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Reasons Why Insurance Companies Reject Slip and Fall Claims

If your insurance company dismisses a slip and fall claim, there are options you can take to attempt to recover losses. You want to find out why they refused to accept the claim and what to do to ensure you are compensated.

Every year, slip and fall accidents cost victims as much as $14 million in the United States. To recover their losses, the majority of these individuals will file an injury claim with an insurance company.

However, the insurer and claim adjusters are trying their best to find a reason why they must reject a claim or get the lowest settlement possible.

A business may justify a rejection by claiming that you failed to show that the property owner was to blame for your accident. An insurer may sometimes argue that it has no choice but to refuse your claim because the policy has expired or you have failed to meet all of the filing criteria.

Whatever the reason for the insurer’s refusal, don’t give up because you may still have a shot at recovering losses. While you may need to employ slip and fall lawyers for assistance, you may still go after compensation for losses you sustained in the accident.

The Insurance Industry’s Denial Bias

Try again if your slip and fall claim was dismissed. It should be apparent that insurance companies exist to make money. However, if they simply pay out every claim without trying to pay the lowest amount or flat out denying them, they would be out a lot of money. Every day, an insurance company is hit with new injury claims, and they try to minimize a victim’s compensation or avoid paying altogether, whether it’s a slip and fall claim or a car accident claim… if they can.

A claims adjuster’s job is to approve the least amount of compensation as possible, resulting in larger earnings for the company as a whole and bonuses for the adjuster responsible for it. This means the entire insurance claim industry has a built-in bias towards claim rejection.

In truth, the entire insurance industry utilizes a variety of strategies to pay out less on slip and fall claims or to reject them as often as possible.

Be Wary of Adjusters Who Pretend to Be Your Friend

When claims adjusters are first assigned to your claim, they will typically want to be friendly to gain your trust. A key reason is because they want you to offer a recorded statement to convey your side of the story.

Adjusters will attempt to persuade you to say things that would affect your claim during these statements. If they accomplish such efforts, they will use your remarks to justify a lower settlement offer or just reject the claim based on what was said.

Because of this tactic, an injury victim should typically avoid offering a statement to an adjuster before consulting with an attorney.

When a recorded statement is given, it should be done with careful consideration. If you decide to do it on your own, make sure to do all the proper research to ensure you are prepared. There is no going back if you make a statement that could damage your case.

A Lowball Settlement Will Likely Be Offered

An insurance adjuster usually begins by making a very low modest offer to settle most claims, including a slip and fall injury.

When the offer has been presented, an adjuster usually claims that it is the highest the insurance company will pay, that it is a reasonable offer, and that they cannot offer anything higher.

Since the insurer wants to pay the least amount, these claims by the adjuster are usually false. Their hope is that you gladly accept their first offer and move on. If this happens, the insurance company will have saved money.

If their low ball offer upsets you, you may hint at reasons why you need the money, and this in turn, could aid the adjuster in determining how to convince you to accept less. Never say that you have overdue bills or that you’re in a rush or anxious to settle.

The offer should not make you angry. Instead, you should keep your cool, decline and continue talks with the insurer.