The Games Florida Insurance Companies Play: What You Need to Know
Whether you’re an unrepresented person or an attorney representing an accident victim, dealing with insurance companies can be a frustrating process. For the unrepresented accident victim, understanding the insurance process is overwhelming. Over the years, I have become very familiar with the tactics used by insurance companies in handling an injury claim; regardless of whether it’s a bodily injury or UM case, or PIP for a medical provider. While this article is not intended to be an exhaustive seminar, the goal is to highlight and educate the public on what to expect when you have an insurance claim.
Insurance Companies Routinely Delay Payments
Delay is the biggest method utilized to make it seem as if your case has fallen into a bottomless abyss. Why the delay?
First, insurance companies have a statutory period to investigate claims; per statute it’s 30 days for PIP absent reasonable proof the insurer is not responsible. When the insurance company (the injured person’s and/or the at-fault) receives a claim, they must act diligently and efficiently in investigating the claim. The investigation phase takes the form of recorded statements, phone calls to persons involved and/or their representing attorneys, securing the police report, determining coverage and fault, property damage issues, sending out various forms, and sometimes examinations under oath. To the insurance company’s credit, these are necessary steps that must be taken.
However, when investigations drag on for months, the wheels of progress grind to a halt and proactive measures must be taken. If coverage is disputed, consider a declaratory action to determine coverage. Cooperation or the lack thereof with parties involved is another stumbling block to insurance investigation and can result in unreasonable delay. For unrepresented persons, trying to figure what to say and whom to talk to can be confusing and unnerving, which is why having an experienced personal injury attorney managing your case is key. We will aid in the insurance companies investigation to the extent necessary.
Aside from coverage investigation, insurance companies tend to delay cases for investigation of injuries. Consider this common scenario: a person gets injured in auto accident and has a prior history of similar accidents with injuries. Insurance companies on both sides will undoubtedly delay the pre-suit settlement process by requesting and awaiting prior medical records to determine pre-existing injuries that could diminish their exposure. Delays of this sort can seemingly drag a case into oblivion. Even once the records are received by the insurance company, delay is inevitable as reviewing the records, whether by the adjuster or a peer review physician, will undoubtedly drag out the process.
Another common reason for delay is inattentive adjusters who are often overworked and responsible for hundreds of claims. The unfortunate result is a back-log of claims that go unnoticed for quite some time. Even 30-day demand letters can go unnoticed. Experience dictates the most effective way to get your case noticed is to immediately file suit. As a corollary, company hierarchy can bog down the claims process. Often the initial adjuster has limited settlement authority and must seek approval when a demand is made above their limit. Likewise, the transferring of adjusters to existing claims further bogs down the process and creates the feeling of no end in sight.
Litigating Against Insurance Companies when Claims are Processed Incorrectly
While litigation is more structured then the pre-suit phase, the same dilatory tactics are seen. For example, endless discovery battles involving mundane issues, issues with coordinating hearings and depositions, disputes over privileged documentation, third party subpoenas, scheduling several months in the future, and simple inaction.
Scheduling is by far the biggest obstacle. When times need to be coordinated amongst multiple parties it can result in simple matters taking days to resolve, with the event happening months in the future. The unfortunate result: an endless drag towards settlement. The best way I’ve found to combat this problem is to implement clear policies about scheduling. For example, after two good faith attempts to coordinate a matter, a unilateral setting of the matter should be done. While unilateral settings are often frowned upon as bad-form, a case cannot drag on over scheduling issues and endless follow-ups. A clear record of attempts should always be kept in the event a court hearing arises.
Inaction by opposing counsel is often frustrating and seen as a dilatory tactic. Healthy and productive relationships with opposing counsel are preferred and beneficial to both sides. However, sometimes the tree needs to be shaken to get the other side to wake-up and move the case along; methods vary from firm to firm but should always be done respectfully.
As stated before, this article is not intended to be an exhaustive discussion of dilatory tactics and strategies utilized by insurance companies. The claims process ought to be swift and efficient, but that is not always the case. Understanding the reasons for delays and coming up with effective combating strategies will ensure an injury claim moves along as steadily as possible. If you have an injury claim in the Tampa Bay area
, contact the litigation team at Dolman Law Group for a consultation and free evaluation of your case. We can be reached at 727-451-6900.
Dolman Law Group
800 North Belcher Road
Clearwater, FL 33765