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Law Office of Robert Mansour

Library Articles

Classic insurance company arguments used to minimize your claim

10/19/2013

 
VIDEO TRANSCRIPT: Hi, this is Robert Mansour, and I'm a lawyer in the Los Angeles area. One of my areas of practice is Personal Injury Law, and I'm broadcasting today from my office in Santa Clarita, California which is in northern Los Angeles County. I want to spend a couple of minutes with you talking about this letter that I got from Mercury Insurance. The reason I like this letter and I think it's a terrific letter and I want to share it with you is because it is very demonstrative of how insurance companies deny claims.

This is an accident case. It was not a big accident. My client knew that going in. Here's the letter. I think this letter just sums it all up really well. I'll show you exactly what I'm talking about. So here's the letter that I'm going to read to you. This is from Mercury Insurance.

It says, dear Mr. Mansour, we have evaluated the specials. Now, the term specials means the damages, the economic bills, et cetera. It says, this loss involves a minor impact to the driver side rear of your client's vehicle. They're using the fact that it was a minor impact to try to minimize the case. So the severity of the impact is very important. That's something that you should keep in mind. It says here, there was no police report filed. So here they're using the absence of the police report as an indication that this was not a major accident which, of course, is silly, but here's how insurance companies work.

If the police are not called to the scene, then obviously it was a minor accident, but if they are called to the scene they generally presume well, maybe there was an injury. So again, very interesting. No police report filed, it says. Your client did not receive emergency treatment on the date of the loss or subsequently. So the fact that my client never went to the emergency room or wasn't taken away by ambulance or anything like that, the lack of emergency treatment is being used against my client.

Now, maybe my client is stoic. Maybe my client wasn't hurt all that badly, but what they are doing is they are using the absence of emergency treatment against her. Also it says here, your client sustained soft tissue injury. That means pulls, muscle strain, sprain, that kind of thing. She was treated by a chiropractor which is interesting. That is the reason that they are using to minimize this claim, the fact that she was treated by a chiropractor.

Now, in some minds of some insurance adjusters, the chiropractic treatment is not as valued as an orthopedist treatment which is very interesting because many chiropractors provide terrific relief for their clients, here it is being used against my client. The fact that she went to a chiropractor. It says here, the treatment charges are excessive in relation to the injuries and the impact sustained.

Basically, they are using the size of the impact to dictate how much treatment she should have gotten. So if it was a low impact she should not have gotten this kind of treatment. Again, they don't take any individuality into consideration. They just look at the amount of the impact and determine, gee, does that make sense? Did they go treat for too long or not too long?

You'll notice in this letter it doesn't say anything about my client's medical condition, what the actual doctor had to say, what my client's reported injuries were, whether she is a frail person, whether she has any pre-existing problems, nothing like that. This denial, well actually it's not a denial. They offered her $2,000, but we suspected that in the very beginning.

Here's the thing. This letter is full of all the classic arguments. No police report, no emergency room treatment, minor impact, chiropractor. All of this being used against my client. I just wanted to share this letter with you as a demonstration of how some insurance companies, especially Mercury, just my opinion, use to deny and minimize these kinds of personal injury claims.

Thanks again. My name is Robert Mansour. You can learn more about me by visiting my website valencialawyer.com or calling my office at 661-414-7100. Thanks a lot for watching.

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    by Robert Mansour

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