Insurance companies are not exactly known for playing fair. They often use the complexity of insurance laws and policy terms to their advantage and offer paltry settlements for things like pain and suffering. If you need to file a complex insurance claim, get a lawyer’s help.
Insurance companies might try to avoid paying for pain and suffering because these damages are often highly subjective and may not have a specific value or cost. An insurance company might argue that your pain was not as intense as you claim, or argue that your medical records reveal pre-existing conditions that contributed to your pain and suffering. Having an attorney represent you throughout the insurance claims process may help you get the compensation you truly deserve.
Get a free, private legal analysis from our Dallas insurance dispute attorneys by calling us at The Queenan Law Firm at (817) 476-1797.
How Do Insurance Companies Try to Avoid Paying for Pain and Suffering?
Insurance companies employ a wide range of tactics to avoid paying claimants the true value of their damages. This is especially problematic when damages are highly subjective, such as damages for pain and suffering.
Delaying Processing Your Claim
Sometimes, insurance companies will prolong the processing of a claim, hoping that claimants will become desperate for any compensation, making them more likely to accept a lowball offer.
Remember, processing a claim can take time, but insurance companies are legally required to process claims within a certain time. Under Texas insurance laws, insurers must notify claimants of the acceptance or rejection of a claim within 15 days of when all materials necessary to process the claim have been submitted to the insurer.
If the insurer cannot process the claim within 15 days, it must notify the claimant of the reason. In such cases, the insurer has 45 days to accept or reject the claim after notifying the claimant that more time is needed.
Disputing Medical Records
Another common tactic that insurance companies use to devalue claims for pain and suffering is to dispute the claimant’s medical records.
When filing claims for physical injuries, medical records are often necessary. Insurance companies might try to dig into your medical history and find something that can argue is a preexisting condition, which may complicate your claim.
It is important to send the insurance companies only medical records that are reasonably related to your claim. If the insurance company demands access to more of your medical history, your attorney can help you push back.
Arguing Comparative Negligence
Insurance companies might instead seek to reduce claims for pain and suffering by arguing over comparative negligence.
In Texas, a plaintiff in a lawsuit may still recover damages if they are partially responsible for their injuries, but their damages may be reduced according to their share of fault. If they are 10% responsible, they may lose 10% of their damages. However, if a plaintiff’s fault exceeds 50%, they may recover nothing.
Insurance companies may try to argue that you are partially responsible for the injuries you are seeking compensation for. If successful, they may reduce the value of your claim, including for pain and suffering.
How to Dispute an Insurance Company’s Refusal to Pay for Pain and Suffering in Texas
Insurance companies often rely on claimants being desperate for help and confused by the insurance process. This makes it far easier to manipulate the situation and reduce claims for pain and suffering. The best way to prevent the insurance company from lowballing you is to hire an experienced attorney.
The Insurance Company is Acting in Bad Faith
While not all tactics used by insurance companies to argue against your claims are illegal, they sometimes cross the line. If you suspect the insurance company wants to reduce or deny your claim in bad faith, tell a lawyer immediately. This is not just unfair but highly illegal.
Bad faith can take many forms. For example, if an insurance company delays processing your claim for a bogus reason, they may be acting in bad faith. More blatant acts of bad faith might involve refusing to abide by clear policy terms or changing the policy terms without informing the policyholder.
Enforce the Terms of the Insurance Policy
Insurance companies often rely on claimants not fully understanding the policy terms. This way, they can use your lack of knowledge and insecurity against you.
Have our Texas insurance dispute attorneys review the policy terms and explain them to you. If the insurance company tries to do something that violates the terms of the policy, you are in a better position to enforce the policy and demand coverage, including coverage for pain and suffering.
Record Keeping
Much of how you dispute the insurance company’s claims will come down to records and documentation. Keep thorough records of all communications between you and the insurance company. Even phone calls should be documented in writing.
If the insurance company tries to reduce your claims related to pain and suffering, it may be much harder if you have a complete and accurate paper trail of all your dealings with the insurance company. Even if the insurance company continues to push for a lowball settlement, your thorough documentation will make it easier for your attorney to build a case.
FAQS About How Insurance Companies Handle Claims for Pain and Suffering in Texas
How Do Insurance Companies Try to Avoid Paying for Pain and Suffering?
Insurance companies often try to avoid paying damages for pain and suffering by disputing the evidence provided by claimants, scrutinizing medical records, delaying the claim, or even illegal acts of bad faith, like deliberately misinterpreting policy terms.
What Should You Do if Insurance Tries to Reduce Your Damages for Pain and Suffering?
If the insurance company tries to reduce compensation for pain and suffering, call a lawyer for help. Your attorney can review everything that has happened and determine if the insurance company is playing by the rules and, if not, how to enforce the policy terms. It is best to hire a lawyer before beginning the insurance claims process.
How Do You Present Evidence of Pain and Suffering to an Insurance Company?
Evidence of pain and suffering can be hard to pin down since these injuries are highly subjective. It is a good idea to keep a journal of your experiences starting from when you were injured and lasting for as long as your pain, suffering, and distress persist. Mental health professionals may evaluate you and offer statements to the insurance company regarding your mental health. Medical records may also be necessary to show how much pain you endured.
What if an Insurance Companies Offers a Lowball Settlement for Pain and Suffering?
If the insurance company offers a lowball settlement for damages including pain and suffering, you do not have to accept. Your attorney can help you push back against the insurance companies, highlight evidence that supports a greater settlement, and demand greater compensation within the terms of the insurance policy.
Do You Need a Lawyer to Help File an Insurance Claim?
While people sometimes try to handle insurance claims on their own, it is a good idea to have a lawyer help you. This is especially true if your claim involves significant damages and complex facts and evidence. Having a lawyer not only makes it easier for you to build a strong claim, but the insurance company may be less likely to try sneaky or underhanded tactics to reduce your damages.
Contact Our Texas Insurance Dispute Attorneys About Your Insurance Claims
Get a free, private legal analysis from our Texas insurance dispute attorneys by calling us at The Queenan Law Firm at (817) 476-1797.