Do Insurance Companies Investigate Injury Claims?

Why Would an Insurance Company Investigate a Claim?

A car accident can turn your world upside down. Likely, you’re already dealing with painful injuries and mounting medical bills. The last thing you may expect in these situations is for the insurance company to hold up the money you need to take care of these costs because they decided to investigate the claim.

When the insurance company gets involved, innocent victims often end up having to wait months to receive any sort of compensation from the insurer. Worse yet, they might see their claim denied because the insurance company finds something that affects their case. If an insurance carrier decides to investigate your claim, you do not have to tackle these companies on your own.

Here, we will dive into what you need to know about these insurance company investigations; specifically why they occur, what information the insurance company is looking for, and how an experienced personal injury attorney can help you get through them and fight for the damages you deserve.

Why Does an Insurance Company Investigate a Claim Following an Accident?

There are numerous reasons why an insurance company wants to investigate your accident after you file a claim. Primarily, they are trying to protect themselves from insurance fraud. Statistics show fraud occurs in about 10 percent of all property-casualty insurance losses. In fact, insurance fraud steals at least $80 billion every year.

To prevent this fraud, insurance companies will ask those filing a claim to provide evidence to support their case, or these companies will bring in investigators and adjusters to gather evidence of the accident.

Secondly, the insurance company may decide to investigate a claim after an accident to properly assess the case and the resulting damages and injuries the victim sustained.

What Happens During This Investigation Process When the Insurance Company Gets Involved?

Generally, this answer will depend on the claim you are filing and whether the insurance company picks up on any potential red flags about the legitimacy of your case. For instance, if the accident involved minor damage and no injuries, the investigation will usually wrap up quickly and be resolved after you answer a few questions and submit the required documents the insurance company is asking for.

However, on the other hand, if the claim involves significant injuries and extensive damage, the insurance company will likely perform a more detailed investigation. This is because the insurance company will need more details to confirm the nature and the extent of the injuries that resulted from the accident. Plus, there is also potentially more money on the line that the insurance company may need to pay out.

As a result, these insurance companies will often have you answer more questions about your injuries, want access to your medical records, and want to look at any police reports you have. In addition, the insurance company may also have the adjuster take a recorded statement, visit the accident scene, conduct a background check, review your social media accounts, and request your cell phone records.

Consequently, the more substantial your losses, the more thorough the insurance investigation will be.

Personal Injury Case Surveillance: Is It Legal for the Insurance Company to Perform This Surveillance?

An insurance company is allowed to conduct surveillance on you after you file an accident claim as long as they do not enter your home or place of employment. In Florida, the laws allow the insurance company to take videos and photographs of the plaintiff in a personal injury case, but it does not permit the insurance company or the defense to intercept their phone calls or call the plaintiff and record the conversation without their consent. 

In performing this surveillance, the insurance company hopes they will catch you doing something after the accident that is inconsistent with the complaints you alleged and what you are telling others that you are incapable of doing. For these reasons, these adjusters may try to follow you in hopes of getting a video of you doing something that you claimed you are unable to do.

The same goes for your social media accounts. Although it may be tempting to post about your accident on your online accounts or in group forums, it may not be in your best interest to do so. Anything you post or is posted about you can be used against you to discredit your claim and show that the injuries and trauma you suffered are not as serious as you claim them to be.

Common Places Where the Insurance Company May Perform Surveillance

Once an insurance adjuster gets involved, they will want to gather as much information as they can from you about the damages you are claiming. To achieve this, they will often try to collect these details through the following methods:

What Information Will the Adjuster Want From You?

Once an insurance adjuster gets involved, they will want to gather as much information as they can from you about the damages you are claiming. To achieve this, they will often try to collect these details through the following methods:

Contacting Witnesses and Others From the Accident

The adjuster may reach out to others involved in the accident. For instance, if you were involved in a car collision, these adjusters will want to talk to witnesses who saw what happened and the other drivers involved in the crash. They will want to compare their version of the accident to yours and see if there are any inconsistencies.

Investigating the Accident Scene

These adjusters may also head to the accident scene to try to gather their own evidence if they believe it can help them figure out what happened and provide them with a clearer picture of your case. However, these insurance adjusters will usually not travel to the accident location unless it is a severe accident or the fault is unclear.

Obtaining Medical Evaluations

Even if your doctor examined you after your accident, these adjusters may also have you go in for a medical examination with a doctor of their choosing, referred to as an independent medical examination. However, this examination is anything but independent, since the doctor that will be giving you the assessment works for the insurance company.

Get Legal Help Before Giving Out This Information

As you can see, these adjusters may try to really dive into your personal life, as well as your medical and financial history, when it comes to these accident claims. However, you need to remember that this investigation is not in your best interest, and the answers you give can affect your claim and the amount of money you receive. 

If the insurance adjuster starts to ask you questions, especially about the nature of your injuries, it is time to reach out to a skilled personal injury lawyer to help you respond to these requests and ensure you get the money you need.

How Long Do Insurance Claims Take to Investigate?

If the accident claim is relatively simple, the insurance investigation may take a few weeks to complete. However, if the accident is more complicated, the investigation can end up taking months. 

The claims process will often vary according to each insurer’s methods for investigating a claim, the severity of the injuries and property damage, the types of claims involved, and how quickly all necessary information is provided to the insurance company.

Once a car insurance claim is filed, an insurance claim adjuster is typically assigned within a few days. The adjuster’s role is to investigate the claim, which involves reviewing the accident details, evaluating the damage, determining fault, and assessing how much the insurance company should pay for losses.

In Florida, insurance companies have 30 days to settle an auto insurance claim from the time they receive notice. This is the amount of time set by state law for an insurance company to either deny or pay a claim. However, this 30-day window applies only if the insurance company has received all the necessary information and documentation needed to settle the claim.

What Does This Insurance Investigation Mean for You?

People purchase insurance to protect themselves from unpredictable circumstances and provide themselves with a safety net when they are in trouble. As a result, most people believe that the insurance company will want to help them in their times of need. 

Unfortunately, this is not always the case. Insurance companies are a business, and like other businesses, they want to make a profit. By keeping costs and expenses as low as possible, they accomplish this goal.

Consequently, when these insurers deny your claim or pay you less than you deserve, they end up making more money in the process.

That is why these companies look for any red flag or point of vulnerability they can use against you, such as:

• If the insurance company finds out you are desperate for money, they may try to present you with a low settlement offer in hopes that you will take it without asking questions or trying to negotiate for more, or
• If the insurance company finds out that you have a history of filing insurance claims, it may raise their suspicions that you are committing fraud.

For the following reasons, you should reach out to a skilled personal injury attorney as soon as possible after your accident. These attorneys can not only help you understand the tactics the insurance company will try to use against you so that you are better prepared to handle them. But they can also take on all the discussions with the insurance company on your behalf to ensure that you do not say anything that can hurt your case.

What Can You Do if the Insurance Company Is Monitoring You?

If you believe the insurance company has begun monitoring you, you need to remember that you cannot lose your cool. If these insurance adjusters and investigators are not violating any laws, there is not much you can do to prevent this surveillance. However, there are things you can do to ensure that you do not mess up and hurt your claim.

• Do not talk or otherwise engage with the private investigator.
• Inform your lawyer as soon as you discover that you are being watched or followed.
• Do not try to embellish the harm you endured.
• Make sure that your social media accounts are private, and you stay away from posting anything about your accident and the injuries you sustained.
• Do not take any interview requests from the insurance company before talking to your lawyer.

How Can an Experienced Personal Injury Attorney Help If the Insurance Company Wants to Investigate Your Claim?

If you are making an insurance claim following an accident, you want to make sure to reach out to a skilled personal injury attorney as soon as possible.

Once retained, these lawyers can:

• Go over all the questions you have about the legal process involved with your personal injury claim and the insurance investigation.
• Determine which types of damages you are entitled to, and determine which legal options you should pursue.
• Protect you while taking on the insurance companies and help you get the respect you deserve.
• Handle all the negotiations with the other side and go after the maximum settlement possible.
• Ensure your claim is not denied in bad faith, and if it is rejected, fight back and go after the money you need.

For these reasons, after an accident, do not wait to secure the legal assistance you require. Instead, contact an experienced personal injury attorney today for a free case evaluation, and let these lawyers show you how they can help your claim and fight for the justice and damages you deserve.