After a car accident or other personal injury incident in Georgia, you will inevitably have to deal with one or more insurance companies. While insurance adjusters may present themselves as helpful and sympathetic, it is important to understand that their primary goal is to protect the insurance company’s bottom line; not to ensure that you receive fair compensation for your injuries. Insurance companies are for-profit businesses, and every dollar they pay you is a dollar that comes off their balance sheet.
Understanding how insurers operate, the tactics they use, and the mistakes they hope you will make can help you avoid common pitfalls and protect your claim.
How the Insurance Claims Process Works
Georgia is a fault-based insurance state, meaning the driver who caused the accident is responsible for paying the injured party’s damages through their liability insurance. After an accident, the claims process typically unfolds in several stages.
You or your attorney file a claim with the at-fault driver’s insurance company, known as a third-party claim. The insurer assigns an adjuster to investigate the claim. The adjuster reviews the police report, medical records, and other documentation. The adjuster makes an initial settlement offer. Negotiations follow, and the claim either settles or proceeds to litigation.
Throughout this process, the adjuster is evaluating your claim with one objective: resolving it for as little money as possible. Every interaction you have with the insurance company — from your first phone call to the documents you provide, is an opportunity for the adjuster to find reasons to reduce your payout.
Common Insurance Company Tactics
Insurance adjusters are trained professionals who use well-established strategies to minimize claims. Being aware of these tactics can help you avoid falling into their traps.
Requesting a recorded statement. Shortly after the accident, the adjuster may ask you to provide a recorded statement about what happened. This request may sound routine, but the purpose is to get you on record saying something that can be used against you later. You might inadvertently downplay your injuries, admit partial fault, or make an inconsistent statement that the adjuster will use to undermine your credibility. You are not legally required to give a recorded statement to the other driver’s insurance company.
Making a quick settlement offer. Insurance companies often make early settlement offers within days or weeks of the accident, before you have completed medical treatment or understand the full extent of your injuries. These offers are almost always far below the actual value of the claim. Once you accept a settlement and sign a release, you cannot go back and ask for more money, even if your injuries turn out to be much worse than initially expected.
Disputing the severity of your injuries. Adjusters frequently argue that your injuries are not as serious as your medical records indicate. They may claim that the force of the collision was too minor to cause the injuries you are reporting, that your symptoms are exaggerated, or that you would have recovered faster if you had followed a different treatment plan.
Blaming pre-existing conditions. If you have any prior medical history involving the same body part that was injured in the accident, the insurance company will try to attribute your current symptoms to the pre-existing condition rather than the accident. Under Georgia law, the eggshell plaintiff doctrine protects you; a defendant takes the plaintiff as they find them, and aggravation of a pre-existing condition is compensable.
Pointing to gaps in medical treatment. If there is any period during your recovery where you did not seek medical care, the adjuster will argue that the gap proves you were not really in pain. Consistent medical treatment is critical for supporting your claim.
Surveillance and social media monitoring. Insurance companies sometimes hire investigators to conduct surveillance on claimants, and they routinely monitor social media accounts. A photograph of you at a family gathering or a post about going for a walk can be taken out of context and used to argue that your injuries are not limiting your activities.
Delaying the process. Some insurers intentionally drag out the claims process, hoping that financial pressure will force you to accept a lower settlement. When you are dealing with mounting medical bills and lost wages, even a lowball offer can start to look appealing.
Your Rights When Dealing With Insurance Companies
Georgia law provides certain protections for consumers dealing with insurance companies. Under O.C.G.A. § 33-4-6, if an insurer refuses to pay a covered loss within 60 days after a demand is made and a court finds that the refusal was in bad faith, the insurer can be held liable for a penalty of up to 50 percent of the amount owed or $5,000, whichever is greater, plus reasonable attorney’s fees.
Additionally, you can file a complaint with the Georgia Office of Insurance and Safety Fire Commissioner if you believe an insurance company is acting unfairly or failing to comply with state regulations.
You also have the right to refuse to give a recorded statement to the other driver’s insurance company, to decline an early settlement offer without penalty, to consult with an attorney before signing any documents, and to have your attorney handle all communications with the insurer on your behalf.
Mistakes to Avoid
The most common mistakes accident victims make when dealing with insurance companies include giving a recorded statement without consulting an attorney, accepting the first settlement offer without understanding the full value of the claim, signing a medical authorization that gives the insurer access to your entire medical history rather than records specifically related to the accident, posting about the accident or your injuries on social media, apologizing or admitting any degree of fault during conversations with the adjuster, and waiting too long to seek medical treatment after the accident.
Each of these mistakes can significantly reduce the value of your claim or give the insurance company grounds to deny it altogether.
How an Attorney Levels the Playing Field
Insurance companies have teams of adjusters, attorneys, and investigators working to protect their interests. Having your own attorney evens the playing field. A personal injury lawyer can handle all communications with the insurance company so you do not inadvertently hurt your case, investigate the accident and gather evidence that supports your claim, accurately calculate the full value of your damages including future medical costs and pain and suffering, negotiate aggressively from a position of knowledge and preparation, and file a lawsuit if the insurer refuses to offer a fair settlement.
The insurance company knows that an unrepresented claimant is far more likely to accept a low offer. Having an attorney signals that you are serious about pursuing full compensation and that you are prepared to go to court if necessary.
Talk to an Attorney Before Talking to the Insurance Company
If you have been injured in an accident in Athens, Duluth, Conyers, or anywhere in Georgia, consult with an attorney before engaging with the insurance company. The attorneys at Burrow & Associates offer free consultations and can advise you on how to protect your rights from the very beginning of the claims process. We work on a contingency fee basis, so you pay nothing unless we recover compensation for you. Contact us today to get started.
