By now you’ve read my first post on how insurance adjusters investigate car accident claims in Bellingham. Once insurers have looked into their claim, accident victims inevitably find themselves in the middle of the second phase of the insurance claim process, when insurance adjusters attack a claim in order to deny responsibility in paying for it. If claimants haven’t already, this is usually an excellent time to consult with a personal injury attorney. We at Bill Coats Law offer this initial consult for free.
Insurance companies need to find out who is “at fault” in a car accident. The investigations they conduct are intended to do this. Many claims are denied at this point in the process. If a defendant isn’t legally responsible, or “liable” for causing the accident, then there’s no reason the insurer has to pay a dime to anyone injured.
Luckily, this isn’t where it has to end for accident victims, but this is where things also get complex. Once a claim is denied, a lawsuit has to be filed by the accident victim or on the victim’s behalf. A judge or jury could ultimately decide fault, if the lawsuit proceeds to that point. Most lawsuits, however, are settled before that happens, and frequently an insurance company will accept liability in order to avoid the expense of a trial. But if that does not happen, the case proceeds to a trial.
Insurers have a host of tactics available to them to reduce a claim’s value. One go-to method to shrink a claim is to focus on areas of compensation which are subjective. Those areas are tough to compensate with a specific dollar amount. Examples of these subjective aspects of a claim are pain, suffering, loss of consortium, and other intangible losses such as chronic pain associated with tangible and real injuries. For example, one victim may have an allergy to the medications prescribed to treat the injuries, so his pain will be greater than another victim taking the same medicine. Or an accident victim might be pregnant and unwilling to take pain medication. Claims adjusters would rarely account for these nuances, but to the accident victim suffering from them, the net effect is very real.
Pre-existing conditions are another trick up insurance adjusters’ sleeves. Some adjusters will claim that their defendants are not responsible for triggering pre-existing conditions. The law, however, is not supposed to be used this way. There is something called the “eggshell plaintiff rule” which generally means a defendant should be held legally responsible for exacerbating underlying conditions. But though the defendant isn’t responsible for the condition itself, additional pain or suffering the plaintiff endured because the defendant’s actions worsened the condition is attributable to the defendant. This subjective value of pain is unfortunately too often taken advantage of by insurers, to the detriment of the accident victim.