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3 Key Things to NOT say about a Baltimore Personal Injury Claim.

I’ve handled thousands of insurance claims over the years. In my practice, we routinely handle car accident claims, personal injury protection claims, homeowners claims and commercial insurance carrier claims. When a claim cannot be resolved with the insurance company amicably, as a Baltimore personal injury litigator, I file a lawsuit in the appropriate jurisdiction, so that a jury or a judge may decide the rights of the parties. Over the course of these thousands of different claims. I have identified some things that it just makes sense not to share with an insurance company.

  • The nature, and extent of any injuries, right after the accident
  • A definitive and certain dollar total representing the full amount the loss or accident, right after the accident
  • Prior injury-causing accidents
  • Prior injury, or prior medical care to the affected body parts

Before we delve into each point, let me offer a word of caution. In the context of this article, I am speaking solely about dealing with the insurance company for the “at-fault” party, the other side, or the adverse side. The suggestions rendered herein, to the extent that it is advice, do not apply to one’s own insurance company. When dealing with one’s own insurance company, there is typically a contractual obligation to cooperate fully and provide any and all details. Those same considerations don’t necessarily apply to pre-suit conversations with the adverse insurance company representative. Moreover, the ability to choose not to divulge certain information is almost invariably lost, once litigation begins. After discovery is served in a litigated case, obligations to disclose certain relevant information attach, and it may and most certainly will no longer be possible to choose not to reveal information as a matter of strategy, tactics, or discretion.

Don’t tell the insurance company you’re not injured, unless you are certain you’re not.

This topic likely requires a little bit of contextual explanation. It is routine for a representative from an insurance company to contact the victims of an automobile accident immediately after the accident and ask if they’ve been injured, among many other questions. The mechanics of many automobile accidents are such that the full nature and extent of any injury -particularly those resulting from trauma to the muscles and ligaments and tendons in the spine in the back- sometimes don’t fully present or manifest for days. The timing of the phone call from the insurance company is such that a person may be injured but has not begun to experience the effects, or the full effects, of that injury at the moment of the call. In my opinion, the better approach is always to tell the insurance company that it’s too early to tell the full nature and extent of any injuries. Particularly where the injured or potentially injured person has not yet seen a doctor, it is perfectly appropriate to state that you are pending a medical evaluation if you intend to pursue that. Clearly if you have a significant injury as a result of a motor vehicle accident that is obvious in nature, and not insidious, tell the insurance company. Conversely, if you are absolutely comfortable and certain in your own bodily integrity and health, to say that you 100%, you were not injured- it is perfectly appropriate to tell the insurance company this as well .

Don’t box yourself into a definite answer “value” of your claim

This concept likely also requires some contextual background information. In my experience, insurance company, and claims adjusters consistently, and from the very inception of the claim do what they can to minimize the event. For example, if you hear a claims adjuster constantly referring to any injuries that result from a motor vehicle accident as “just soft tissue”, or “only soft tissue, but no broken bones” with a drip of sarcasm, understand what is happening. This is an example of the insurance company setting the dialogue, and this is an attempt to frame your accident from, the very beginning, as one that was not serious and did not have serious consequences.

One other common tactic that I’ve seen over the years is to attempt to pin an individual down to a specific dollar figure regarding the extent of the loss, early on, or indeed at the very inception of the claim. Timing is key. At the time of a settlement discussion, this information is known, and exchanged. Prior to that, at a time when damages are evolving, or worse yet, unknown, it’s an unfair question.  For example, if you’re making a claim regarding the damage to property, and the insurance company representative wants a definitive, absolute estimate of the amount of repairs- at the time the claim is opened- this is unfair. This is an attempt to minimize or limit the insurance company’s exposure. As a practical matter, the full nature and extent of any casualty or loss may not be ascertainable in the moments, hours or days after the event. In many instances, experts must be consulted in order to determine not just the cause of the loss, but also all of the consequences that might flow from the loss. The amount needed to repair the damage might only be part of the loss. There could be consequential damages, such as business interruption, future medical care for a serious personal injury, loss of profits, and other claims, the amount of which simply is unknown, and not knowable immediately after a loss. Don’t misunderstand that the insurance company will use definitive, absolute answers against you later in the claim.

Do not discuss prior accidents or pre-existing conditions.

This piece of advice applies more generally in the context of automobile accident claims or personal injury suits premised on negligence. In many such claims, a thorough claims adjuster will wish to take a statement from the injured person. The thorough and inquiring claims adjuster may well ask if you’ve ever been involved in any accidents, or if you have ever injured or received treatment for the part of your body that has been impacted in the subject accident. Let me be clear. Before a lawsuit is filed, in the context of a voluntary statement to an opposing or adverse insurance company, you don’t have to answer this question. However, once litigation commences, that is to say, the filing of a lawsuit, alleging personal injury, in a court of appropriate jurisdiction, the option to provide this information, or not, dissipates. Once litigation is commenced, you have no choice, but to provide relevant, non -privileged information to the other party, either through interrogatories or in response to specific deposition questions. But, in the investigatory stage of an accident immediately after it, these types of details are not pertinent to anything that an insurance company has to do. There is no legal obligation to give an insurance company ammunition to deny, or further minimize a claim that they are going to minimize in any event  Any insurance company will always want to know that this is the second, third, or fourth accident that you’ve been involved in. They can use this information then, to argue that “you weren’t hurt in this event”, “ you were hurt in other events” or “if you were hurt in this event, it simply was a minor aggravation or exacerbation of your prior injuries”. In the same vein, the insurance company invariably would want to know if you had prior treatment for the affected body part. They could then argue that any injuries sustained in the subject accident simply represented a minor flareup of a chronic and long-standing condition.

To re-iterate as a cautionary matter, comments in this article pertains to pre-suit communications with an adverse insurance company. In other words, not your own insurance company. Different rules apply when dealing with your own insurance company. Claims for uninsured motorist benefits after a car accident, personal injury protection benefits, and homeowners claims are considered first-party claims or claims brought against your own insurance company. Different rules apply in this scenario. When making a claim against your own insurance company, it is imperative that you fully answer all questions and thoroughly and comprehensively provide all documents, requested. The option to reveal certain information only after litigation commences does not typically apply when you are dealing with your own insurance company.