Are you panicked and angry because an insurance company is giving you the runaround? Has your claim been unfairly denied? Find out here how to beat the insurance companies at their own game.

Insurance Company Marketing

Insurance companies spend a huge amount of money each year on slick marketing to convince you that they are caring professionals who are on your team, waiting to go to bat for you if you get into an accident and need compensation for your lost wages, medical bills and other expenses.

After 25 years of battling insurance companies on behalf of people whose claims have been unfairly delayed or denied, I am going to tell you that this is far from the truth.

Insurance companies are for-profit businesses with shareholders and bottom lines.

Don’t let those big budget commercials fool you:

  • “Like a good neighbor, State Farm is there.”
  • “You’re in good hands with AllState.”
  • Amica. We keep our promises to you.”
  • Nationwide is on your side.”

Sound familiar?

It’s no wonder, with snazzy Madison Avenue marketing teams working for them, insurance companies are so successful in convincing you that they are working for you and are there to help you out should you be injured in an accident.

The reason they invest so much money in creating this impression of helpfulness and caring competence is because they want you to trust them. They want to be the first phone call you make after an accident, and they want you to believe that cooperating fully with every request they make is the best strategy to get your claim quickly processed and your check in the mail.

Insurance Company Motivation

Do they truly care and do they truly want what is best for you?

Let me tell you what the insurance companies are really up to. Allow me to pull back the curtain and show you what’s really going on behind the scenes. Understanding the insurance companies’ game will help you better protect yourself should your claim be put on permanent delay, or even denied.

When you rush to contact your good friend, The Insurance Company, right after an accident, you are going to be in a heightened emotional state, panicked, woozy and upset.

You are much more likely, in this state of mind, to say the wrong thing that they can later use against you in order to minimize or deny your claim. The best time to pump you for information is right after an accident, when you are at your most vulnerable, injured and confused.

Insurance companies make money when they deny claims, not when they pay out maximum compensation to people like you.

The illusion of The Insurance Company as your friend is one they have very strategically implanted in your mind with their marketing campaigns. In truth, insurance companies are for-profit business whose top priorities are the bottom line and the shareholders.

Insurance adjusters are praised and promoted when they find tiny details they can use against you to reduce the amount of compensation you are awarded. This is their job.

Insurance Company Tactics

They will immediately, once they have you on the phone, begin requesting you to sign various paperwork and submit to recorded interviews. Once you agree to these things, they know they’ve got the upper hand, and that you are naively trusting them and don’t understand the game that’s being played.

If you don’t agree to the first lowball compensation amount that’s offered to you, because it’s not enough to cover your expenses, an insurance company may then employ the infuriating “sit and wait” strategy, where they begin a long series of delay tactics. You’ll find yourself unable to get your adjuster on the phone, shuffled to different departments, told you filled out the wrong paperwork, or need to submit one type of document after another.

This is all being done by design, in order to frustrate you into giving up and going away. When that happens, the insurance company has won the game. And they usually do win, because after an accident, most people are too worn down, emotional and exhausted to keep fighting. Don't let this happen to you!

Steps to Take

Here are ten action steps to take if you want to beat the insurance company at their own game:

  1. Request a written explanation if they deny your claim. This is required by law in most states. You have a right to this information.
  2. Gather all paperwork and records of everything into one file, including your original policy, any documents you’ve signed, explanation of benefits, any paperwork that the insurance company has sent to you. If you are missing anything, request a copy from them.
  3. Go over the policy yourself, carefully, to determine whether or not you believe your claim was denied fairly. See if you can find anything in writing in the policy that allows them to deny your coverage, and if it seems plausible to you. Some insurance companies will insert clauses and addendums into policies that are questionably legal and impossible to decipher, but that allow them to deny you coverage, should you ever submit a claim.

    For example, policy holders in Louisiana found themselves denied coverage after Hurricane Katrina, even though they had purchased hurricane insurance! This happened because the insurance companies had included obscure clauses (called “anti-concurrent clauses”) in their policies that allowed them to get out of paying claims.
  4. Check to make sure your signature is valid. Insurance companies have been known to forge signatures on documents that allow them to then deny you coverage when you submit a claim. Find out on what specific grounds they are denying or delaying your claim, and request a copy of the document that supports this refusal to pay. Is your signature on this document, and are you sure that it’s yours?
  5. Start putting all requests in writing, and make sure you send it registered mail. Request a response within 30 days from the receipt of the letter (by using registered mail, you will know exactly when the company received your letters and who signed for each one). This is very important.

    If your adjuster stops returning your calls, or otherwise giving you the runaround, don’t give up. Send all further requests for information in writing, and send it to your adjuster’s supervisor, and keep going up the chain of command, if the person you write to doesn’t reply promptly within 30 days. Save copies of everything you send.
  6. Challenge any claim that’s denied because of a filing error. Insurance companies are not legally allowed to dismiss your claim due to your having filled out paperwork incorrectly, or because you submitted your claim after an arbitrary deadline you weren’t informed of until it was too late. They are trying to confuse and frustrate you. Stand up for yourself and challenge that claim.

    Only 1% of those who file claims ever challenge the insurance company’s decision, and the insurance company knows this, which is why they deny and delay paying claims as often as they do.
  7. Call a lawyer. If your attempts to receive fair compensation from your insurance company are unsuccessful, do not give up without calling a lawyer to handle your case. Most reputable firms, including mine, will consult with you for free, and won’t charge you a fee unless your case is successful.

Summary

Do not walk away without contacting an attorney to represent you, you have nothing to lose!

If the insurance company won’t budge, call someone who knows exactly how to make them snap to attention, and start cooperating. When the insurance company knows you’ve got a lawyer working for you, they know you mean business, and aren’t going to just give up and go away. You will be thrilled when you see how quickly the delay tactics stop, and your claim gets processed.

I hope you will consider my firm, Day & Nance, to handle the insurance company shenanigans on your behalf, so you can focus on getting better and getting on with your life.

Last updated on Nov 17, 2012.