Questions Insurance Adjusters DON'T Want You to Ask After a Car Accident

You've just been in a car wreck and now some insurance adjuster is trying to trap you into a bad settlement before you're even done getting all of your medical treatment. I'm Shane McGuire. I'm a personal injury lawyer here in Texas and in this video I want to walk you through nine questions you can use to put pressure back on the insurance company on the record as they're asking you questions trying to maneuver you into taking some lowball settlement These nine questions are going to help you put the pressure back on the insurance company, kind of shift control from that adjuster back to you as you try to negotiate your claim. So I'm going to give you nine tips on how to do that so that you can maximize the recovery you get and the claim that you're making against the at-fault driver's insurance company. Now before I do that, I just want to tell you up front, you really shouldn't be dealing with the insurance company at all. You should hire a personal injury lawyer to help you through the process, but I totally get it. If you're like me, a lot of other people like me, and you want to try to do it yourself, I'm going to give you these nine tips and you can do with it what you will. Okay, first ask the adjuster on the record, are you recording this call? You know, Texas is a one-party consent state and while most insurance companies will tell you up front that they're recording the call in the state of Texas, they don't have to. Only one party to a phone conversation needs to consent to the recording in order for the recording to be legit. So what does that mean? What you cannot do is like tap somebody's phone so that neither side of the phone conversation knows they're being recorded. That's a no-no. But what you can do is have one side of the phone conversation recorded and the other side not know. It's totally legal and you put the pressure back on them by saying, hey, are you recording this call? And hey, can I get a transcript of the recording or a copy of the recording when we're on? Okay, second question you can ask, and this is a question that will really throw them back on their heels because they're in the business of asking you questions and not answering questions. So something you can say is to get them to show their cards, hey, what facts are you alleging that this wreck is my fault? And you know what they're not going to want to say? What they're going to try to do is just say, we're still investigating, we need to talk to our insured, we're still trying to gather evidence, those sorts of responses, that sort of language is indicative that they are blaming you. Unless they say we are taking a hundred percent responsibility for this wreck and we're going to compensate you, then they're not doing it. They are talking to you in order to get you to slip up and say something that gives them an excuse to not pay you. When you say, hey, what facts are you claiming that would show this wreck is my fault? Or how are you trying to shift blame to me? Make them answer that question, lay the law down with them and say, hey, I'm not going to answer your questions unless you tell me what it is you're saying I did wrong to cause this wreck. Third question you can ask, and man, they will hate this one. What coverages apply in this case? You know, in Texas, the insurance carrier for the at-fault driver does not have to tell you how much coverage their insured has without filing a lawsuit, unless they're tendering the limits of that policy to you. I mean, if they say, hey, listen, we're going to give you all the insurance that we have, yeah, they have to show you how much insurance they have. If they're not doing that, they don't have to tell you. They can, but most insurance companies are going to have a hard and fast rule of they're not telling you how much coverage is available. They may use coded language like, I don't have much coverage, we've got plenty of coverage, but those are all meaningless because you don't know what that adjuster means and there's no rule that says they can't lie to you. Their job is to minimize the amount of money that you get, and so they're playing games with you. Put them back on their heels and make them answer the question, how much coverage is available? And while you're at it, make sure that you look at your own insurance carrier to see if you have coverage there too. You might have underinsured motorist coverage in case the at-fault driver doesn't have enough insurance to cover your loss. You might have personal injury protection to help pay for medical bills, and that's not even PIP or PIP. That's not even a cantankerous process. That's not even a litigious process most of the time. That's just show your own insurance carrier your bills and they should write you a check for those bills. You need to know all the coverages that are available to you to compensate you for the injuries and the damages you have from the wreck. Fourth question you should ask that insurance company. Get that adjuster on the phone and just ask this question, what is your best offer today and what is it that that offer is covering? And when you ask that question, if they even give you a halfway candid response, it is going to reveal sometimes explicitly, sometimes tacitly how it is they're trying to screw you over. And here's what I mean by that. If you say how much are you offering and what does that cover? A lot of times they're going to say something like this. Well, what we're offering is $12,500. And here's what that covers. $10,000 for reasonable medical expenses and 2,500 for your pain and suffering. And I keep in mind they haven't talked about physical impairment. They haven't talked about your lost wages. They haven't talked about mental anguish. That's how they're going to work. Okay. Embedded in that is a couple of things. One, the medical they're offering up to $10,000, they're going to say reasonable medical expenses. And what is unstated, what is hidden and concealed is that they are going to determine what's reasonable, not you and not your healthcare provider. Because what they're going to do is if you agree to that deal on the back end, they're going to say, well, we just said we were going to pay $10,000 of reasonable medical expenses. You know, that CT scan you got at the ER, they charged you $4,500 for that. We think that's too high. So we're going to pay $1,500 for that. And then when you went to your primary care doctor, they did an x-ray and they charged you $250 for that x-ray. We're going to pay $150 for that. And then when you follow it up at a pain management specialist and he gave you an epidural steroid injection for $6,500, we think that should really be $2,500. And then you find at the end of it that they said they would pay up to $10,000 for reasonable medical expenses. And they paid like $3,500 and you're left with a bill for $6,500 or more. And you didn't expect that. You thought you were getting this deal where they were just going to pay $10,000 for the bills that you showed them. But never forget, they are not in the business of paying money. They are in the business of making money. And you are always recorded as a loss. They record it as a date of loss. You are a claimant. You are not your name. You are just a number. And they view you as a potential loss for them. And they are trying to minimize the damage at every single turn. So ask them, point blank, what is it you're offering and how is that broken down between physical pain, physical impairment, lost wages, past medical bills, future medical bills, I may incur. I'll tell you another question you need to ask them. At some point in the claims process, these insurance companies are going to try to get you to sign a medical authorization form. And you should not do it. You should not do it. I know how it is. I can tell you not to do it all day long. And some of you are still going to do it. And you're going to say, I got nothing to hide. I'm just going to do it. First of all, don't do it because you have no clue what's in your medical records. You don't remember. I mean, if you're like me, you don't remember what you had for lunch yesterday, much less that you might've complained of some back pain two years ago with your primary care doctor. And it may even be associated with like the flu or something because you were having body aches everywhere. And then some insurance adjusters are going to look at it and say, oh, you have this chronic history of back pain. So don't do this anyway. Okay. But if you do, you're trying to handle it yourself and you're going to sign a medical authorization, ask that insurance adjuster exactly what it is they are looking for so that you can narrowly tailor the medical authorization to that. Like limit it to neck, limit it to back. I'm telling you, I have seen it such that insurance companies even get gynecological records on female clients. They come in and they sign an authorization form and it's a neck back case. It's neck pain, it's back pain, it's shoulder pain. And they just got this blanket release for every healthcare provider they've ever had. And they're getting gynecological records from my client. That is absurd. And then I get the case and I see that they've ordered all these records and they're diving into the most intimate medical records that you have. It's absurd. I'm telling you, these insurance companies, they're godless, soulless entities. They're only out to try to save money and minimize your claim. Don't let them do it. Ask them exactly what it is they're looking for so that you can narrowly tailor the medical authorization that they're trying to get. Sixth question you need to ask that insurance adjuster. Are you saying that my medical treatment costs too much? If so, what are you basing that on? How much should it have cost? Here's the reality. These insurance companies base their payment schedule on how much medical bills ought to be based on Medicare rates, Medicare reimbursement rates. And you know, and I know that Medicare reimbursement rates are arbitrarily low, that private health pays more, that the cash price is higher. And so these insurance companies, Progressive, Allstate, all these auto insurance companies, they're trying to get the benefit of Medicare rates, or like just a shade over Medicare rates, when you're not on Medicare. When your healthcare provider treated you, saying, hey, I'll wait to get paid when the case settles, or the ER takes you in, because they have, by law, they have to take you in. And they're like, hey, we'll get paid out of the auto insurance carrier. Then the auto carrier tries to squeeze the hospital down, tries to squeeze your chiropractor down, or your pain management doc down, saying they'll take Medicare reimbursement rates when you're not a Medicare beneficiary. It is absurd. You ask that insurance adjuster, are you saying my medical bills are too high? And what do you base it on? And they're not going to show you the goods, because they have this proprietary software that's just designed. I mean, here's the order that they, please design a software for me that makes it such that we can show our insurance that we don't owe all of their bills. That's the goal. Again, never forget, their goal is to minimize payout on these claims. You're sitting there, your goal is to get your medical bills paid and to get a reasonable amount for pain and suffering. That is why you can't trust these guys. That's why you've got to hire somebody like me. But if you're just determined to talk to them yourself, make them show you their cards. Ask them how much they're saying your medical bills ought to be. Seventh question you ought to ask, what additional information is it that you claim to need in order to evaluate my claim? Delay, delay, delay. That's the name of the game for these guys. You know, if you think about it, the longer they hold on to those premium dollars they get from the insurance, the more money they make and interest at the bank. So if they can delay your $10,000 claim, and that guy's $100,000 claim, and that guy's million-dollar claim, all that adds up, all that interest adds up, and they make more and more money. So the further they delay your claim, the more money they make. So it's good to put pressure on them by saying, hey, you say you're still evaluating it. What more do you need? And then you can determine if they are being honest with you with their response. Here's what they're going to say. We still need to talk to our insurance. I mean, why do you still need to talk to him? The crash report says it's his fault. We're still evaluating your medical history. Listen, do you think I went to the ER for fun after this wreck? What more do you need from me? All they're trying to do is delay payment and dig and find dirt on you so they can save money. Eighth question you ought to ask. Hey, if I sign this release, what rights am I giving up? I tell you what, they don't want that because what you're giving up, hey, listen, three weeks after a wreck, four weeks after a wreck, you still may not know the nature and extent of all of your injuries. I've had clients who get a back or a neck surgery or a shoulder surgery a year and a half after a wreck because they've cycled through physical therapy, they've cycled through some pain management and it didn't fix their problem and now they have to get surgery. Now the insurance company wants you to sign away your rights three, four, five, six weeks after a wreck and you need to know that you are signing away your ability to go back and get money for future care and needs you have as it relates to that wreck and make the insurance company tell you that. I mean, they may lie to you, but the reality is in that release language that they're going to send to you, if you've negotiated a deal, it's going to say you cannot under any circumstance, go back and make a claim against the insured or the insurance company for injuries you sustained in that wreck. Even if you don't know all the medical treatment you made in the future at that point, you're waiving all of your rights. Be sure to make absolutely crystal clear before you sign any release that you know what it is you're signing. Ninth question you need to ask and I guess, I mean, you just need to ask it. You can ask it to the insurance company, but they may lie to you, but you ask it to yourself, what are the deadlines I have and what happens if I wait? In Texas, you get two years from the date of the accident to make a personal injury claim. It's two years to file suit, okay? So if you're negotiating, this happens. I've seen it happen. I got a call last year from a guy, they had waited the insurance company was negotiating and they said, hey, can we have a little more information? Can we have this and that? And then it got to be a week before the statute of limitations ran. In other words, it was one year and 51 weeks out from the wreck and man, I hate taking those cases. I hate taking those cases because I'm jammed up on the statute of limitations, but my heart went out to this guy and typically I won't take that case, but my heart went out to him because it was so clear the insurance company was taking advantage of him. I signed it up. I filed a lawsuit 30 days later. They pay us the limits of the insurance policy. Why? Because he went out and he hired a lawyer and he knew I wasn't going to mess around with these people. They know who I am. I mean, they know that I'm going to sue them. They know that I'm going to try the case. They know that I'm going to get a verdict and they know that I'm going to collect on that verdict. They know that about me at this point, because I've got a 20 year track record of taking these guys to the cleaners all the time. So when he came and signed up with me a week before the statute and I filed suit, insurance company knows I mean business and so they pay my client and that's what we do here. But the insurance company is delayed, delayed, delayed. If the guy waited another week, he would have gotten zero. Make sure you have an understanding of what your deadlines are because you may waive your rights without even knowing it. Okay, so what do these questions do? Well, they do two things. These nine questions, one, prevent you from falling into the low settlement trap that that insurance adjuster is trying to set for you. And two, it puts the insurance company on their heels where they're playing reaction instead of being proactive. You want them being reactive instead of proactive on your claim. Because if they're proactive and you're just reacting to what they do, you're playing their game. You don't want to play their game. That's the game where you lose and you get less money than you're entitled to. If you want, pause this video. We'll show the list on the screen. Write the list down, these nine questions. And you ask these questions to the insurance adjuster to put them on their heels. And for more tips on how to maximize the value of your personal injury claim, follow us at McGuire.