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Fighting the Insurance Company After a TBI
Suffering a traumatic brain injury (TBI) can turn your world upside down. Not only are you dealing with the pain and challenges of recovery, but you’re also facing the very real and often frustrating experience of fighting with an insurance company that seems determined to deny or minimize your claim. However, an experienced brain injury lawyer can empower you to challenge insurance companies and fight for the compensation you deserve.
Here’s how you can stand against an insurance company, ensuring your TBI claim is treated with the seriousness it deserves.
Understanding the Insurance Company’s Playbook
Insurance companies often have a systematic approach to handling claims. They aren’t quick to give out high payouts, and when they see a TBI claim, they might label it “high risk” right away. High payouts mean higher costs for them, so expect tactics to minimize their financial obligation. Insurance companies know the stakes are high for you, and they’re prepared to defend their money – often using various methods to deny, delay, or reduce your claim’s value.
From questionable evaluations to insisting on unnecessary medical exams, an insurance company will try different strategies to avoid paying a fair settlement. Your personal injury lawyer’s goal will be to respond effectively to whatever tactics the insurers use to deny your rightful compensation. Some common tactics include the following:
Insurance Adjuster Tricks
Once you’ve filed your TBI claim, expect an insurance adjuster to reach out. They might sound polite, even empathetic, as they inquire about your injury and experience. But remember, the adjuster’s priority isn’t you; it’s the insurance company’s bottom line. Their role centers on reducing your insurer’s payout, even if it comes at the cost of your rightful compensation.
Don’t let their kindness fool you. Adjusters are trained to seem supportive but often ask questions to undermine your claim. They’ll ask about your symptoms, recovery progress, and any limitations you’re experiencing.
These questions might sound routine, but your responses can significantly impact your case. If you downplay your symptoms or, in an effort to be optimistic, suggest that you’re feeling better, the adjuster might seize these statements. They can argue that your injury isn’t as severe as you claim, using your own words against you in future settlement discussions.
If you’ve hired a personal injury lawyer, they can handle these conversations. A lawyer will know how to respond strategically, ensuring the insurance company can’t twist your words to reduce your claim. They’ll also advise on what you should avoid discussing, minimizing the risk of unintentional statements that can harm your case.
Denying the Seriousness of TBIs
Insurance companies often attempt to downplay the severity of TBIs, especially if they think they can save money by classifying your injury as “minor.” They might argue that most TBIs have a straightforward recovery path, or they may cite studies suggesting that brain injuries often resolve quickly. Unfortunately, this perspective ignores the reality that every TBI is unique, with recovery times and challenges varying widely from one person to another.
In their attempt to minimize your claim, insurers might label your TBI as a short-term issue. They may even suggest that your symptoms are exaggerated or unrelated to the injury, implying that your recovery should have been complete by now. Such dismissive tactics can be incredibly frustrating, especially when you’re still dealing with the real, life-altering effects of your TBI.
Recovery from a TBI depends on several factors: the severity of the injury, the specific areas of the brain affected, and even your overall health before the accident. Insurance companies often ignore these nuances, focusing only on what benefits their case. But medical evidence can be your best defense against these arguments. Detailed records from your healthcare providers, neurologists, and rehabilitation specialists can accurately depict your condition.
With a personal injury lawyer’s help, you can compile and present this medical evidence effectively. Your TBI accident attorney will gather records from doctors who’ve seen the true impact of your injury, including documentation of symptoms, treatments, and progress over time. Comprehensive records showcasing your injury’s reality will counter the insurance company’s narrative and emphasize the need for a fair settlement.
Using Medical Examinations as a Tool to Undermine Claims
Insurance companies may request an “independent medical examination” (IME) as part of your TBI claim process. Although “independent” suggests impartiality, IMEs are often anything but. Typically, insurance companies hire the doctors who conduct these exams, meaning the physician may be inclined to produce a report favorable to the insurer’s interests rather than yours.
The IME doctor might downplay the severity of your symptoms or question their connection to your TBI. They can claim that your recovery timeline should be shorter or suggest your injury was less significant than reported. In some cases, IME doctors may even state that your symptoms aren’t consistent with a brain injury, giving the insurance company grounds to dispute your claim.
As a claimant, you’re not required to agree to every exam the insurance company requests. Before attending an IME, consult with your personal injury lawyer. Your personal injury attorney will help you understand the purpose of the IME and can offer guidance on how to handle the exam. They’ll prepare you for what to expect, including questions you might face and ways to present your symptoms accurately. This preparation can prevent the IME doctor from misinterpreting or downplaying your condition.
If the insurance company insists on multiple IMEs, that’s often a red flag. They may be fishing for a report that benefits them rather than a fair assessment of your injury. With your lawyer’s help, you can challenge excessive requests for exams and maintain control over how your TBI is evaluated.
The Importance of Documenting Everything
When dealing with a TBI claim, detailed documentation is your strongest ally. Insurance companies will look for any gaps in your documentation as an excuse to challenge your claim. To build a strong case, keep thorough records of every aspect of your injury, treatment, and recovery process. Here’s how to do it.
Medical Records
Detail each doctor’s visit, diagnostic test, and therapy session. This includes neurology appointments, physical therapy sessions, cognitive therapy, and any prescriptions related to your TBI. Documentation of your appointments and treatments will show that you’re actively addressing your injury and that your symptoms are ongoing, reinforcing the validity of your claim.
Keep a Personal Journal
Beyond medical records, maintaining a personal journal of your symptoms and struggles can add weight to your case. Each day, note any pain levels, limitations, and your TBI’s impact on daily activities. Record these incidents if you experience memory lapses, fatigue, or difficulty concentrating. Insurance companies tend to challenge claims for “invisible” injuries like TBIs, so a daily journal helps substantiate your experience and highlights the injury’s effect on your life.
Financial Records
Financial documentation also plays a key role. Keep receipts and records of all expenses related to your TBI, including co-pays, out-of-pocket medical costs, transportation expenses for doctor’s visits, and costs for home modifications if necessary.
Don’t forget to document lost income if you can’t work or have had to reduce your hours due to your symptoms. Every dollar spent and every day of work missed strengthens your claim and counters the insurance company’s attempts to downplay your need for compensation.
Responding to Insurance Company Tactics
Dealing with an insurance company after a TBI can feel like a never-ending battle, but with careful planning, you can respond to their tactics confidently. By preparing for common strategies, such as dismissing your symptoms, questioning your recovery, and undermining your claim through IMEs, you’re already one step ahead.
Your personal injury lawyer is there to counter each tactic. They’ll ensure you’re well-prepared for interactions with the insurance company, from handling adjuster questions to addressing IME requests. With the right approach, you’ll build a solid case that withstands scrutiny, even in the face of insurance company pressure.
Calculating the Full Cost of a TBI: Going Beyond Medical Bills
Insurance companies might want to settle your TBI claim by covering only your immediate medical bills. But TBIs often come with long-term costs, which must be accounted for in any settlement. Consider not only the physical but also the emotional and financial toll this injury has placed on your life. Lost income, reduced earning capacity, future medical expenses, and ongoing therapy all factor into the actual cost of a TBI.
Personal injury lawyers understand how to quantify these “non-economic damages” like pain and suffering or loss of enjoyment of life. Your TBI accident attorney can work with economists and medical professionals to create an estimate that reflects the full impact of your injury.
Challenging Lowball Settlement Offers
Insurance companies often start settlement negotiations with a lowball offer, hoping you’ll settle quickly to avoid further stress. Lowball offers typically cover only a fraction of what you’re truly owed. When an offer doesn’t account for future costs, ongoing care, or the extent of your suffering, it’s time to fight back.
Rejecting an offer doesn’t end the negotiation; it’s the beginning. You can counter these offers by submitting additional documentation and clearly showing the full scope of your injury’s impact. A TBI accident lawyer can counter these offers and keep the negotiation open until the insurance company sees what you actually deserve.
Recognizing Bad Faith Tactics
Sometimes, insurance companies act in “bad faith,” which means they aren’t fulfilling their legal obligation to handle your claim fairly. Bad faith tactics can include:
- Unreasonable delays
- Denial of valid claims without explanation
- An outright refusal to negotiate
Documenting the company’s actions becomes even more critical when you suspect bad faith. Save copies of every email, letter, and recorded call with the insurance company. Your personal injury lawyer can use this information to show the insurance company isn’t holding up its end of the bargain, possibly increasing your leverage or grounds for additional compensation.
Don’t Rush the Process
After a TBI, it’s natural to want a resolution quickly, but rushing can lead to missed opportunities for fair compensation. Insurance companies often pressure claimants to settle fast, hoping you’ll accept less in exchange for a quicker payout. Unfortunately, once you accept, you lose the chance to pursue additional compensation if new symptoms appear or your condition worsens.
It’s wise to wait until you have a complete picture of your injury’s impact on your life. Give yourself time to understand the long-term costs and consult with medical professionals and your lawyer to create a settlement demand that reflects the total impact.
Keeping Communication Professional and Limited
Insurance companies may contact you directly, often with questions or follow-up calls about your condition. While it may seem polite to answer, limit your communication with them, as anything you say can be used to challenge your claim.
Let your personal injury lawyer handle most of the communication with the insurance company. Having your lawyer speak on your behalf reduces the chance of misunderstandings or statements being twisted to harm your case.
Preparing for a Possible Trial
If negotiations don’t produce a fair settlement, going to trial may be necessary. Trials can be lengthy, but sometimes, it’s the best way to secure the compensation you need for a TBI. Insurance companies know trials carry risks and expenses, so simply being prepared to go to court can strengthen your negotiating position.
In court, the burden will be on you to prove the extent of your injury, how it occurred, and its impact on your life. A personal injury lawyer can present your case convincingly to a judge or jury, ensuring your side of the story is told fully and fairly.
Leveraging a Personal Injury Lawyer’s Strategy for Success
To fight back effectively, you’ll need more than determination; you’ll need a well-planned strategy. Your personal injury lawyer knows the best ways to build and present your case and how to counter every argument the insurance company might use. They’ll guide you through gathering the right documentation, preparing for medical evaluations, and negotiating from a position of strength. With these strategies, you can confidently approach each stage of the claim.
Take Control of Your TBI Claim
By understanding insurance companies’ tactics, documenting every aspect of your injury, and having a dedicated personal injury lawyer, you’ll be in the strongest position to secure the compensation you need and deserve.
Every step you take in this fight matters, and with perseverance and the right support, you’ll overcome the challenges and reach a fair resolution. A skilled Boca Raton personal injury attorney is standing by to help you do precisely that. Contact an attorney for a free consultation as soon as possible.