Pitfalls to Avoid When Dealing with an Opposing Insurance Company

After any sort of injury-causing event insurance companies will quickly begin searching for and gathering evidence on every aspect of the case.  Promptly hiring a seasoned Tulsa personal injury attorney can position a victim to begin doing so as well before information, evidence or witnesses are lost or destroyed.  While some people may elect to attempt to perform that work on their own, others may delay hiring an attorney because they are overcome with their injuries or the situation altogether.  In either scenario it is not uncommon for victims or their loved ones to find themselves communicating with insurers directly.

Insurance companies routinely implement programs and tactics designed to gain an early advantage in a claim.  Everyone who is a party to an insurance contract has an obligation to comply with the terms of their insurance agreement with their own insurance company.  Although each company’s policy has its own unique characteristics, an insured generally must promptly notify the insurer about a claim, fully cooperate in the investigation of a claim and submit to a recorded statement or examination under oath.  These are just a few of the requirements typically found an insurance agreement.

While contractually required to perform certain tasks with one’s own insurance company, a victim of personal injury is under no obligation to do so when dealing with another person’s insurance company, particularly that of the at-fault party.  Throughout their decades of combined experience of handling personal injury claims on behalf of injured individuals, the attorneys at Biby Law Firm have encountered the following most common practices insurance companies utilize to gain an early leg up when dealing directly with an injured party.

What Specific Things Should I Be on the Lookout For?

• Recorded Statement. Once the identities of potential claimants are known to an insurance company, they often contact those individuals to attempt to obtain recorded statements about the loss. What may seem like an innocent fact-gathering mission can instead be used as a means for the insurer to start building their liability and damages defenses.  Although a statement must be given to your own insurance company, there is no obligation to do agree to give a statement to any other insurer.
• Medical Authorization/Release. In order to gather one’s medical bills and records or speak to a medical provider about an individual’s care, a HIPAA-compliant medical authorization must be executed by the subject of the treatment. Insurers for at-fault parties will often lead an injured party to believe that the injury portion of their claim cannot and will not be considered absent that person executing a HIPAA release.  That simply is not true.  Executing an unlimited medical release will allow the insurer to gather the entirety of an individual’s medical history from before and after the collision whether it relates to the underlying claim and injuries or not.  Despite there being no justification for them to access otherwise confidential and privileged information, insurance companies are given the opportunity to use whatever they uncover, be it unrelated medical issues, doctors’ notes and the like, as a basis to devalue or deny the claim they are evaluating.  While required to execute a limited medical authorization in Oklahoma (12 OK Stat. 3226(A)(2)(a)) if and when a lawsuit is filed, injured parties are under no duty to execute a medical release for an at-fault insurer prior to litigation.
• Wage/Employment Authorization. Similar to a medical release, some insurers may entice injured parties to sign employment authorizations that will allow them access to the individual’s employment records. While documentation regarding lost wages may be a component of a personal injury case, allowing an opposing insurance company full and unfettered access to information normally contained within a personnel file is unnecessary and risky.  Much like a medical release, an employment release is not required to be given by an injured party prior to a lawsuit being filed, and may not be required at all if lost wages are not being claimed by the victim. 

These are just a few examples of the countless ways an at-fault insurer may attempt to gain an unfair advantage over an injured party in the early stages of a claim.  The Tulsa injury attorneys at Biby Law Firm are well-versed in what is and what isn’t required of their clients and take pride in their ability to successfully resolve claims while also protecting their clients’ private and confidential information to the full extent allowed by law.

Should I Consider an Early Settlement Offer? – The “Recorded Release”

One practice that is becoming more and more prevalent among all insurers is attempting to secure early releases, many times verbally over the telephone, in the hours or days after a person has been injured in an accident.  This tactic is designed to take advantage of individuals who are physically, mentally and financially vulnerable by offering quick money, often $500 – $2,500, in exchange for a full and complete release of any and all claims.  Commonly the proposed agreement will include a medical component wherein the insurer will pay for “all reasonable medical bills” up to a certain dollar amount.

Why Should I Be Wary of a Recorded Release?

Insurers know that individuals oftentimes may not realize the full extent of their injuries and losses until many days after a collision.  By seeking out and securing early releases, insurance companies realize enormous financial gain by resolving claims for a nominal amount before their targets, the injured parties, have adequate time to fully appreciate all the ways they may have been affected by the underlying event. Insurance companies will argue these recorded conversations are full and final settlements, meaning those who enter into them will be left to bear the costs and burden of any unknown injuries, costs of future medical treatment, lost wages and other losses that are not contemplated at the time.

Dangers of The Recorded Release

• Inability to contemplate the terms. By seeking a recorded release the insurer puts the injured party on the spot for a decision that will have long-lasting, permanent implications. The lack of a written agreement also allows the participant little or no time to fully and completely analyze each and every term of the prospective deal.  In fact, many recorded releases take less than one or two minutes for a company to secure.  Insurers know that if an agreement is put into writing an individual is more likely to understand it, less likely to execute it and will very likely seek the assistance of an attorney to ensure their interests are being protected and the proposed agreement represents an equitable resolution of the claim.
• Unknown injuries or damages. Most people have never found themselves victimized as the result of another person’s negligence. Their daily lives unexpectedly become inundated with medical visits and insurance communications in addition to their pre-injury obligations like work and family.  When juggling all of these tasks shortly after an incident it is not uncommon for a person to underestimate injuries that later prove to be more significant than initially thought.  This can result in damages which were initially unanticipated such as medical expenses, scarring and time off from work, just to name a few.  If a release has been entered, the injured individual will not be compensated for all they failed to account for when contemplating the release.
• “Reasonable medical bills.” While an agreement which includes a promise to pay for “reasonable medical bills” from a wreck may seem like a good thing, the devil is often in the details – under those circumstances the insurer is unilaterally in charge of determining what is “reasonable.” For instance, if an injured party undergoes an MRI at the request of their doctor, but after entering into the release the insurer believes the bill is unreasonable in terms of its cost, the insurer will only pay for what they deem to be appropriate, leaving the remainder of the bill for the patient to pay.  In addition to cost, insurers are also known for disputing the reasonableness of the number or frequency of medical visits an injured party should undergo, including but not limited to chiropractic care or physical therapy.  Medical bills presumed to be covered under the terms of the release may be denied by the insurance company under the guise of “reasonableness,” leaving the injured party financially responsible for the unpaid balance.

The attorneys at Biby Law Firm urge anyone injured as a result of another’s negligence to seek advice from an experienced Tulsa personal injury attorney, particularly if they are contemplating a release which will result in a full and final resolution of their case.  Biby Law Firm is proud to offer free consultations throughout their statewide practice including Tulsa, Broken Arrow, Bixby, Claremore, Jenks, Owasso, Skiatook, Pryor Sand Springs, Sapulpa, Wagoner and Muskogee.  To schedule an appointment call us at 918-574-8458 or fill out our contact form.