Toronto Injury Lawyer Blog
It’s not everyday you have to deal with an insurance company. It’s not an interaction which people are accustomed to.
Think about it.
You don’t need legal advice to buy a pair of shoes.
You don’t need legal advice when negotiating a price for a new/used car.
You don’t need legal advice for a parent/teacher conference at school.
You don’t need legal advice opening a bank account, or negotiating the terms of your mortgage.
What’s set out above are adult interactions which we are used to in everyday life.
But, when it comes to personal injury, car insurance and disability claims, we do need legal advice. We need legal advice because these interactions don’t happen everyday for consumers. We need legal advice because there are complicated laws around getting compensation. We need legal advice because more often than not, these claims are disputed and often end up being litigated in Court.
Given that our personal injury lawyers deal with insurance companies on a daily basis, here are some tips which we’ve procured for you based on our experience and expertise in dealing with them.
Tip #1: S/he who acts as their own lawyer has a fool for a client! Don’t be your own personal injury or disability lawyer. Don’t do it. Leave it to the experts. You might think that you know everything, but you don’t. You might think that you’re saving money but you aren’t. You might think that you won’t get emotionally invested in the case, but you will, and, as a result, you will make some bad decisions or exercise poor judgment. The insurer will have no sympathy on a self represented Plaintiff. The Court also expects a self represented Plaintiff to know all of the rules and procedures.
Tip#2: Don’t let the insurance company take a statement from you without a lawyer present. Once an insurance company finds out about an accident, they will be quick to deploy a field adjuster to meet with, or to reach out to the accident victim to take a statement, take photos, and gather as much information as they can. There are a few big strategic advantages to their haste. For starters, they are simply doing their jobs. Gathering information as soon as possible from the date of the accident is an effective method to better understand the nature of the claim, injuries etc. The faster which information is gathered, the more people will remember, and the better prepared they will be. But, in going out quickly to set up a statement, there is a good chance that the accident victim has not retained a personal injury lawyer (they haven’t lawyered up). Getting confessions, admissions or asking unfair questions in such a way as to minimize the insurer’s exposure is much easier to do when the accident victim does not have a personal injury lawyer present. They can, and will, push the boundaries of what’s permitted in order to get the information they want to defeat your claim before it even gets started.
Tip #3: If the insurance company wants you to go to specific a clinic for treatment, run in the opposite direction. Many insurance companies have “preferred clinics” for where an accident victim does his/her treatment (physio, massage, chiropractic, OT, etc.). Ever wonder how or why these clinics are the “preferred clinics” of insurance companies? Think about that through a critical lens, long and hard. The answer is self evident. If you are still satisfied that going to the preferred clinic of an insurance company is a good idea, that’s on you. Our advice is to go to any clinic you want, so long as it’s not one of these preferred clinics. The clinic should be close to home, it should be clean, friendly, with knowledgeable staff both for the technical treatment which needs to be done; AND knowledgeable in terms of how to bill the insurance company for the approved and incurred treatment. The magic in all of this is in the billing. This is just as important as the treatment itself (unless you are independently wealthy and can afford to pay for the treatment out of pocket for each and every session). So many times we hear from people that they would attend for treatment if they could afford it, but they can’t and the insurer won’t approve the treatment. Other times we hear that the clinic isn’t billing, or properly billing the insurance company because they can’t manage all of the paper work or they don’t know how to do so within the car insurance system. This is why it’s so important to have a clinic which understands how to bill insurers for their approved and incurred treatment. If the clinic isn’t familiar with the paperwork and expects you to pay out of pocket for treatment, perhaps it’s time to find a different clinic.
Tip #4: Expect every call to/from the insurance company to be recorded. When an insurance company calls you, it’s not a social call; particularly after a car accident. They will ask you how you’re doing, but this sort of question hits different when it comes from an insurance adjuster rather than a friend, family member or loved one. When that question comes from a friend or loved one, the answer that you’re doing “fine” or “managing” won’t be scrutinized. But, if you’re telling the insurance company that you’re doing “fine” the same way you would tell this to a friend, it carries unintended consequences. You are signaling to the insurer that all is well, and that you don’t need help. You’re signaling to the insurance company that you’ve plateaued and are no longer in need of care, compensation or benefits. Even though this may not be the case, by chatting with the insurer and leaving the impression that all is well and that you’re doing ok, they will view this through a critical lens. They will not give you the benefit of the doubt. Their lawyers will likely highlight this recorded conversation to use against you moving forward when you ask for benefits or compensation. Their rationale is that you told us that you were fine, so we took you at your word that you’re fine and terminated your benefits.
