8 Secrets Insurance Companies Don’t Want You to Know (About Injury Claims)


– I’m Justin Ziegler, an injury attorney. Today I’m gonna talk about eight secrets that insurance companies won’t tell you in a personal injury case. The reserve amount is an amount of money when you make an injury claim that the insurance company
sets aside to pay your claim. Generally speaking, the
higher the reserve amount, the higher amount of money
that the insurance company will ultimately pay you in a case, or has the authority to
ultimately pay you in a claim. Now, you may be dealing
with an insurance adjuster, a claims representative
of the insurance company, and think he’s extremely nice but, just to get a good idea
of how much you think you’re gonna get paid,
or how willing you think the insurance company is to pay you, ask the adjuster what is the reserve, what have you reserved my claim at? 95 out of a hundred times you’re gonna get the adjuster to say “I can’t tell you that, it’s
privileged information.” Occasionally you may
get an adjuster who says I’ve reserved your claim at X. Now X could be 5,000, 40,000,
a hundred thousand, whatever. Even if the adjuster
tells you the reserve, you have to assume that
it’s not really the reserve. Why? If he told you the reserve he would be showing you all his cards. An example of a claim that I had where the adjuster told me one reserve
that was totally incorrect, and much lower than the actual value of the claim and settlement value was, I had a case I settled for $445,000.00. Now after my client was
released from the hospital, I made a claim against the truck driver who caused the accident. And I sent the adjuster some
medical bills and records, and the adjuster told me
that when I asked him I said “What do you have the claim reserved at?” He told me “$100,000.00.” Now, from that point forward
not much changed with the case. However, the case ended up
settling for $445,000.00. So, even if the insurance adjuster does tell you what the reserve is, take what he tells you
with a grain of salt. A low first offer does not mean the case is not worth
that much money, okay? I have had many cases, too
many to go over right now, where my client, or we,
received a low first offer and the claim ended up settling
for multiples of that offer. One example was where
my client was offered by Travelers Insurance Company $20,000.00 for a wrist fracture and
the surgery as a result of falling from a booth at a restaurant. Now, the adjuster told me “$20,000.00 “Is all that I’m allowed, “All the authority I have to offer you.” But we ended up filing a lawsuit and just a few months later,
not a whole lot of time later, but after hard fought litigation, we settled the case for $210,000.00. So, the moral of the story is, just because you get an initial low offer, don’t think your case
is not worth that much. Now, on the other hand,
there are some cases where the insurance adjuster will offer you 4,000, 5,000, 7,000, whatever, and he really only has the
authority to increase his offer a few thousand dollars
or so more than that. But just because he only has the authority to offer a few thousand more, doesn’t mean your case
is not worth a lot more. Don’t expect the insurance
company to tell you that you may have a case
even if they deny liability. Now, from time to time, in claims that I represent people in, where they’re hurt and
someone else is at fault, the insurance company will deny liability. But one of the big secrets out there to people who don’t handle
these claims routinely is that just because an insurance
company denies liability, essentially saying we did nothing, their client, their
insured, did nothing wrong, that doesn’t mean that you
don’t have a fantastic claim. Let me give you an example. I represented a gentleman who slipped and fell in a
supermarket in Miami, Florida. Prior to the slip and fall he
had hurt his Achilles tendon, but the fall made it much worse and he had to have a
couple of skin revisions. Now, the insurance company, actually it was the
supermarket themselves, initially denied liability. They said, they even sent a copy of the surveillance
video showing the fall, they said “Look at it,
we did nothing wrong.” Well, I ultimately filed a lawsuit and we settled for $300,000.00 some time later after
hard-fought litigation. But the point of the story is, just because an insurance
company denies liability and says our client, or our
insured, did nothing wrong, it doesn’t mean you don’t
have a fantastic claim. On the other hand, there are times where an insurance company
does deny liability, and you really may have a terrible claim. Don’t expect the insurance
company to tell you if there’s any more available
insurance out there, many adjusters will not do it. So, let’s say you’re in an auto accident and you have a claim against the driver. The insurance company
tells you that the driver has $10,000.00 of insurance, or you send a letter to them requesting that they tell you what
the insurance limits are, sworn under oath, they say $10,000.00. They say on the response that there’s no other available insurance
that they’re aware of. They’re not always right. Sometimes the adjuster
does not take the time to ask his insured, the person
who caused your accident, sir, mister, do you have
any other umbrella insurance that would apply for this accident that covers you above the
bodily injury liability? Or, were you working for an employer at the time of the accident? That insurance may kick in. Or, were you driving a
car for Uber or Lift, or were you volunteering? Or, do you live with a resident relative whose insurance may cover
you for this accident? Bottom line is, insurance adjusters are
loaded up with claims. They may not take the time to research and speak with their
insured and really find out if there’s additional insurance
that applies to the claim. You need to do the work,
you need to investigate it, you need to send the proper letters, and you need to demand that
they give you an answer. Don’t expect them to do the work for you. Don’t expect the insurance
company to tell you that suing their insured
will get you a higher offer, they’re just not gonna do it. Now, occasionally an adjuster will say hey, if you wanna get more
money, you have to sue us, meaning their client. However, overall don’t
expect them to tell you this. Now, I heard years ago that one
particular insurance company when a lawsuit is filed against them, they double their settlement reserves, their reserves to pay the claim. One of the reasons that suing
them may get a higher offer is because a lot of insurance companies have to then hire outside
attorneys to defend the case. they have to pay them hourly fees which can really add up very quickly. Also, when you file a lawsuit the insurance companymay
switch the adjuster. The new adjuster may have
more settlement authority, money, to pay your claim. One of the best kept secrets
in the insurance business is do not expect the
insurance adjuster to tell you that you do not have to
give a recorded statement. In many cases, you do not have
to give a recorded statement. There are some cases where you do have to give
the recorded statement. For example, if you’re making a claim against your own auto insurer, there’s a very high probability that you have to give
a recorded statement. But generally, if you’re injured
on someone else’s premises, you never have to give
a recorded statement. If you’re making a claim against a driver, someone who was careless,
or an owner of a vehicle, who caused your injury, you generally never have to
give a recorded statement. The recorded statement will
later be used against you and the insurance company
will try to point out things, such as you saying that
you were not in pain when you gave the statement, and now you’re telling
the insurance company how bad your life has been
damaged because of the accident. The recorded statement can generally only favor an insurance company. The same is true with the
non-recorded statement, just a regular informal statement. If it’s to your own insurance company you generally have to give it. If you’re making a claim against someone else’s insurance company for damage that they caused
to you in an accident, you generally never have to
give a recorded statement. Don’t expect an insurance
company to tell you that you should go to the
hospital or get medical treatment. If you don’t go to the hospital
or get medical treatment, expect them to later on offer you less to settle your personal injury claim. But don’t expect an insurance
adjuster to tell you, to say to you hey, I
just wanted to point out you haven’t gotten medical
treatment in a while, you should go to the doctor,
it’s gonna help your case. The number eight secret
that the insurance company for the careless party
likely will not tell you are bad facts that hurt
their insured’s claim. Essentially, facts that
make your claim better. What are examples of that? If their insured calls
the insurance company and tells them that the
insured was speeding, the careless driver was speeding. If it’s a slip and fall for
example in a supermarket, and they know that the liquid was on the floor for a
long time before your fall, which makes your case easier to prove. If the insured was on a cell
phone at the time of the crash and many, many, many more bad facts that can hurt the other side’s claim. So, do not expect the insurance company to tell you bad facts for them. I have had cases where
the insurance adjuster has told me bad facts that
hurt the other side’s claim. Or, defenses against your claim such as I had a client who was injured when shower glass broke and sliced him, the insurance adjuster told me, she says in that same hotel they have had past instances of glass breaking. She said they didn’t happen in the shower, but they happened in other
areas in the bathroom. Now, that helped my claim
because it allowed me to show that the hotel was on notice, or arguably was on notice, that there was a problem with the glass. And again, I’ve had many other cases where the insurance
adjuster has shared with me bad facts that make it easier
for us to prove liability that their insured was negligent, although it’s the exception to the rule and it rarely happens. I hope you got a lot out of these secrets that insurance companies likely will not tell
you in an accident case. My name is Justin Ziegler. My office is in Miami, I serve
the entire state of Florida. I represent people who
are injured in an accident where someone else is at fault. Please subscribe to my YouTube channel, thank you so much for watching this video.

11 comments

what if you get hit in the back by a clothing inventory rack, where the employees did not see u and u later have pain a day later is that a personal injury claim and you can't get rid of pain

I injured my leg playing pickup basketball and needed surgery. No other player was at fault. Is there a chance my employers health insurance will deny this claim?

What do you think is a bigger insurance company secret? (The claim reserve, or the fact that a low offer may still mean your case is good.)

Please let me know in the comments below.

Please like this video and subscribe to our channel.

I like how you just go straight to the points you want to make in ALL of your videos. You don't waste your time and viewers time playing around your topics. Great job.

I was a passenger in a Uber. The at fault driver was driving in the wrong direction on the turnpike (Orlando) and had open container (Whiskey) in the car plus headlights were off. Head on collision. Both cars totaled. At fault driver was in a Hertz rental car. All of us transported to hospital with ambulance. I had 4 months of physical therapy. 2 herniated and 3 bulging discs, neck and lower back. 1 MRI and 6 CT Scans were done. I have another MRI for right shoulder tomorrow. Looks like rotary cuff tear. Also will get 2 epidural injections next month. I hired an attorney the next day. But I love your videos. Thank you for all the information. Good job…

I have watched your video's and I can tell you make me ashamed for the lawyers I settled with and more ashamed for them. You are a true proffessional. I have done almost all ground work on case. Taking pictures of stairs that collapsed on me and then taking picture of all traikers in oark to show that property owner is a slum lord and many others are in danger. I measured all treads and photographed as well.
Months later I slipping on the no permit stairs they rebuild. I have two claims in and a demand letter for first case that is getting ready to be sent. He has promised me this for weeks. When I read his demand letter and it sounded like an elementary student had written it. I than googled professional demand letters and was shocked at the calibur of the letter.
I sent an email to my lawyer and told him it needed to explain what i had been through during the accident amongst other things. I realize if this letter is not concise my demand can go unanswered at the keast and lso ignored. I even had to correct him on information that was incorrect in that letter. Inportant facts. Facts that I went over with lawyer and paralegal and should be in my file.
IT IS too late to get another attorney and my statute of limitations is up in Jan. 2020.
I qm very angry and depressed over this whole experience. Do you have any advice.

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