Insurance adjusters are trained professionals whose primary goal is to minimize the payout for their company, which often means offering low settlements or denying claims to save money. They may use tactics like requesting fast recorded statements, offering quick, lowball settlements, or encouraging the use of company-preferred vendors to limit liability and control the claim.
In this day and age, it can be surprising that a large auto insurance company would try to screw its customers. The fact is, this sort of behavior is common, widespread, and profitable.
When talking to an insurance adjuster, avoid admitting fault, speculating on the cause or extent of injuries/damages, giving recorded statements without legal advice, and volunteering extra information like past injuries or unrelated details, as anything said can be used to minimize your claim; instead, stick to basic facts, remain polite but brief, and consider getting legal counsel. Don't sign anything without review, and avoid saying you're "fine" or "okay" immediately after an incident.
Plus, insurance companies fear litigation; they would rather pay your claim than risk losing even more money in a lawsuit. Keep reading to learn about the top nine tricks insurance companies use to avoid paying you a fair settlement and how a legal professional can help you get the compensation you deserve.
The 3 D's of insurance are “delay, deny, and defend.” They represent the 3-part strategy insurance companies use to avoid paying policyholders what they may be owed. These tactics may pressure some Americans into accepting lowball settlements, and they can result in claims being held up in court for years.
How to Outsmart an Insurance Adjuster
If you are out in public, they can record you doing things like walking, shopping, or driving. They might also take photos. As long as they stay in public places, it is typically legal. However, if they start peering into your backyard over a fence or tapping your phone calls, that is not allowed.
What they won't tell you is that their primary job is to save their company money—often at your expense. Insurance adjusters are not your advocates. They're trained professionals whose performance is measured by how much they save their company. Every dollar you don't receive is a dollar their employer keeps.
8 Red Flags That Insurance Companies Aren't Going to Cover Your Bills
Insurance companies determine fault by having adjusters investigate, gathering evidence like police reports, witness statements, photos, and videos, analyzing vehicle damage and skid marks, and applying state traffic laws and negligence principles, often resulting in shared fault (comparative negligence) if multiple parties contributed.
The 80/20 rule in insurance refers to two main concepts: the Medical Loss Ratio (MLR) under the Affordable Care Act (ACA), requiring insurers to spend 80% (85% for large groups) of premiums on care or refund the rest, and a common home insurance clause where you must insure your home for at least 80% of its replacement cost to receive full coverage for partial losses, preventing underinsurance. In health insurance, it limits administrative costs and profits, while in homeowners insurance, it ensures adequate dwelling coverage to avoid penalties on claims.
Here are the 3 worst car insurance companies in 2023 in the USA according to Consumer Reports:
Here, we discuss the first five most common medical coding and billing mistakes that cause claim denials so you can avoid them in your business:
7 Things Insurance Companies Don't Want You to Know
Kaiser Permanente has the lowest claim denial rate among major health insurance companies, which the analysis defined as brands offering Marketplace plans in seven states or more during the 2025 plan year. The California-based healthcare company denied just 6% of claims based on the available 2023 data.
Delay Tactics
Known as one of the “3 D's,” insurance company delay tactics are used to stretch out the claims process. Adjusters may repeatedly request unnecessary documentation, fail to return your calls, or prolong the investigation in hopes you'll accept a smaller settlement or give up entirely.
You can claim for anxiety alone, or alongside other injuries, such as whiplash. Expert psychiatric reports can form a huge part of your evidence. If someone you know has suffered anxiety after a car accident and they're unable to make their own personal injury claim, you can potentially make a claim on their behalf.
You can get a wide range for pain and suffering in a car accident, from a few thousand for minor whiplash to millions for catastrophic injuries, with settlements often calculated by multiplying total economic damages (medical bills + lost wages) by a factor (1.5 to 5) based on injury severity, or using a daily rate method, but amounts vary widely by state, injury, and lawyer negotiation.
TL;DR: Yes, an MRI can increase a settlement because it provides clear, objective medical evidence of injuries. It helps prove severity, supports higher medical costs, and gives leverage in negotiations with insurance companies.