The Top Reasons Why Insurance Companies Don’t Settle Injury Cases

It’s estimated that about 95% of all personal injury claims are settled in negotiations, while the remaining 5% of cases are taken to court. Based on this data, it’s very likely that any claim you file will be settled outside of the courtroom in negotiations. But, there is a small chance that the insurance company will not be willing to settle. Why does this happen? Here are some of the top reasons why insurance companies don’t settle injury cases:

Lack of Evidence

A lack of evidence is the most common reason why an insurance company will not settle with an accident victim. Lack of evidence can refer to either insufficient evidence that the insurance company’s policyholder is to blame or insufficient evidence that the victim is actually injured.

If the insurance company does not have proof that their policyholder is to blame, there’s no reason for them to make an offer. They will need to see concrete evidence that their policyholder’s negligence was a direct cause of the accident. This can include witness testimony, surveillance camera footage, accident reconstruction, and photos from the scene of the crash.

The insurance adjuster will also need to review medical records and consult with medical experts to verify the victim’s injuries. If the insurance adjuster believes the victim is lying or exaggerating their injuries, they may choose not to enter settlement negotiations. Fortunately, an attorney can help victims provide the proof that they need to avoid this problem.

Pre-Existing Conditions

A pre-existing injury can also impact your ability to reach a settlement with the at-fault party’s insurance company. A pre-existing injury is an injury or condition that was present prior to the accident.

For example, let’s say you sustained a back injury while gardening several years ago. After several months of treatment, the injury completely healed and the symptoms went away. But then, you are involved in a car accident and start to experience back pain once more. The insurance company may argue that you are experiencing back pain because of your pre-existing injury, not because of injuries sustained in the car accident. Since their policyholder did not cause your pre-existing injury, they may argue that they do not need to pay.

In situations like these, the insurance company may refuse to settle so the victim may need to take the case to court to recover compensation. If you are aware of a pre-existing injury, it’s best to work with an attorney who knows how to prove that the pre-existing injury is not related to the accident.

Stall Tactics

Some insurance adjusters will intentionally delay settlement talks in an attempt to frustrate the victim and motivate them to accept a low offer to resolve the case faster. They may ask the victim to provide unnecessary details and records regarding their injuries or take days to respond to every question or concern. If these tactics work, the case will end with a low settlement. However, if you do not fall for these tricks, the case will go to court since the insurance company has made it clear they are not serious about negotiating.

Lack of Coverage

Insurance companies are only responsible for compensating victims who were injured by one of the company’s policyholders. If the at-fault party was not covered by insurance at the time of the accident, the insurance company is not obligated to pay for the victim’s expenses.

For example, let’s say the accident occurred on August 1st, but the at-fault party’s insurance policy lapsed on July 31st because they failed to make on-time payments. Since the policy lapsed prior to the accident, the driver was not insured at the time of the accident. This means the insurance company is not liable for compensating the victim.

Procedural Issues

There are also a number of procedural issues that can affect the outcome of a personal injury claim. Every insurance company has specific rules that must be followed when someone files an injury claim. If one of these rules is not followed, the insurance company may immediately deny your claim instead of negotiating a settlement. For instance, the insurance company may require all claims to be submitted within 30 days following an accident. If you submit a claim after the 30-day window has passed, the insurance company may automatically reject it. For this reason, it is important to review the insurance company’s policies and procedures as soon as possible following an accident.

Unrealistic Expectations

It is sometimes the victim–not the insurance company–that is to blame when a claim is not settled outside of the courtroom. This typically happens when the victim has unrealistic expectations about the amount of compensation they are going to recover for their injuries. For example, if a victim believes their claim is worth $500,000 when it is actually worth closer to $100,000, the two sides may never reach a settlement.

While it is important to fight for compensation, it’s also crucial to set realistic expectations. Talk to your attorney to determine how much your claim is actually worth so you know when the insurance company is making a fair offer. You will also need to find out the limits on the at-fault party’s insurance policy since this can impact the amount of compensation you are able to recover. For instance, if the insurance policy has a $50,000 limit, the victim should not expect to reach a settlement that is above this number.

Have you been injured in an accident? If so, contact Carpenter & Zuckerman as soon as possible to discuss your case. Our team of experienced personal injury attorneys will aggressively negotiate with the at-fault party’s insurance company to secure the compensation you deserve for your injuries. Schedule a free, no-obligation consultation now.