By Francis M. Smith
When you pursue a personal injury claim of any kind, it's critical to understand your enemy: the insurance company. It may sound like an exaggeration to refer to the opposing party in any legal claim as “the enemy,” but this isn't hyperbole – it's in the insurance company's financial interest to pay you as little as possible, or nothing at all, if they can get away with it. The insurer's representative in your claim, the adjuster, is a trained negotiator whose job is to attack your claim ruthlessly. The fact that your case involves a seriously injured child is completely irrelevant to the insurance adjuster's task, except insofar as they have all the more reason to trick you into giving up your claim or accepting an unreasonably low settlement, because a jury might be more sympathetic to a child's suffering and award your family more money.
For decades, the insurance company has been waging a propaganda war against injured plaintiffs in general. How often do you hear calls for “tort reform” and complaints about “frivolous lawsuits” being awarded “excessive” amounts of money? This is a misrepresentation in a couple of different ways at once. The version of events reported in the press about many “frivolous” multi-million-dollar lawsuits is frequently very distorted to make the plaintiff's injuries seem more minor and the circumstances of the accident seem more absurd. This creates an unfair hyper-skepticism in the minds of some potential jurors in injury cases. In addition, these seven-figure damage awards are by far the exception, rather than the rule. Much more often, cases involving serious injuries are resolved for a very low figure, or with no compensation for the victim at all. When a child's medical treatment and future is on the line, that's a terrible possibility – but one that rakes in big annual bonuses for insurance adjusters and executives.
Insurance companies have vast resources at their disposal: highly-paid and well-trained attorneys and negotiators, medical “experts” who are willing to testify to whatever is in the insurance provider's best interests, and as much time as they like to resolve a claim. In fact, many insurance companies are perfectly willing to spend more money fighting a claim than they would pay if they settled for the injured plaintiff's initial demand figure. It's not just spite motivating this behavior – they want to avoid starting a trend of having to pay more people fair compensation for their injuries. What you experience as the reality of your child's pain and trauma is merely a numbers game to the insurance company. Remember, the longer the company can put off the day of compensating an injury victim, the longer that company can keep that settlement money invested and making money for the insurance company. So why would they rush to compensate anyone?
Adjusters have a sizable repertoire of underhanded tricks that they use to pressure injured plaintiffs (or their parents, in the case of injured children) into abandoning their claim or accepting an unfairly low settlement. One of the most obvious – and most dangerous – is trying to convince you not to hire an attorney. They may tell you that you simply don't need a lawyer, or that your case will take longer to resolve with an attorney involved. The adjuster might tell you that attorney's fees would eat up your entire settlement (which is a lie – most personal injury lawyers take a fixed percentage of your eventual settlement or damage award as their fee, and most injured plaintiffs who have lawyers receive more compensation, even after legal fees, than unrepresented plaintiffs (one study said three and half times as much). Some adjusters say they will “deny your claim” if you hire an attorney, which sounds scary, but doesn't actually do anything to end your case or prevent you from taking them to court. All these falsehoods are engineered to keep the playing field as uneven as possible: the insurance company with its legal experts and experienced negotiators, and you and your child without the help of someone who knows all their tricks.
Another particularly deceptive technique many insurance adjusters is to pretend to be your friend. They're not. It's not the adjuster's job to care about you, or your child, or your family's future. Any pretense of being “in your corner” or looking out for your best interests is just an act designed to make you lower your guard and get you to listen to their (bad) advice. The insurance adjuster has a responsibility to his employer – the insurance provider – and the policy holder who negligently caused your child's injuries. Any attempt to act for your benefit, if sincere, would be a major conflict of interest. It's not sincere. No matter how friendly or concerned or genuine the insurance adjuster seems, remember that they are being paid to make sure that you don't get paid, or if a payment is made, it is kept to a minimal amount.
There are many other strategies an insurance adjuster can bring to bear against your case, from stalling until you give up in disgust to demanding unnecessary documents to disputing the medical charges and treatments your child needs. An experienced personal injury attorney handles these tactics on a daily basis, and may be the best answer to resolving a claim, especially on behalf of a child., which resolution usually has to be presented to a judge in open court for approval.
If you or a loved one have been injured in a serious accident, please contact me or call me at 908-233-5800 for a free consultation.