I frequently say to my clients that insurance companies are in the business of making money and collecting premiums as opposed to paying money out to deserving claimants. Insurance adjusters are trained by the insurance company to use common defenses in response to a claim that is presented. The following are some of those common claim defenses that are used by insurance company adjusters to fight back and resist paying fair value for fair and legitimate car accident claims.
The first common defense used by car insurance companies is to claim that there was little or no property damage sustained to the vehicles involved in the collision. This is perhaps the most popular car accident claim defense used by car insurance companies. Their argument is essentially that injury to a person inside the vehicle is unlikely when there is a very small degree or extent of damage sustained to the vehicle.
Therefore, they claim that it’s unlikely that a personal injury could reasonably follow from such a low-impact accident. Typically, we will argue in that situation that lack of property damage does not correlate to lack of bodily injury harm to the person inside. The basis for that argument is that the occupant of the vehicle absorbs most of the damage as opposed to the vehicle itself.
A second common defense used by car insurance companies is to claim that the injured victim had gaps in medical treatment. It is not uncommon, especially today, during the pandemic, for there to be gaps in medical treatment. For example, if someone is involved in a collision and he or she goes to the hospital, if that person has a delay in seeking follow-up care either through chiropractic or physical therapy treatment, the insurance company will assert that the person wasn’t injured.
An effective response to that argument is that the claimant was trying to resist needing to go for medical treatment but instead needed to eventually get treatment. The argument is that the victim tried to tough it out but ultimately had to acquiesce and receive medical treatment, albeit even if there was a gap in the medical treatment received.
Another very common defense used by insurance companies is to claim that the injuries are pre-existing. This argument is based on an assumption that the injuries claimed by the injury victim predated the accident. For example, if the injured victim asserts that his or her neck and/or back was injured in the accident, the insurance adjuster is likely going to want to point out and stress that the claimant had prior neck and/or back injuries well before the occurrence of the accident that had nothing to do with the accident itself. An effective rebuttal to this argument is to produce prior medical records, which show that the claimant was not actively [treating / treated 04:42] for any such pre-existing injuries.
A fourth common defense that an adjuster will put forth is that the statute of limitations has run out. Keep in mind that the statute of limitations for a car accident claim in Massachusetts is generally three years from the date of the accident. There are exceptions to this rule when there is a minor that is involved in the accident, but generally, this three-year statute of limitations is sacrosanct and has very little, if no, wiggle room to maneuver around.
In this situation, regardless of how the accident happened or what defenses are ultimately raised by the insurance company, your best bet is to contact a local personal injury lawyer near you to obtain a free consultation. Otherwise, you are simply fighting the insurance company on your own in an arena that you are not familiar with.