How Insurance Companies Settle Cases


inside information from industry veterans

How Insurance Companies Resolve Cases covers the spectrum of settlement concerns, from estimating bodily injury damages and investigating coverage to claim denials and insurance schemes. action cards. speed up the processing of your claims and reduce your frustration with insurance companies. this book offers:

  • insurance company liquidation techniques to consider
  • aspects of claims frequently questioned by insurance companies
  • insurance policy defenses and coverage issues
  • how to contact insurance companies
  • duties owed by insurance companies
  • how to effectively deal with adjusters
  • how insurance companies process claims
  • Most Popular Adjuster Negotiation Techniques
  • how indexing and booking systems work
  • what insurance companies look for in their investigations
  • how insurance companies seek to limit coverage
  • Knowing how insurance companies operate can help you get fair settlements faster. By learning what the home office counts on and what it doesn’t, you can present your case in the best light with minimal wasted effort and make both you and your case stand out.

    The book is packed with expert settlement information you can use today. Some tips include:


    • “liquidators will often offer two-thirds or one-half of the claim received from the plaintiff’s attorney” section 240
    • “A local claims administrator has about $50-100,000 of discretionary settlement authority. Typically, he will extend $20-30,000 of discretionary settlement authority to his claims supervisors, and $10-15,000 to office claims staff.” section 240
    • A prudent plaintiff’s attorney will ask the insurance company directly, early in the relationship, “Is there a coverage issue? Is there a liability issue? Section 702.1
    • “Avoid Monday mornings and Friday afternoons, as these are the busiest times for adjusters. These are the times when they will be less receptive to phone calls from attorneys or requested meetings.” article 780
    • valuation

      • “99% of plaintiffs’ attorneys are unaware of supplemental coverages that expire and are paid in excess of policy limits.” section 240
      • “A natural trap many attorneys fall into is negotiating the value of your case against the policy limits. If the plaintiff was 20% at fault in a comparative fault jurisdiction and the policy limits are $100,000, many attorneys will ask for $80,000. instead, they should value the case regardless of the policy limits.” article 740.1
      • documentation

        • “Nurses in hospitals and clinics maintain the best documentation of pain observed in a given patient. use your notes to rule out false claims of soft tissue injury.” section 240
        • “An undocumented lawsuit is not worth the paper it is written on. the insurance industry loves all the documented claims and loves the paperwork. why? because that’s how it’s always been done.” section 702.7
        • response time

          • “The general rule of thumb in the claims settlement industry is that 30 days is the usual and customary time frame for requesting an insurance company to respond to a settlement claim. This is because the claims industry is set up on a 30-day journal system.” section 702.7
          • “Usually, when an attorney sets a ten to thirty day time limit in their demand letter, the paperwork requirements are set aside and settlement authority is granted over the phone. the idea is that the paperwork can be done on or after the date the case is resolved, rather than before.” section 240
          • How Insurance Companies Settle Cases reveals how insurance companies evaluate and negotiate claims and answers the following questions:

            • How do insurance companies rate cases?
            • what do adjusters need to settle a case?
            • Who makes the real decisions on insurance cases?
            • How do insurance companies rate pre-existing injuries?
            • How do I prove my client really has a soft tissue injury?
            • what is the structure of most claims departments?
            • How can I find out the policy limits and get a copy of the insurance policy?
            • Straight answers to each of these questions can be found in section 240 of How Insurance Companies Resolve Cases, and the book is packed with more insurance company secrets.

              revision 29 highlights

              Get a better understanding of how insurers work and how to get better deals for your customers. learn how to convey the true value of your case, sidestep delays, and how to resolve your case. This edition of how insurance companies resolve cases brings you the new chapter 19, impact of covid-19 on the insurance claims handling issues it covers:

              • claims related to covid-19 and specific businesses


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