Call anytime: 661-414-7100 or text 661-249-9990
Santa Clarita Car Accident Attorneys - Call (661) 414-7100
  • Home
  • About
    • Client Reviews
    • Fees and Policies
  • Cases We Handle
    • Car Accidents
    • Motorcycle Accidents
    • Pedestrian Accidents
    • Bicycle Accidents
    • Brain Injury Cases
    • Wrongful Death
    • Spinal Cord Injuries
    • Estate Planning
  • Resources
    • Videos
    • Blog
    • Library
    • FAQ
  • FREE CASE EVALUATION
  • Contact
    • ZOOM VIDEO
  • Home
  • About
    • Client Reviews
    • Fees and Policies
  • Cases We Handle
    • Car Accidents
    • Motorcycle Accidents
    • Pedestrian Accidents
    • Bicycle Accidents
    • Brain Injury Cases
    • Wrongful Death
    • Spinal Cord Injuries
    • Estate Planning
  • Resources
    • Videos
    • Blog
    • Library
    • FAQ
  • FREE CASE EVALUATION
  • Contact
    • ZOOM VIDEO

Law Office of Robert Mansour

Frequently Asked Questions

Why isn't the insurance adjuster accepting the bills I sent them?

9/8/2013

 
When you submit a bill to an insurance company for payment, don't expect the insurance adjuster to simply accept whatever you send them.  Whether it's a property damage claim or an injury claim, most adjusters will not accept the bills you send them.  They will look for every conceivable reason to reduce the bill you sent them.

Many insurance adjusters will do everything they can to minimize payment on your claim. Some look for reasons not to pay your claim. Insurance companies do not make money by giving you money, they make money by holding onto their money. That means they will look for reasons not to pay or to pay you less than what you expect.  Sometimes, you just get unlucky and get assigned an insurance adjuster who thinks everyone who makes a claim is trying to "game the system."  Others are working for insurance companies that have company wide policies/culture and software programs designed to reduce claims and payouts.  Here are some common arguments:

1) The property damage estimate is too high.
2) The property damage estimate includes items not involved in the accident.  (Most adjusters don't actually go to the body shop - they send "estimators" who are arguably beholden to the insurance companies)
3) You treated with the doctor too long (most insurance adjusters don't have medical degrees last time I checked).
4) The charges from the doctor are too high.  (This is usually based on software programs arguably designed to favor the insurance companies).
5) The frequency of your treatment was too frequent. 
6) The frequency of your treatment was not frequent enough.
7) You waited too long to seek treatment.
8) You sought treatment too soon. You should have waited.
9) You did not have any diagnostic testing like an MRI or CT scan.
10) You should NOT have had diagnostic testing because it was "unnecessary." (and too expensive).
11) Some of the medical records don't specifically mention the accident, so the treatment was obviously unrelated (these are adjusters who can't see the forest from the trees).
12) Your injuries are pre-existing.

If you think about it, the insurance adjuster's job is to "adjust" your claim. That means they have to legitimize their existence by "adjusting" the claim you present to them. If they don't adjust your claim, then it is reasonable to question why they are even employed by the insurance company. Therefore, in an effort to legitimize their position, they MUST adjust the numbers you send them. This is true whether it is a property damage claim or a medical claim. So if the adjuster's job is to "adjust" the numbers, which direction do you think they will adjust? To "increase" the claim or to "decrease" the claim?

While there are rare exceptions, they will typically adjust the numbers downward. It is rare that I see an insurance adjuster simply accept the numbers as given to them. They also rarely "adjust" the number upward.  For example, I've never had an adjuster say, "I know you sent me the bill for $5000, but I think the bill should be $10,000!" Can you imagine if an insurance adjuster did that? Therefore, by design, an insurance adjuster will "adjust" your figures downward. I have never seen it the other way around. Be prepared to be disappointed. It's just the way the game is played.

    Categories

    All
    Alternative Dispute Resolution
    Attorneys
    Basic Speed Law
    Brain Injury
    Car Rental
    Case Value
    Claims Adjusters
    Comparative Negligence
    Damages
    Defendant
    Depositions
    Doctors
    Ear Injuries
    Fractured Patella
    Health Care
    Health Insurance
    Hearing Loss
    Injuries
    Insurance Adjusters
    Insurance Companies
    Knee Injuries
    Lawsuits
    Medical Expenses
    Medical Treatment
    Meeting With Your Attorney
    Personal Injury
    Police Reports
    Property Damage
    Proposition 213
    Punitive Damages
    Settlement
    Shoulder Injury
    Speed Limit
    Statute Of Limitations
    Value Of Case

    Archives

    November 2022
    July 2021
    April 2020
    November 2019
    September 2019
    July 2019
    March 2019
    August 2018
    May 2018
    January 2018
    October 2017
    July 2017
    May 2017
    March 2017
    January 2017
    December 2016
    October 2016
    July 2016
    May 2016
    February 2016
    December 2015
    November 2015
    October 2015
    September 2015
    July 2015
    June 2015
    May 2015
    April 2015
    February 2015
    January 2015
    November 2014
    September 2014
    August 2014
    July 2014
    June 2014
    May 2014
    April 2014
    March 2014
    January 2014
    December 2013
    November 2013
    October 2013
    September 2013
    August 2013
    July 2013
    June 2013
    May 2013
    April 2013
    March 2013
    February 2013
    December 2012
    November 2012
    October 2012
    September 2012
    August 2012
    July 2012
    June 2012
    May 2012
    April 2012
    March 2012
    February 2012
    January 2012
    December 2011
    November 2011
    October 2011
    September 2011
    August 2011

    by Robert Mansour

    Robert Mansour is a personal injury lawyer serving Santa Clarita, Valencia,
    Saugus, Canyon Country, Newhall, Stevenson Ranch, Castaic and surrounding
    communities.

 Home | Attorney Profile | Practice Areas | Client Reviews | Personal Injury Blog | Personal Injury Library | FAQ 
 Videos | Directions | Google Maps | Disclaimer | Contact Us

Visit our Google Business Page | Like Us on Facebook | Our Yahoo! Business Listing | Follow Us on Twitter  
Linked In Profile | Please give us a great review on Yelp | Our YouTube Channel | BrandYourself Profile
FAQ RSS Feed |  Blog RSS Feed | Library RSS Feed | Our Bing Local Business Listing | Cornell University Listing

Office hours are Monday through Friday, 9 am to 5 pm.  By appointment.  If you are trying to reach us after hours or on the weekends, the best way is to use the form on the "Contact" page or simply send an email to info@valencialawyer.com

* The information on this website does not create an attorney/client relationship.  It is not legal advice and is presented for general informational purposes only.  Always consult with a professional when handling legal matters as the law is constantly changing.

Law Office of Robert M. Mansour, 28212 Kelly Johnson Pkwy #110, Santa Clarita, CA 91355 (661) 414-7100
Picture