Law Offices of Melissa Mack & Associates
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This site is for informational purposes only and in no way constitutes legal advice, or establishes any attorney client relationship, for any specific individual or circumstance.

Mistake #1: Giving written or recorded statements to insurance adjusters.
Adjusters are trained in the art of asking questions and vetting all documents you unwittingly provide them. Their goal is to elicit information which will severely damage your case. They are highly skilled and literally take hundreds of statements each year. Chances are HIGH that you will make a statement that will adversely affect the value of your case. Bottom line: NEVER give insurance adjusters written or recorded statements, because they will find a way to use it against your claim.

Mistake #2: Signing medical releases.
As soon as you are contacted by an adjuster following an accident-and you WILL be contacted by an adjuster-he or she will ask you to sign medical releases and/or medical authorizations. You will undoubtedly be led to believe that the adjuster will only obtain records related to your accident. Nothing could be further from the truth. These authorizations are routinely used to obtain your ENTIRE medical file, often dating back to childhood. There may be issues in your medical records which could adversely affect your case, and which the adjuster should NEVER have access to. Remember, the goal of the adjuster is to find any issues or pre-existing conditions to dilute the power and substance of your present claim. Bottom line: NEVER sign a medical release or authorization provided to you by an adjuster, even one who represents your own insurer.

Mistake #3: Signing a release to obtain employment records.
Like medical releases and authorizations, similar authorizations seeking your employment information are extremely broad. They seek much more than just the information regarding your time off as a result of your injuries. The goal of the adjuster is to obtain your performance reviews, adverse employment action, attendance at work, health questionnaires, workers compensations claims, pension information and other confidential documents which have nothing to do with your claim. This is particularly important in employment law cases, as well as accident injury claims. Bottom line: NEVER sign a release or authorization allowing adjusters to obtain your employment information and personnel file.

Mistake #4: Failure to take into account Liens.
More often than not, there will be medical, and possibly other, liens applied to your claim, which the adjuster will not tell you about. If you attempt to settle the case yourself with the adjuster, you may have to pay these liens out of your settlement, leaving you with much less than you anticipated, or the adjuster led you to believe. Remember, the adjuster’s goal is to minimize your settlement and pay you as little as possible. They will not act on your behalf to consider the applicability of liens in evaluating your claim for a settlement offer, nor will they attempt to negotiate your liens down from their original amount. A related, complicated issue is subrogation, which should always be handled by an attorney. Most health insurance companies, Medi-Care, Medi-Cal, union benefit plans and others often have legal rights to recover benefits from your settlement [subrogation]. You will end up netting much less out of your settlement than you had anticipated, if subrogated liens are not properly handled. Always know the status and amount of all lien holders before attempting to settle a claim. A good attorney will negotiate those liens. Bottom line: adjuster’s do not have your best interests in mind, because they work for insurance companies and are solely concerned with reducing the settlement value of your claim.  

Mistake #5: Relinquishing medical reimbursement.
Adjusters will often say that you are not entitled to reimbursement of your medical bills if they were covered by your private insurance. That assertion is blatantly false under CA law, and the Collateral Source Rule. If an adjuster is allowed to get away with that misrepresentation, thousands of dollars can be lost in settlement value if you claim only your deductible or out-of-pocket co-pays. You should ALWAYS be reimbursed the full amount of your medical bills, regardless of whether or not they have been paid by insurance. Bottom line: This issue can become complicated, and there is an exception for medical malpractice claims, so it is best to have a skilled accident injury attorney represent your interests.

Mistake #6: Relinquishing sick pay or disability benefits.
When you miss work as a result of being injured by another, you are entitled to reimbursement for time off work and loss of any fringe benefits, including vacation and bonus pay. Adjusters WILL avoid reimbursing you for lost profits and benefits if you received sick pay, or other disability benefits. Again, this is contrary to CA law. Bottom line: NEVER believe an insurance adjuster who says you are not entitled to reimbursement for your time off if you received sick pay, or other disability benefits.  

Mistake #7: Waiting until the last minute to resolve your claim.
All claims have time deadlines, called statutes of limitation. If your claim is not resolved within the appropriate time period, or if a lawsuit is not timely filed in the event that you are unable to satisfactorily settle your claim, your claim will be barred by law. Statutes of limitation are serious; even the most grave injury claim will be lost forever if it is not resolved, or filed, in a timely manner. If you wait until the last minute to resolve your claim, the insurance company has a HUGE advantage, which it will press with lowball offers, to your detriment. When adjusters know that you are running out of time, you will receive low ball offers. Since your only option at that point is to file a lawsuit, you may feel coerced into accepting an unfair offer, simply to avoid going to court. In CA, general personal injury claims have a 2 year statute of limitation, but different time deadlines apply to medical malpractice claims and employment related claims. Bottom line: ALWAYS be aware of the appropriate time deadlines for your case.

Mistake #8: Letting the insurance adjuster make the initial offer.
The injured party should always make the initial demand. The initial demand should be very carefully analyzed and drafted so that it covers all of your damages, and allows you plenty of negotiation room. Adjusters are rewarded based upon how low they can settle the claims they handle. You should demand reimbursement for all of your special damages [medical bills, lost earnings, future medical bills, future lost profits, loss of fringe benefits], and any other economic losses incurred ,as a result of the injury. You should also demand reimbursement for all of your general damages [non-economic losses caused by the injury, such as the pain, suffering, discomfort and inconvenience that the injury has caused you], and for any such damages that you are likely to incur in the future. A good attorney will present your theories of liability, and evidence in support of your damages, in a formal demand containing the dollar value of the compensation you are seeking. Bottom line: NEVER rely upon the insurance adjuster’s evaluation of your injury, and the value of your claim.