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Brooklyn, NY Legal Blog

Monday, February 11, 2019

How An Insurance Adjuster Works To Limit Your Settlement In A New York Personal Injury Claim

Annually, insurance companies spend vast sums of money training their claims adjusters how to pay as little as possible on as few claims as possible. Any claim submitted to an insurance company by a claimant acting on his/her own is immediately challenged, both in its validity and in the value of the claim. This is why it is so important for accident victims to have legal advice when negotiating with an insurance company. The claims adjuster is tasked with working against your financial interests. With the experienced legal advice and help of a  New York personal injury attorney, personal injury victims can protect their legal interest in fair compensation for their financial losses. Whether you have been injured in an auto accident, a slip and fall accident, by medical malpractice, burned, bitten by a dog, or injured by consumer products, the New York personal injury attorneys at The Law Offices of Effie Soter, P.C. can help protect you during negotiations with an insurance company claims adjuster.

What To Do If The Insurance Company Denies Liability For Your Accident Claim

The first and most direct method of attacking a claim is to deny responsibility altogether. If a defendant is not legally responsible (“liable”) for causing an accident, then his or her insurance company is not obligated to compensate victims who are injured as a result. This is why insurance companies conduct investigations to determine who was “at fault” for a car accident. Liability is also assigned in premises liability cases, such as slip and fall injuries at stores or restaurants. Private homeowners can also be liable for injuries which occur on their premises. Many claims are denied at this initial phase. Luckily, injury victims have recourse when a claims adjuster denies liability.

Often, a denial of liability will require a victim to file a lawsuit, in order to let a judge or jury determine who was liable for the accident. In some cases, the mere act of filing a lawsuit will cause the insurance company to accept liability. Other times, it does not, and the case must proceed to a trial. In either event, the injury victim has the right to let another party make the determination of liability. An initial denial of liability by a claims adjuster does not mean the end of an injury victim’s claim.

How Claims Adjusters Dispute The Value Of A Personal Injury Claim

There are many tactics that insurance companies use to reduce the value of a claim. One popular tactic is to target those areas of compensation which are subjective, and thus difficult to compensate with a specific dollar value. Pain, suffering, loss of consortium, and other intangible losses are very real and compensable injuries. But they can also vary greatly from victim to victim. Some victims are allergic to certain pain medications, and must, therefore, endure greater pain as a result of their injuries. Some victims choose to restrict their pain medications due to pregnancy. These conditions can exacerbate a victim’s suffering as a result of an accident, but claims adjusters rarely take such considerations into account when making an offer of compensation for pain and suffering. Worse, some insurance adjusters will claim that their defendants are not responsible for triggering pre-existing conditions. This is a blatant misstatement of the law. The “eggshell plaintiff rule” is a general theory of law which holds a defendant legally responsible for exacerbating underlying conditions. The defendant is not responsible for the condition itself, but any additional pain or suffering the plaintiff endured because of the condition is still attributable to the defendant. Unfortunately, many insurance companies attempt to take advantage of the subjective value of pain, and the difficulty in separating the pain of a pre-existing condition to that which is attributable to the defendant’s conduct.

Another way in which claims adjusters attempt to devalue a claim is by challenging future expenses. Defendants who have been found negligent are responsible for compensating all future financial losses which are attributable to their negligent conduct. This can include a decrease in the victim’s future earning potential, future medical expenses, long-term nursing care or rehabilitation, and any other costs which are the direct result of the accident. Unfortunately, many of these expenses can only be projected during the settlement of a claim, as they have not yet actually been incurred by the victim. Personal injury claims are subject to statutes of limitation which fall before all medical treatment and accident-related expenses may have been incurred. In this event, the injury victim must project what these expenses will be, and support the projections with expert testimony or calculations. Medical experts may be required to testify about the surgeries, rehabilitative services, or other medical expenses which will be required over the years as a result of the accident. An injury victim may need to hire an economist who can testify about the wages he or she has lost and the projected decrease in earning potential over the victim’s lifetime.

Finally, a claims adjuster may challenge the cost or necessity of medical treatment which was obtained. Emergency services or surgical care is common after a car accident, but less-traditional services such chiropractic care or acupuncture are often disputed by insurance companies. Again: injury victims need not be bound by an insurance adjuster’s determination of what treatment was necessary. These costs can be submitted to litigation so that a judge or jury can determine whether they were necessary. While litigation can require an investment of time, money, and energy, it is sometimes the only way to achieve a fair result in a personal injury case. With experienced legal representation, personal injury victims need not hesitate to reject an unfair settlement offer and submit their cases to litigation.

Insurance Adjusters Will Pressure You To Accept A Settlement Offer

Insurance companies will always try to minimize the costs that come with payment of claims. Since the insurance adjuster represents the interests of the insurance company and not those of the victim, they will pressure you to accept the settlement offer they make.

Choosing to accept such a settlement offer right away is likely to be a huge mistake. In cases where the victim sustained physical injuries, it will require a considerable period of time to establish the extent of the injury as well as the expenses incurred and suffering endured. A hurried settlement may fail to capture the real worth of the case.

Insurance Adjusters Will Suggest That You Do Not Need To Hire An Attorney

Since insurance adjusters know that an attorney will make sure that you are given the compensation that is due to you, they will dissuade you from seeking legal help. It may be tempting to agree with the insurance adjuster when you are undergoing distress and significant pressure due to the severity of your injuries. However, it is important to hire an experienced New York personal injury lawyer to negotiate the settlement on your behalf. The lawyer has experience in negotiating such settlements and will represent you in court if the two parties fail to reach an agreement.

Experienced Representation For Your New York Personal Injury Claim

After any accident, contact The Law Offices of Effie Soter, P.C. and speak with one of our New York personal injury attorneys as soon as possible in order to ensure that your legal rights are protected. Whether you have been injured in a an auto accident, a slip and fall accident, by medical malpractice, burned, bitten by a dog, or injured by consumer products, we will aggressively protect your right to be compensated for your injuries. Call our office at (646) 504-7384 or contact us here to schedule your free consultation with an experienced New York personal injury attorney. Our personalized service, highly-skilled attorneys, and friendly staff will ease the burden after an accident so that injury victims can focus on their recoveries.  Our team of New York Personal Injury attorneys represent victims in New York County, Brooklyn, Queens, the Bronx, Staten Island, Nassau County, Suffolk County, and Westchester County.

 


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