Top 5 Adjuster Tricks and How to Combat Them
I was recently asked to be a guest on a personal injury lawyers podcast. I was asked on to give my top 5 tricks adjusters use in pre-litigation on car accidents in Missouri and how to handle them. The following were my top 5. Keep in mind that you can’t do each of these on every case, and that lawyer client communication is the number one thing that unlocks the rest of these as possibilities.
1.) Adjuster claims that client’s injuries were pre-existing
How To Combat: Know Your Client’s Medical History
Ask about prior injuries to the impacted area during INTAKE. Do not miss
out on this. If you have a client with prior surgery, you need to get those records. If they have prior treatment, you need to get a list of all doctors visited and order the records. There are no shortcuts to this. You need to do your homework to be able to show how the new crash exacerbated the old problems.
2.) Adjuster claims that too much time lapsed between accident and first treatment
How To Combat: Generally, don’t take cases where more than 30 days have elapsed between accident and first treatment. Aside from this, don’t let them convince you it is unreasonable for someone to go to the emergency room 3 weeks after an accident. I like to find out exactly why it took my client longer than normal and put it in my demand. Some clients, myself included, are less inclined to seek out medical treatment. An injury victim shouldn’t be punished because they only go to the doctor as a last resort.
3.) Adjuster evaluates case based on the amount of outstanding medical bills only.
How To Combat: I struggled with this a lot as a new lawyer. You need to be able to show why the injury caused greater pain than the special damages indicate. You need to do your homework on what this injury is, what are it’s complications, and how long it takes to recover from. You need to learn how this caused a loss in your client’s life. This is where you make your mark. Find out how it impacted their work, activities of daily living, and enjoyment of leisure activities. Know if that type of injury is a painful one where recovery painful but treatment atypical.
(i.e. broken ribs – I settled a case for $100,000 on $3,000 in specials. This is because there usually isn’t any treatment for broken ribs. They often heal on their own after 4-6 weeks of excruciating pain.)
5.) Adjuster cuts down the amount of treatment accepted for nebulous reasons
How to Combat: Negotiate this. I see this happen a lot with chiropractic treatment. Adjusters feel that people should only go to a chiropractor for a maximum of 2.5 months or a certain number of visits. They will say they did not consider any visits over their threshold when making an offer. I don’t give in to this if the treatment was medically necessary. Force them to consider this treatment by negotiating for a higher offer. In the situations I have seen this arise, the adjusters almost always have more wiggle room in their offer.
6.) Adjusters try use your client’s medical records against them.
How To Combat: Don’t let the adjuster be a better expert on your client’s treatment history than you are!
-I had a recent case where first imaging my client had at ER was an x-ray. It came back unremarkable. 6 months later my client had an MRI. This showed multiple small hairline fractures.
-Adjuster tried to tell me fracture wasn’t caused by accident because not listed on first x-ray. When I explained to them how MRIs are a better resolution imaging than Xrays, and that xrays would never pick up on the small type of fracture my client suffered, they relented and paid me the policy limits.
-You can’t be timid. You must know your case cold and not be pushed around. Sometimes adjusters want to bully you, other times they are overworked and failed to pick up on important details. It is your job to educate them in a persuasive manner.
7.) Adjuster says hospital’s bills are higher than customary in the region
How To Combat: Your client did not ask to have to go to the hospital. They were not given a brochure with various treatment pricing options. They were forced into this due to someone else’s negligence. They went to the facility they did out of necessity. They had no meaningful choice on this, the selection having nothing to do with cost. Hospitals hide the cost of their procedures from patients. Calculating the cost of a procedure is a big messy labrynth of health insurance contracted rates (each policy has variable rates for different procedures), how much overhead the medical facility has, and how aggressive medical providers feel they can be with charges
-I typically try to send a redacted bill from another facility inthe area to show that the amount billed was in line with the market rate for the area. This doesn’t always work but sometimes will.
-Last summer an adjuster told me that one area hospital’s MRI charge of $2,200 was too high for the region. They would only accept $500 of it. I just so happened to talk to the billing coordinator of the largest hospital in the area later that afternoon. She confirmed that they charge $200 more per MRI than the other hospital the adjuster said was too high.
-If you investigate this and see that the medical facility in fact is charging too much, be reasonable in your counter. I worked with one chiropractor in Saint Louis that charged almost $500 per visit for standard soft tissue back treatment. If providers over charge like that you will have no problem reducing their bill later. You will need to explain this to your client why the amount of their special damages is misleading. Never send your client to such places. They discredit your client's injuries by overcharging.
Stephen Gerring of The Gerring Law Firm is a Missouri Car Accident Lawyer based in Kirkwood, Missouri.
