How Do Denver Insurance Companies Investigate Claims?
How Do Denver Insurance Companies Investigate Claims?

How Do Denver Insurance Companies Investigate Claims?

Have you ever thought about how Denver insurance companies come to a conclusion on how much they decide to pay?
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Have you ever thought about how insurance companies come to a conclusion on how much they decide to pay?

Imagine you’ve just been injured in a car accident that was caused by a negligent driver. Now, not only are you injured and out of work, but you also have to think about filing an insurance claim. That means you’ll have insurance adjusters contacting you to talk about the accident so they can conduct their own investigation into the accident.

The Most Important Piece of Information to Remember: Insurance Adjusters Are Biased

Once you file an insurance claim, insurance companies will assign an insurance adjuster to your claim to launch an official investigation. What you need to know as an injury victim is that they are biased – meaning, they’re not impartial to your claim. Their job is in fact to keep the insurance company’s liability to a minimum, which means they will investigate to find ways to protect their policyholder.

As such, when you file an insurance claim, you can expect insurance companies to conduct investigations that will help limit the amount they owe you. As in, they’ll look for evidence to minimize your financial recovery and reduce their liabilities. One of the ways they do this is by trying to use your own statements against you or find inconsistencies in your story, as opposed to just looking at the facts.

How Do Denver Insurance Companies Make a Determination of Liability?

The insurance company’s representative, or adjuster will evaluate the accident. More often than not, this investigation is their way to find some fault in another party, be it the injury victim or a third party. In doing so, they minimize their own liabilities and how much they have to pay.

As your Denver personal injury lawyers, we may pursue different types of insurance through the at-fault party, depending on how the accident or injuries occurred. For example, in a car accident, we would pursue auto insurance, or homeowner’s insurance for a dog bite injury.

Even if it’s pretty clear and obvious that the crash wasn’t your fault the insurance company will try and find a way to reduce their liability. Let’s say you get hit by a drunk driver; obviously the drunk driver is fully liable and at fault for the accident. But the insurance company will find a way to turn this around and say you contributed fault somehow.

After the accident, you can expect them to call you and ask questions and even request a recorded statement. You are not obligated to give one, so don’t fall into this trap – it’s okay to say you’d rather have them contact your attorney. They may even do some digging into your driving history to see if you have anything on your record to use against you and even go as far as looking into your social media.

The Job of Insurance Adjusters Is to Minimize Your Claim Payout

As we’ve explained, insurance company claims adjusters operate with the objective of protecting their company and their bottom line. The more serious your injuries are, the more financial compensation you’ll be entitled to, which means they’ll fight harder to limit their liability and financial losses.

Here are some ways the insurance company will try to minimize, deny, or delay your claim:

  • They may do background checks to find incriminating or negative information about the injury victim
  • They often search your social media to look for any contradictory information to the statements you’ve given them. For example, if you claim that you have severe neck injury but you post pictures of yourself outdoors doing physical activities, they will definitely argue the credibility of your claim.
  • They try to talk to witnesses, friends, neighbors, and even your family members to get information that disagrees with your claim
  • Unfortunately, sometimes, they even go as far as waiting to catch you in moments where you aren’t using your crutches, or other information that will downplay your injuries, like skipping doctors appointments or simply living your life.

With all this in mind, you need to move strategically too if you want to get the most out of your personal injury claim and walk away with fair compensation. To really make smart moves and avoid giving the insurance company information that will give them a reason to deflect liability, you need to hire a Denver personal injury lawyer.

They can help you avoid making mistakes when dealing with insurance companies and understand the insurance companies tactics to get out of paying you the full amount you deserve. An attorney will help strengthen your case and protect your rights.

Breaking It Down: Here’s How Insurance Companies Investigate Claims

They Will Try to Obtain Your Medical Records

The insurance company might try to get copies of your medical records to really get all the details of your injury or even see if you have a pre-existing condition.

Doctors are not legally allowed under Colorado law to release your medical records to anyone, including insurance companies, without your written consent. If the insurance company gets a hold of your medical records, this could significantly hurt your case. Here’s why. They might look at your complete medical history and find that you have a history of injuries or medical conditions – that are completely unrelated to the accident. They will then use your medical history to weave a story that your current injuries have nothing to do with the accident. This is why the insurance company should have limited access to your medical records and only get specific accident-related injury documentation. This will help ensure that the treatment plan, medications, injury details, and costs related to all the medical care are only related to the accident.

Any pre-existing condition or medical condition that the insurance finds can hurt your claim and give them an excuse to pay you less. What they’ll do is argue that your injuries already existed and weren’t actually caused by the accident. As a result, they’ll want to pay less than what you actually need to cover your medical expenses related to the accident.

Never sign any documents or agree to release your medical records, as clearly this can jeopardize your claim. Instead, if you’re unsure about how to proceed or respond to an insurance adjuster’s request, simply redirect them to your attorney or say you’d rather have your attorney present while communicating with them.

They’ll Try to Get Recorded Statements From Witnesses

Insurance companies love to record statements. This gives them the opportunity to find discrepancies between what one person has testified and another person has testified, or even within one person’s story.

Proceed with caution when speaking to insurance companies, especially if you agree to give a recorded statement (for the record, you are not legally obligated to do so). Better yet, don’t give a recorded statement without your attorney present, as they truly have your best interests in mind (unlike the insurance adjuster).

They Will Gather Evidence to Rebut Your Claim

The insurance investigator will look over all of the evidence, including police reports, witness statements, your claims, and damage assessment. Since Colorado follows at-fault laws, it’s important to determine fault before assessing the severity of damages. You need to identify which parties will be paying for your damages before calculating them.

They Will Look For Evidence to Undermine the Severity of Your Injuries

To reiterate, the insurance company is looking for evidence related to your injuries, to diminish them. From medical bills to records and other documentation, they will investigate with partiality to their own company’s assets. What they really don’t want is to pay for any long-term or ongoing medical costs so if you think you have an injury that requires long-term treatment, be sure to get prompt medical care and track all of your medical records diligently.

This is why you need to work to devise a strategic winning plan with a skilled Denver personal injury lawyer.

Insurance Companies Will Reach Out to Witnesses

As they continue their investigation, they may contact you several times. And they’ll contact witnesses who might have seen the accident. They do this on purpose – to ask the same questions several times in hopes that you’ll give inconsistent answers.

What they ultimately want to do is discredit you so you don’t seem like a trustworthy individual who deserves the full payment that you really need to recover from all the accident damages. It’s not beneath them to go as far as saying that you have memory or issues or bring your character and honesty into question if you give them varying versions of the story or inconsistent statements.

Once They Conduct Their Investigation, They’ll Make You a Settlement Offer (And Start Low)

Now that they’ve conducted an investigation to build a case that supports their best interests, it’s time to negotiate a settlement. They will always start with a very low offer because they know there will be a counter-offer or some negotiations that follow. Although, if you have a reputable attorney working on your case they might skip wasting time and give you a reasonable offer.

Adjusters are known for trying to pressure injury victims into accepting fast, low offers so they can shut the case and move on to the next one. But whatever they offer you initially is almost never a fair amount. Don’t give into any pressure and remember that your health is at stake as well as your financial ability to recover fully from an accident that wasn’t your fault.

Contact Our Experienced Personal Injury Attorneys in Denver, Colorado Today

What we’ve outlined for you is the reality of how insurance companies operate. They are profit driven businesses and work tactically to keep their payouts as low as possible.

The good news through all of this is that a knowledgeable and experienced attorney can help you avoid their tactics or falling into common traps that leave you with less than what you deserve. This can take a toll on your finances, your health, your family, and your future if you don’t take it seriously and really fight to get the rightful amount you need to recover.

If you are injured from a car accident caused by a negligent driver in Denver, call our attorneys today to get a free initial consultation.

We will fight aggressively to win you the full value of the compensation you’re entitled to.

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