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Red Flags That Insurance Claims Adjusters Look Out For

Personal injury lawyer-Samer habbasIf you are trying to collect on an insurance policy due to a personal injury, you may have to convince the insurer as to the validity of your claim. It is the job of the insurance claims adjuster to decide whether the policy applies to your case and then decide the validity of specific items in your claim. Naturally, the adjuster will be skeptical of anything that doesn’t seem right given the facts presented, and, depending on his experience, the claims adjuster will make further inquiries into things that need further explanation or seem suspicious. An Irvine personal injury attorney may be able to help you present your case in the most favorable light and satisfy the adjuster. Here are some telltale signs that claims adjusters often look for regarding medical treatment:

The adjuster’s responsibility is to verify and articulate, in monetary terms, the amount of loss or damage sustained by the claimant. The adjuster may look at your detailed list of medical expenses and evaluate whether the treatments you are receiving are justified by what is in your medical reports. The adjuster may also look at the type of doctor treating you (if you are only seeing a chiropractor, your case may invite more inquiry than if you saw a neurosurgeon as well). Additionally, the adjuster may look at the frequency and amount of your treatment to see if you are showing any signs of improvement.

Adjusters are particularly skeptical of claims of soft-tissue injuries (sprains or strains) for which you claim chronic pain and disability but which no medical test supports. If you claim medical bills that seem excessive to the injury sustained (inordinate amounts of physical therapy, for example), or claim treatment that does not seem directly related to your injury (psychiatric treatment for low-impact accidents, for example), that will seem suspect as well.

Adjusters look out for certain personal injury attorneys and doctors who often refer clients and patients to one another and who may be “in cahoots” with one another to create a network of referrals. The adjusters will scrutinize those doctor’s records more closely and possibly give them less credibility. If you use one of these red flag doctors, the insurer may request an independent medical examination.

If you have further questions about how to deal with your insurance company, contact experienced Irvine personal injury attorney Samer Habbas for a free consultation.

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  • Samer Habbas Achieves a $880,000 Settlement on a Low-Impact Auto Accident
  • Corbin Moore Lands a $400,000 Settlement for Victim of a Six-Car Accident.
  • Samer Habbas and Kristina Akers Secure $11,000,000 for a Truck Accident Case
  • Jeffery Crissman Secures $150,000 Auto Accident Settlement
  • Corbin Moore Obtains $101,000 Underinsured Settlement for Auto Accident Victim
  • Samer Habbas Achieves $300,000 Settlement for a Three Vehicle Collision Accident Victim
  • $140,000 Broken Sidewalk Trip & Fall Settlement Against Kern County
  • Law Offices of Samer Habbas & Associates Achieves $3,450,000 Settlement for Motorcycle Victim
  • Laguna Niguel driver struck by an impaired driver receives a settlement in the amount of $235,000.00
  • Samer Habbas Settles a Premises Liability Case Against an Apartment Complex for $500,000

Testimonials

Samer Habbas & Associates PC
4.9
Based on 142 reviews
Awesome service the team here is very attentive and keep you notified with your case. Summer answered all my questions and really explain the process thoughrly. She made sure everything was taken care of and made the process comfortable and easy. Highly recommend this office.read more
Lolita F.
Back in May my husband and I got in a car accident. I tried to deal with the insurances myself, to no avail...then our friends referred us here. It is one of the best choices we've made! Mike goes above and beyond! He will make sure you get the reimbursement you and your doctor deserves!Keep up the great work and thank you so much for helping us!Rini (A.Buisan)read more
Aurene B.
Best personal injury lawyers in the game!!
Jener S.
They are the best, very good and professional I will highly recommend them.Thanks
Victor F.
I got into an accident and these guys helped slot and I walked away happy
Jeffrey J.
I was involved in a car accident and was injured and decided to file a claim, the staff was very helpful and managed to file my claim very fast. Thankful for their help!
Yolanda T.
I’ve never used an attorney for an auto claim before, but I have to say that this law firm was an exceptional first experience. From the moment I contacted them to get more info on how they could help me, they have been extremely helpful and super responsive. I communicated with Basim Habbas throughout the process, who did an awesome job of keeping me informed and updated. He answered all of my questions and addressed any concerns I had, and even made it easy to communicate via text - all of which I thoroughly appreciate! The law firm took care of every single aspect of this claim for me - I didn’t have to do anything besides provide the basic info and stay in touch with them. I highly recommend and advise anyone who’s involved with an accident or personal injury claim to use them! They are trustworthy, reliable, and get the job DONE.Thank you guys for everything you did for me, I sincerely appreciate your help.read more
Eva A.
Highly recommend this law firm, they helped me with everything, always checked in on me to see how I was doing. Sommer and Cristina always listened and made sure I knew everything that was going on. Couldn’t have asked for better lawyers.
Sabrina S.
Wow, such an amazing experience. I can't say enough good things about Kristina Akers, she is helpful, polite, and always has an answer to all your...
Christopher P.
I've never used an attorney for an auto claim before, but I have to say that this law firm was an exceptional first experience. From the moment I contacted...
Eva A.

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