If you have sustained an injury that was caused by the negligent actions of another person or entity, you may be entitled to compensation through an insurance claim. However, these cases can become complicated, and you will likely end up dealing with insurance adjusters. At the Ciccarelli Law Offices, our Philadelphia accident attorneys understand the importance of knowing what insurance adjusters look for when they are evaluating your claim.
What do insurance adjusters look for?
There are various red flags that insurance adjusters are going to look for in order to justify offering a lower settlement or even deny an insurance claim.
1. Lack of medical treatment following an accident
One of the most glaring red flags that an insurance claims adjuster will look for is a lack of immediate medical care after an accident occurs. They will argue that a person could not be too badly injured if they did not seek immediate medical care.
2. An inconsistent course of medical treatment
An insurance claims adjuster will also look for an inconsistent pattern of medical treatment. This can include missing scheduled appointments, continually delaying appointments, or ending care before a physician says it should be terminated. Injury victims are expected to take steps to minimize the consequences of their injuries by pursuing the fastest recovery protocols.
3. The decision to forgo necessary surgery
If a physician recommends that a patient undergo surgery as the best course of action to remedy a problem, and the plaintiff in the case decides to forgo the surgery, this could have an impact on their claim for damages. This is because the law will not allow a person to recover damages for an injury that could be addressed through a low-risk surgical procedure. If a person seeks to say their injury has caused “permanent” damage that could be likely treated with surgery, their claim could be denied.
4. Using “plaintiff-friendly” medical providers
There are some medical providers that have a reputation for being “plaintiff-friendly.” While this may or may not necessarily be the case, insurance carriers certainly know who these medical providers are. If an attorney and a doctor have a reputation for working together in personal injury cases, there is a strong chance that the insurance adjuster will use this as a reason to deny or limit a settlement payout.
5. Alternative medicine treatments
Alternative forms of medicine have gained traction and acceptance over the last few decades, but insurance adjusters may still view these courses of treatments as signs that an injury is not serious.
6. Difficult to get ahold of
Anytime that an injury victim is difficult to reach, the insurance claims adjuster is going to be more likely to deny the settlement. In the eyes of the insurance adjuster, it should not be difficult to find somebody who has claimed they are injured. After all, the injury victim should be at home most of the time and available to speak because they cannot go to work or do many other things. At least, that is how the insurance adjuster will see it.
Contact us for a free consultation of your case today
If you or somebody you love has been harmed due to the negligent actions of another party, you may need to file a personal injury lawsuit in order to recover the compensation you need. At the Ciccarelli Law Offices, we are going to conduct a full investigation into your case so we can obtain maximum compensation on your behalf. This can include coverage for your medical expenses, lost income if you are unable to work, pain and suffering damages, and more. When you need a Philadelphia injury lawyer, you can contact us for a free consultation calling 215.228.0100.