insurance claim

- 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 companysets aside to pay your claim. generally speaking, thehigher the reserve amount,

the higher amount of moneythat the insurance company will ultimately pay you in a case, or has the authority toultimately pay you in a claim. now, you may be dealingwith an insurance adjuster, a claims representativeof the insurance company, and think he's extremely nice but, just to get a good ideaof 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'sprivileged information." occasionally you mayget 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 adjustertells you the reserve,

you have to assume thatit'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 reservethat 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 wasreleased from the hospital, i made a claim against the truck driver who caused the accident. and i sent the adjuster somemedical bills and records, and the adjuster told methat when i asked him i said "what do you have the claim reserved at?" he told me "$100,000.00." now, from that point forwardnot much changed with the case. however, the case ended upsettling for $445,000.00.

so, even if the insurance adjuster does tell you what the reserve is, take what he tells youwith a grain of salt. a low first offer does not mean the case is not worththat much money, okay? i have had many cases, toomany to go over right now, where my client, or we,received a low first offer and the claim ended up settlingfor multiples of that offer. one example was wheremy client was offered

by travelers insurance company $20,000.00 for a wrist fracture andthe 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 caseis 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 theauthority to increase his offer a few thousand dollarsor so more than that.

but just because he only has the authority to offer a few thousand more, doesn't mean your caseis not worth a lot more. don't expect the insurancecompany to tell you that you may have a caseeven if they deny liability. now, from time to time, in claims that i represent people in, where they're hurt andsomeone else is at fault, the insurance company will deny liability.

but one of the big secrets out there to people who don't handlethese claims routinely is that just because an insurancecompany denies liability, essentially saying we did nothing, their client, theirinsured, did nothing wrong, that doesn't mean that youdon't have a fantastic claim. let me give you an example. i represented a gentleman who slipped and fell in asupermarket in miami, florida.

prior to the slip and fall hehad hurt his achilles tendon, but the fall made it much worse and he had to have acouple of skin revisions. now, the insurance company, actually it was thesupermarket themselves, initially denied liability. they said, they even sent a copy of the surveillancevideo 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 afterhard-fought litigation. but the point of the story is, just because an insurancecompany denies liability and says our client, or ourinsured, did nothing wrong, it doesn't mean you don'thave a fantastic claim. on the other hand, there are times where an insurance companydoes deny liability,

and you really may have a terrible claim. if there's any more availableinsurance 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 companytells you that the driver has $10,000.00 of insurance, or you send a letter to them requesting that they tell you whatthe insurance limits are,

sworn under oath, they say $10,000.00. they say on the response that there's no other available insurancethat they're aware of. they're not always right. sometimes the adjusterdoes not take the time to ask his insured, the personwho caused your accident, sir, mister, do you haveany other umbrella insurance that would apply for this accident that covers you above thebodily injury liability?

or, were you working for an employer at the time of the accident? that insurance may kick in. or, were you driving acar for uber or lift, or were you volunteering? or, do you live with a resident relative whose insurance may coveryou for this accident? bottom line is, insurance adjusters areloaded up with claims.

they may not take the time to research and speak with theirinsured and really find out if there's additional insurancethat 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 thatthey give you an answer. don't expect them to do the work for you. that suing their insuredwill get you a higher offer, they're just not gonna do it.

now, occasionally an adjuster will say hey, if you wanna get moremoney, you have to sue us, meaning their client. however, overall don'texpect them to tell you this. now, i heard years ago that oneparticular 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 suingthem may get a higher offer

is because a lot of insurance companies have to then hire outsideattorneys 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 companymayswitch the adjuster. the new adjuster may havemore settlement authority, money, to pay your claim. one of the best kept secretsin the insurance business

is do not expect theinsurance adjuster to tell you that you do not have togive a recorded statement. in many cases, you do not haveto give a recorded statement. there are some cases where you do have to givethe 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 givea recorded statement.

but generally, if you're injuredon someone else's premises, you never have to givea 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 togive a recorded statement. the recorded statement willlater be used against you and the insurance companywill try to point out things, such as you saying thatyou were not in pain

when you gave the statement, and now you're tellingthe insurance company how bad your life has beendamaged because of the accident. the recorded statement can generally only favor an insurance company. the same is true with thenon-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 causedto you in an accident, don't expect an insurancecompany to tell you that you should go to thehospital or get medical treatment. if you don't go to the hospitalor get medical treatment, expect them to later on offer you less to settle your personal injury claim. but don't expect an insuranceadjuster to tell you,

to say to you hey, ijust wanted to point out you haven't gotten medicaltreatment in a while, you should go to the doctor,it's gonna help your case. the number eight secretthat the insurance company for the careless partylikely will not tell you are bad facts that hurttheir insured's claim. essentially, facts thatmake your claim better. what are examples of that? if their insured callsthe insurance company

and tells them that theinsured was speeding, the careless driver was speeding. if it's a slip and fall forexample in a supermarket, and they know that the liquid was on the floor for along time before your fall, which makes your case easier to prove. if the insured was on a cellphone 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 wherethe insurance adjuster has told me bad facts thathurt 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 otherareas in the bathroom. now, that helped my claimbecause 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 insuranceadjuster has shared with me

bad facts that make it easierfor 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 tellyou in an accident case. my name is justin ziegler. my office is in miami, i servethe entire state of florida.

i represent people whoare injured in an accident where someone else is at fault. please subscribe to my youtube channel, thank you so much for watching this video.

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