Can A Maryland Insurance Company Deny a Claim Based on a Serious Car Accident ?
There are three principal methods available to an insurance company, in my view, to dispute any claim for compensation or benefits after an automobile accident: Denial. Minimization. Stalling.
DenyThe first is the frank, outright denial where the insurer takes the position that they owe no money because they're not obligated under the policy of insurance to pay, or, that their insured person has a viable legal defense to the claim.
MinimizeThe second method available is to minimize the claim or the injuries alleged to have been sustained by the plaintiff in the case. Here, the argument is that although there might have been an accident, or some level of minor injury, that injury was not serious or was related to any cause under the sun -other than the motor vehicle accident.
StallThe final method is to delay the resolution of the case. Here, the goal would be to “wear down” the injured person -who may be facing missed time from work coping with mounting expenses in, addition to ongoing physical or emotional pain. Insurance companies are mammoth entities with essentially unlimited resources. They can afford to wait. The injured person, most often, cannot.
MethodsThis article explores some of the methods and insurance company can use to fight a claim for personal injury in the wake of a significant car accident. What I tend to see is that in the realm a serious Maryland motor vehicle accidents, insurance companies and their attorneys tend to rely more on the “minimization of the injuries” tactic. If the accident in question is a serious one involving significant physical forces and impact, immediate hospitalizations, surgeries, and some of the other hallmarks of a serious personal case, it might be difficult to argue that the accident didn't happen, or that at least some compensation is not due and owing. The strategy here is often to minimize the severity of the injury, beginning with setting the tone of the dialogue early in the case. Some of the commonly used ploys here are to constantly refer to injuries as " just soft tissue”, or by using the phrase “no surgery recommended”. The implication of course is the injuries to the muscles, ligaments, tendons or disc material in one's neck or back cannot have serious consequences, or, that if an outright surgical repair is deemed unnecessary, that the injuries sustained are, in fact, not serious ones at all.
The major insurance companies in Maryland employ some of the most experienced, effective and savvy litigators in this state to represent their interests in court. Most of these skilled insurance defense attorneys will seek an independent review of the medical evidence by a doctor of their choosing, whom they have paid for their opinions and conclusions. In the legal lexicon, this is the “IME” or “Independent Medical Examination”. The results of these examinations are most often an opinion that either minimizes the nature and extent of the plaintiff's injuries, or as we frequently see, that attributes complaint of pain to any other conceivable cause other than the subject motor vehicle accident. A common conclusion found in these reports is that the plaintiff suffered from a heretofore, asymptomatic and undiagnosed degenerative condition in the impacted body part. It necessarily follows, in the doctor’s opinion, then, that whatever symptoms pain or discomfort the plaintiff is experiencing now is related simply to a degenerative or arthritic process, rather than injuries sustained as a result of being involved in a serious automobile accident.