When we decide to represent clients in a personal injury claim, we frequently find ourselves sitting opposite the insurance company of the party responsible for the injuries.

It doesn’t matter if it is a motorcycle accident, a slip and fall at a place of business, or nursing home abuse, at some point the other party’s insurer will likely become involved and you can be certain the insurer does not want to pay your claim.  

You may have medical bills and lost wages as well as pain and suffering. You may need to be reimbursed and soon, but please understand insurance companies look at you as a number.

They are not necessarily your “Good Neighbor” and you are not necessarily in “Good Hands.” These are just advertising slogans.

According to the American Association of Justice (AAJ), the property/casualty insurance industry enjoys annual profits of over $30 billion a year while taking in over $1 trillion annually. Their obligation is to their shareholders. Period. They do that by paying out less money.

Here are some of the things insurers often do when they want to avoid paying a claim.

When you file a claim after an auto accident, you are actually filing the claim, not against the person, but against their insurance company. The first contact is generally the insurance adjuster.

It becomes the adjusters’ job to delay and deny, to minimize your injury, and to negotiate down the true value of your claim, all in an effort to pay less for your claim. Remember who the adjuster works for.

Adjusters are generally skilled negotiators and know the tactics to give you the impression they are just there to facilitate your claim.

We strongly suggest you hire a personal injury firm to deal with the adjuster during this crucial time. A misstep, a recorded statement that gives the impression that you are admitting some fault, anything signed, could doom your case. 

In the courtroom, don’t be surprised if the lawyer for the insurance company claims you were responsible for the accident and therefore do not deserve any compensation. That’s because Virginia applies the “contributory negligence” legal doctrine.

In layman’s terms, under contributory negligence, the other party has to be one hundred percent at fault for you to be awarded any compensation. If you contributed, even one percent, you may not have a case.

It should go without saying that the insurance companies favor this law.

Most other states look at this scenario differently and more reasonably. Most have comparative negligence laws which weigh the degree of fault or contribution to the accident.

We know insurance adjusters are encouraged and even rewarded for keeping claims payments low. This may also be true of your own insurance company.

For years, you paid premiums and on time, but when it comes to a disability claim, for example, you may find delay and deny applies to your own insurers’ attitude toward you.

Please consult with an experienced Virginia personal injury attorney, because you have only a two-year statute of limitations (in most cases) to act within.

Other examples of insurance practices include:

It is not illegal for an insurance company to investigate an injury claim and gather information on the claimant through various means. This is done to verify that the claim is legitimate and that you are not exaggerating the extent of your injuries.

Insurance companies do not use surveillance in every case, and if your claim is small, the risk that they will spy on you is much lower. That said, you should behave as if you are being watched no matter what the circumstances, and always follow your doctor’s advice with regards to physical activity and your attorney’s advice with regards to legal matters.

Ways that Insurance Companies Might Gather Information on You

There are a number of legal ways that insurance investigators might compile information on you for your injury claim:

Physical Surveillance

As creepy as this may sound, it is not unusual for insurance investigators to follow you and record video of you as you go about your daily activities. This may include running errands, going to and from doctor’s appointments, going to and from work, or even taking a walk in the park. All of this is legal, as long as they do not violate your privacy. For example, an investigator would not be allowed to install a hidden camera inside your home or something like that. A good rule of thumb is that an insurance company can only review information that is publicly available or that you give them. If they go any further than that, then that is crossing the line.

Examining Medical Records

When you file an accident injury claim, the insurance company will most likely ask for authorization to obtain your medical records. While it is reasonable to ask for records about previous injuries or conditions that are related to your accident injury, you should not give them a blanket authorization to review any and all prior records, because these records could be used to go on a fishing expedition and look for information that could damage your claim. Always consult with your attorney to determine which medical records the insurance company should be authorized to review.

Reviewing Social Media Accounts

Facebook, Instagram, Twitter, and other social media platforms often contain a wealth of information that insurance investigators will try to get their hands on. It is important to realize that anything you post electronically is discoverable in a personal injury case. For example, if you say you are bedridden and you post photos of you and your family vacationing in Virginia Beach, this could be very damaging to your claim. But even seemingly innocuous comments and other more subtle posts could be twisted and taken out of context. The best advice is to stop all social media activity altogether until your claim is settled, or at the very least, only read other people’s posts and do not put anything out there yourself.

Once you take that check or sign any papers, you are relieving the defendant of any responsibility toward your case. This is ill-advised, because only a doctor can tell you what sort of injuries you may have suffered, and sometimes, these can be long-term injuries.

Not following your doctor’s orders could not only cause you to experience a physical setback, it could also complicate your personal injury claim. If someone else caused your injury, you are entitled to damages. But injury victims also have a legal duty to mitigate their losses by seeking prompt medical attention and following through on doctor’s recommendations. Not doing so gives the other side an opening to argue that they are not responsible for additional medical expenses and other losses you incur because you didn’t do what your doctor told you to.

Keep All Doctor’s Appointments

To the best of your ability, keep all of the appointments you have made with doctors, therapists, and other health professionals. Some people have been hesitant about going into medical facilities during the Covid-19 pandemic, but these facilities are taking the necessary precautions to ensure that everyone who needs to see a medical professional can do so safely.

Visit Recommended Specialists

If your doctor refers you to a specialist, be sure to follow up and make an appointment as soon as possible. The treatments provided by various specialists will often be critical in your recovery, so do not put off seeing someone if your doctor recommends it. You should also follow the recommendations of specialists that you are referred to, although you may decide to seek a second opinion if a specialist is recommending a major procedure.

Adhere to Medical Restrictions

As we touched on earlier, be sure to adhere to any limitations and restrictions that your doctor has placed on your physical activity. This means not going back to work earlier than you should, and it also means not participating in other activities that could cause you to experience a setback. Insurance companies are known for spying on injury claimants, and if you do not follow your doctor’s restrictions, there is a good chance that they might find that out.

Stay in Close Contact with Your Medical Team

Throughout the entire treatment process, work closely with your doctor and other health professionals. Keep them up to date on how your recovery is progressing, and promptly notify them if things seem to be getting worse.

Preserve All Medical Documentation

Keep records of all of your doctor visits, visits to physical therapy, procedures and treatments that you had, prescriptions given, etc. It would also be a good idea to keep a journal tracking your progress each day. During recovery, some days are better than others, and it is helpful to note how you are feeling each day as well as improvements and setbacks that you are experiencing.

The law firm of Buck, Toscano & Tereskerz strongly suggests you do not have even a conversation with a representative from the other side’s insurance company and do not make a statement. You certainly do not want to sign anything they present. The best thing to do is to get an experienced personal injury lawyer involved as early as possible after the accident, so you can preserve your legal right to compensation and keep your case on track.

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