The Role of an Insurance Company in Paying a South Carolina Accident Injury Claim Settlement: Denial, Delays, Devaluation, and How to Overcome It

If you’ve been hurt in a South Carolina accident, you are right to wonder what role the insurance company will play in the settlement of your claim. I’m here to give you the truth, even if neither of us likes it. The insurance company’s goal in your claim can be described as deny, delay, and devalue. Deny the claim if possible, delay making an offer, and devalue your injuries.

I’m going to show you why and how the insurance company does this. Along the way, I’ll explain how an insurance company processes a typical South Carolina personal injury claim.

If you’re already worried about dealing with the insurance company in your South Carolina personal injury case, there’s no need to suffer. Get your questions answered in a free*, no-pressure strategy session with a Spartanburg, SC personal injury attorney. Call toll-free at (864) 582-0416 or fill out a Get Help Now form.

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Why the Insurance Company Does What It Does: It’s About the Money

Denial, delay, and devaluation of your case are all tied to the insurance company making money. Insurance companies make money in two ways:

1. Collect premiums
2. Deny claims or devalue them to get out cheap

That’s it. There’s no magic other than the insurance company magically earning interest on billions of dollars of premiums.

And that’s partly why delay is an insurance company tactic. Every month they can wait to pay your claim is another month of interest on that money.

The First Step in a Typical South Carolina Accident Injury Claim Process: Meet the Adjuster

Once the insurance company gets notified about your accident, the claim is funneled to an adjuster. This is the claims representative. Insurance companies have legions of them. Do not underestimate the power of the adjuster. Insurance adjusters are highly trained professionals familiar with settlement values for your area.

By the way, if you’ve been seriously hurt in a South Carolina car accident, now’s a good time to switch over to our article about the South Carolina car accident insurance claims process.

The adjuster has a single goal, assuming the insurance company can’t find some reason to deny your claim: get out cheap and quick.

The first consideration for any South Carolina personal injury victim is, should I talk with the adjuster? Know this: the first step in the adjuster’s prime objective to cheat you out of a settlement is getting a recorded statement from you that traps you into sinking your case in your own words. Like good-naturedly ribbing you into admitting you don’t really know how you got hurt, or you should have paid more attention, or their all-time favorite, pushing you into stating you’re not hurt that bad.

Be afraid, be very afraid before talking to the adjuster.  Here are guidelines on whether you deal with the adjuster.

If you’re seriously hurt, meaning there’s a possibility of surgery, long-term treatment, shots, broken bones, traumatic brain injury, or multiple injuries, beware the adjuster and their tricks. You’ve got to understand what you look like to the adjuster: a wounded amateur. Easy prey. There’s a lot of reasons why you’re making the insurance adjuster’s life way too easy:

• Your lack of experience in valuing your case for settlement enhances the adjuster’s ability to take advantage of you with a cheap settlement.
• Your ignorance of the evidence needed to support settlement negotiations helps the adjuster devalue your case. 
• There’s no urgency to respond to a settlement offer without a demand letter containing a hard deadline to respond, backed by a real threat of a lawsuit.
• Your inability to sue immediately gives you no recourse for unjustified delay or devaluation of your case.

If you’re NOT seriously hurt, meaning maybe you just suffered a sprain or a pulled muscle that requires a trip or two to the doctor before it clears up, your injury is simple enough to handle on your own. Because your claim is small, you can likely take advantage of the adjuster’s need to close the file fast, but even then, don’t shortchange yourself. Keep reading.

The Key to a Good South Carolina Personal Injury Settlement Is to Help the Adjuster Help You

To help the adjuster help you, you’ve first got to understand the adjuster’s work environment. Insurance claim offices are generally structured based on two things:

• Separate adjusters are often assigned for unrepresented victims and represented ones. Based on years of reports from my clients, the adjusters they face without me can be mean and unresponsive. On the other hand, the adjusters I deal with as a personal injury attorney are usually professional and pretty nice. I suspect it’s because they know they’re dealing with a fellow trained professional.
• The size of the claim generally dictates the experience and skill of the adjuster. I’ve had some big cases where I thought the adjusters would make excellent attorneys. If you’re seriously hurt and going it alone here, you’ve thrown yourself to the wolves.

Our job is to help the adjuster help you in your South Carolina accident injury case while you just get better and stop worrying about it. Find out how we can help. Call me toll-free at  (864) 582-0416.

Cut Through Insurance Red Tape and Bureaucracy to Make Your South Carolina Personal Injury Claim Work for You

Maybe the most repeated complaint I get from clients before they hire me is the adjuster’s delay in responding. Again, it’s about insurance company money.

• The insurance company pays to employ as few adjusters as possible. Many are overworked, with hundreds of claims. That makes it more important for your adjuster to stand out.
• Before an adjuster can make a settlement offer, they must get “authority.” That’s a feel-good word for permission from their supervisor. To get it, the adjuster meets with their supervisor about your case. In cases with severe injuries, like broken bones, multiple trauma, and brain injuries, the insurance company may conduct a “round table discussion” with a room full of executives to decide how much to offer.
• Don’t overlook this: that permission to give you money will be based on the evidence you present.

Here’s how you help the adjuster help you: send a well-organized demand letter showing how their insured is legally at fault, your injuries, the treatment it required, lost wages, and pain and suffering, which I call human loss.

If you send the adjuster a pile of papers, expect it to be shoved to the bottom of an even larger pile until the adjuster finds enough time to sort through it. It could be months.

In our bigger cases, like ones involving traumatic brain injury, multiple broken bones, or other life-changing injuries requiring months of treatment, I usually send the adjuster several letters over time to update them with my client’s medical treatment, supplying them copies of medical records and bills. I often track the development of my client’s human loss. This helps the adjuster get additional authority, which for us means more money for you over time.

PRO TIP: In big cases, delay might work for the insurance company, but it won’t work for you. While you shouldn’t try to value a South Carolina personal injury case settlement until you’re released from treatment, waiting to send all medical evidence at once to the adjuster is a bad idea. Sending the adjuster hundreds of pages of medical evidence incurs a massive delay. You’ve surprised the adjuster with too much information and made them look like they mishandled the claim because they didn’t get the evidence you should have sent. The adjuster looks bad in front of their supervisor, which doesn’t help you get money and sure doesn’t help you get it fast.

Serious injuries need serious legal help. Get your questions answered in a free*, no-pressure strategy session with a Spartanburg, SC personal injury attorney. Call toll-free at (864) 582-0416 or fill out a Get Help Now form.

Even Settlement Doesn’t Always End the Risk of Your Ignorance or the Delay

Once you overcome all the barriers thrown up by the adjuster and actually get them to agree to pay you, it’s still not over. The adjuster will send a settlement document called a release. It will contain complex legal terms. That’s another reason to have an experienced lawyer help you with your serious accident injury case: you truly don’t know what you’re agreeing to other than taking their money.

WARNING: You may be setting yourself up for paying attorney fees for the insurance company’s lawyer to defend lawsuits from medical providers or your health insurance company if they claim they aren’t paid from your settlement when they had a legal right to it. An experienced injury lawyer can help make sure those providers get paid and potentially protect you if a provider sues claiming they went unpaid from the settlement.

Just when you thought it was over, you likely encounter more delay. You’ve asked an insurance company to do the last thing it wants, which is to pay you money. Expect delays here. I don’t hesitate to call the adjuster once a week or even more if my client’s checks don’t show up within about two weeks of reaching a settlement agreement.

If the idea of all this wears you out, reach out for peace of mind. Call me toll-free at  (864) 582-0416.

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