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Common Tactics Used by Insurance to Deny or Reduce Injury Claims in Texas

Most people understand that insurance companies are looking out for their own interests. As such, many employ common tactics to deny injury victims the compensation they deserve.

The best way to ensure you do not fall victim to the insurance company’s tricks is to work with our attorneys. When an insurance company delays paying your claim or unreasonably disputes parts of it, it is likely acting in bad faith. Insurance companies are legally obligated to process claims in a timely matter. However, they often use tactics that might not seem unjust at first glance. Our team can review your claim and identify the tactics that have been used against you. We will press the insurance company to pay your claim as required. If they still refuse, we can help you file a lawsuit for bad faith.

Call The Queenan Law Firm, P.C. at (817) 476-1797 for a free case review with our Dallas bad faith insurance lawyers.

What Are the Most Common Tactics Used by Insurance Companies in Texas to Deny or Reduce Personal Injury Claims?

Insurance is crucial to covering unexpected injuries and expenses. However, most of us know that insurance companies are rarely on our side. Even your own provider might use tactics to lower or deny your claim. This is because some insurance companies act in bad faith when processing a victim’s claim.

While it can be hard to tell if your provider is acting in bad faith, our Texas bad faith insurance attorneys are quite familiar with their tactics and can review your claim for red flags. Some of your insurance company’s behavior might seem perfectly reasonable, but they are very good at masking their intentions. That is why you should contact our team before filing your claim to avoid potential bad faith conduct. If you have already filed an injury claim or are preparing to, the following are common tactics used to reduce or deny compensation in Texas:

Contact You Immediately After You Are Injured

Insurance companies will often contact injury victims right after an accident. For instance, it is common for insurance adjusters to contact car accident victims the same day as the accident.

Providers do this to catch you off guard. They know that you have not had the time to fully examine your injuries and likely have not spoken to an attorney yet. The hope is that the stress of the accident and the need for quick compensation will get you to settle your case then and there. However, you are not obligated to settle your case or even speak with the insurance company until you are prepared. Our attorneys can assess the full value of your damages before we start negotiating a settlement.

Deny the Claim

Some insurance companies might deny your claim outright without explanation. Other times, they will deny your claim under false pretenses, like claiming you were negligent. If your claim is denied, our lawyers will review your policy and the reasons the insurance company gave justifying the denial. If they did not tell you why they denied your claim, it is a clear case of bad faith.

In some cases, we can gather additional evidence and file an appeal. If the insurance company is not allowing you to file an appeal, we can help you prepare a lawsuit to file against them.

Delay the Claims Process

The most common tactic insurance companies employ is delaying the claims process. They know that most people understand that claims are not processed overnight. Insurance companies often “lose” records, request unnecessary documentation, and request additional medical evaluations. This is all done in an effort to wear you down and frustrate you to the point of accepting a settlement lower than what you deserve.

In other cases, the insurance provider might tell you that a heavy workload or staffing shortages are causing the delay, but these are often just cover for stretching out the process. According to Tex. Ins. Code § 542.056(a), insurance companies have 15 business days to accept or deny your claim after it is filed. While this law gives them some wiggle room, the delay must have a reasonable justification. Our attorneys can help you determine if the delay rises to the level of bad faith.

Underestimate the Value of Your Claim

Another highly common tactic is to undervalue your claim. Insurance companies are notorious for intentionally underestimating the value of your damages to minimize the money they have to pay out. Considering how complex medical billing can be and the values associated with certain treatments, insurance companies can easily confuse victims as to the true value of their damages.

Our team can get the evidence that proves your losses, like medical records and proof of lost income. If the insurance company still refuses to pay the proven damages, we can file a lawsuit.

Dispute Your Medical Treatment

Insurance companies often generate confusion over victims’ medical treatment as a way to reduce and deny claims in Texas. In some cases, they might dispute the treatment altogether, stating you did not get the appropriate treatment or it was excessive and unnecessary.

Your insurance company might request you submit to an independent medical exam by a doctor of their own choosing. This is usually done to downplay your injuries, thus giving them evidence to lower the settlement amount. Or, the provider will use a pre-existing condition to argue that your current injuries were not the cause of the accident for which you filed your claim.

Purposefully Misinterpret Policy Language

Your insurance company might also intentionally misinterpret your policy to deny you coverage. They know policies can be challenging to understand, as many of them are purposely written to be confusing. The insurance company might purposefully twist the meaning of key terms in the policy or apply exclusions not included in your policy. Our attorneys can review your policy with you and help determine if they unfairly denied your claim based on the language therein.

Encourage You Not to Speak with an Attorney

The best way to maximize your compensation in a claim is to work with our lawyers, which is why some insurance companies will encourage you not to. Anytime an interested party tells you not to get legal counsel, it is usually because they do not want you to know your rights. The insurance companies also know that the tactics discussed above and others will not work on our skilled and experienced attorneys.

Our team can typically tell immediately after reviewing a claim if an insurance company is acting in bad faith. If bad faith is occurring, we will help you file a lawsuit to get the coverage you are entitled to and possibly additional damages.

Our Texas Bad Faith Insurance Attorneys Can Help You Today

For a free case evaluation with our Texas bad faith insurance attorneys, contact The Queenan Law Firm, P.C. at (817) 476-1797.