Seek assistance from an experienced injury attorney who can help you understand and forge ahead. Stand up for yourself. Don’t let the insurance company bully you into thinking your case is worth less – that you are worth less. You aren’t.

*Previously posted on The Legal Examiner, November 18, 2011


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