The “Secret Playbook” the Insurance Industry Doesn’t Want You to Read

Shh. Keep this under your hat. The insurance industry has a secret playbook they use with all plaintiffs to try to prevent you from hiring an attorney in order to keep their payouts low. Here’s an excerpt from their secret playbook and remember don’t pass this around – too much.

1. Insurance companies don’t want you to hire a lawyer. Insurance companies pay more money to plaintiffs who hire a lawyer. Therefore, insurance companies will try to tell you that you can do better or just as good without a lawyer. Reason being they want to pay you less than what your claim is worth. It goes without saying that insurance companies are in the business of making money and they make more money the less they pay to settle your claim, regardless of how injured you are or the merits of your case.

2. The insurance adjuster is not your best friend. He may be pleasant on the phone and personally he may understand what you are going through. However, he has a job to do and the less money he pays you, the more money he makes through big bonuses and promotions.

3. The insurance adjuster can tell you things that are not on the level. You are stressed and in pain. The adjuster knows this and will try to take advantage of your vulnerability. He will try to tell you that your case is minor because it’s just a soft tissue injury with no broken bones or a low impact car crash with slight damage to your car. He may try to tell you that you aren’t entitled to certain kinds of benefits such as pain and suffering since you recovered from your injuries within 3 to 6 months or had a prior injury.

4. An insurance adjuster can bluff when negotiating settlement. He can tell you that he doesn’t have any more settlement authority even when he does. For instance, the adjuster can say, “That’s my best offer.” But, the adjuster may be bluffing and have more money. You may hear the adjuster say something to the effect of, “If you hire an attorney, you’ll end up with less money because of attorney fees and trial costs,” or “You have until the end of business today to take the offer or we’ll see you at trial.”

5. A settled case is a closed case. The insurance adjuster wants to close your case. The more open cases he has, the more work he has. This means the adjuster wants to settle, even though he acts as if he could care less about settlement and claims he’d rather go to trial. The adjuster will discount the settlement value of your case considerably until you retain an attorney.

6. The insurance adjuster won’t tell you your rights. The insurance adjuster won’t tell you about things that you have a right to be compensated for. For example, you are entitled to be reimbursed for items such as prescriptions, the loss of use of your car, damage to items in your car, mileage to your doctors, and diminution of value to your car after the wreck.

7. When you are talking to the insurance adjuster, you might as well be talking to their lawyer. The adjuster often has their lawyer on speed dial and has already spoken to the attorney about your case. Adjusters attend training programs put together by their attorneys who know how to push your psychological buttons and prey on your fears of dragging out the case in order to get by with paying you the least amount of money.

8. The insurance company has deep pockets. It goes without saying that the insurance company has millions and billions of dollars and you don’t. In fact, the longer the insurance company holds onto its money, the more money it makes on interest and the more profit it makes. Therefore, it is in the insurance company’s best interest not to settle your case quickly, unless they can settle it cheaply.

9. Prime time TV advertising costs insurance companies big bucks. But insurance companies wouldn’t be spending the big bucks on TV advertising if they weren’t raking in the money.

10. Insurance companies factor the cost of litigation in their decisions. In settlement you should always consider the trial cost in settlement decisions. Besides the cost of paying their attorney there are court reporter, expert and filing fees.

The best defense against the insurance companies’ “Secret Playbook” is to know your rights. Having an Affleck & Gordon lawyer on your side will make the insurance company sit up and take notice. This is because the personal injury lawyers at Affleck & Gordon understand the value of your claim and won’t let the insurance company get away with pressuring you to take a low-ball offer.

If you have been involved in a car wreck or truck accident in the Atlanta area, or anywhere else in Georgia, please call us today at (404) 373-1649.

 

Top 5 Tips on How to Fill Out Social Security’s “Activities of Daily Living” Form From Marci McKenna

Marci McKenna
Marci McKenna

Top 5 Tips on How to Fill Out Social Security’s “Activities of Daily Living” Form

At some point during the disability process Social Security will ask you to fill out one or more forms about how your illness or injury limits your ability to work, and how it affects your daily activities. If your job required a lot of standing and walking or heavy lifting, you probably won’t have any problem explaining why you can no longer stand and walk for 8 hours a day if you have diabetic neuropathy in your feet or lift and carry 25 to 50 pounds if you have a back injury.

Social Security will also ask you to describe how your illness or injury limits your day-to-day functions or what is called your “activities of daily living.” This is where it can get a bit tricky, and where a number of disability claimants have a problem and don’t give a full explanation of the true-to-life impact of their disability on their daily activities.

Tip 1: Copy the Form. You will receive from Social Security a Function Report – Adult – Form SSA-3373 to describe information about your “activities of daily living” or “ADL.” Make a copy of this form and once you have your explanation as you want it, write it over onto the original form and send the original into Social Security. If you don’t have access to a copier, use a sheet of paper and write down the sections and subparts from the form and your answers on the sheet of paper and then transfer your final answers to the form.

Tip 2: Think in Terms of Disabilities Rather Than Abilities. One of the questions on the form is: Describe what you do from the time you wake up until going to bed. For example, a claimant who is thinking in terms of abilities may write: “When I wake up, I take my pills, shower, make the kids and myself breakfast, drive the kids to school, return home, lie down for an hour, get up and wash the dishes.” However, a claimant who is thinking in terms of disabilities may write: “When I wake up, it takes me 30 minutes to get out of bed due to severe, chronic low back pain when it used to take me 5 minutes, I take my pills, and because of my back injury I have to shower in the hall bath because I can’t step into my bathtub in the master bath, it takes me 30 minutes to shower when it used to take me 10 minutes, I used to wash my hair every day but I can’t because it hurts to raise my arms above shoulder level for longer than a few minutes at a time, I no longer cook breakfast for the kids because I can’t stand at the stove for longer than 5 minutes so I make cereal and I keep the cereal boxes at waist level in the cabinet because I can’t bend over at the waist, I drive the kids to school in a van we had to purchase after my back injury because I couldn’t bend to get into the 4-door sedan I had before the back injury, I return home and because my back is in muscle spasms after this activity I have to lie down for an hour before I am able to rinse the dishes for 5 minutes and set them aside for my daughter who will load them in the dishwasher when she gets home after school.” And don’t worry about not having enough room for your answer as the last page of the form has a Remarks page for you to continue your answer.

Tip 3: Think in Terms of How You Did Things Before and How You Do Things Now.

Another question addresses how your illness or injury affects your personal care including your ability to dress, bathe, use the toilet, care for your hair, shave, and feed yourself. Wait. Before you check everything and say you are still able to do these things, you need to think about it as you may have made a lot more modifications in your personal care routine than you realize. For instance:

You no longer take tub baths because you can’t get in and out of the tub, and you installed grab bars in the shower because your chronic back pain makes you unsteady on your feet.

You no longer use a manual razor blade to shave and use an electric shaver because of hand numbness.

You no longer wash your hair every day because it hurts your back to raise your arms overhead.

You no longer wear shoes that tie because it hurts to bend over.

You no longer cook your meals on the stove because you can’t stand longer than 5 to 10 minutes before your back starts to hurt.

Or, it takes extra time to get showered and dressed than before the illness/injury because of the pain.

This also applies to social activities and hobbies. Social Security is interested in what you used to do and what you do now. You no longer read the newspaper because you can’t see the fine print or can’t concentrate. You no longer go out with friends or to church because you’re depressed and don’t feel like seeing anyone.

Tip 4: Be Consistent. The activities of daily living or ADL form asks a number of questions about what you do during the day, how long it takes, how your illness/injury affects your ability to care for yourself, care for others, care for your pets, go shopping, prepare your meals, do household chores, both indoors and outdoors, and what your hobbies, interests, and social activities are and how they have been affected by your illness/injury. You need to make sure your answers are consistent throughout the form along with your medical records and social media accounts. Don’t forget that if you told your doctor that you overdid it cooking Thanksgiving dinner for the family and you write on the ADL form that you never cook anymore because it’s too much on your back that this won’t be consistent. For example, you could say, “I never cook anymore except for the one time I tried cooking Thanksgiving dinner for the family and my back was killing me the whole time. The next day I couldn’t get out of bed for 24 hours.” One more thing: Don’t forget those family photos on your Facebook page showing you walking around Six Flags Over Georgia for eight hours. You’ll want to make sure that your Facebook page is consistent with your statements on the ADL form and if you take a family trip to an amusement park we recommend that you stay within your doctor’s limitations.

Tip 5: Tell Your Doctor Your Difficulties Doing Daily Activities. You’ll want to tell your doctor how your illness/injury is affecting your daily activities so it becomes part of your medical record, and your reports of difficulty with your day-to-day functioning will be corroborated by your medical record.

Do You Have A TBI (Traumatic Brain Injury)?

Brain injury and neurological disorder represented by a human head and mind broken in pieces to symbolize a severe medical mental trauma and cognitive illness.

The catastrophic and life-changing nature of a traumatic brain injury will affect the victim and their loved ones in countless ways. The pain of the initial trauma is soon overshadowed by the growing burden of the recovery process. The cost of treatment and recovery is overwhelming but not necessarily a stress the victim and their family have to tackle alone.

Have you or someone you know suffered a brain injury after a construction accident? Our attorneys at Affleck & Gordon will fight to safeguard you or your loved one’s rights.

  1. Overview: Traumatic brain injury (TBI) is a major cause of death and disability in the U.S. Those who survive can face effects that last a few days or for the rest of their lives.
  2. What is a TBI? A TBI is caused by a bump, blow or jolt to the head that disrupts normal brain function. Not all bumps or blows to the head cause a TBI.   The severity may range from “mild” (brief change in mental status or consciousness) to “severe” (extended periods of unconsciousness or memory loss).

In 2013, a report from the National Center for Injury Prevention and Control states that nearly 2.8 million people fall victim to traumatic brain injuries across the United States annually. What’s even more astonishing is that almost 50,000 of these incidents result in death.

A 2013 Center for Disease Control report notes the top three leading causes of brain injuries are:

  • Falls
  • Being struck by or against an object
  • Motor vehicle accidents

The brain injury victim’s main concern should be regaining his or her health and returning to satisfactory quality of life. This is a lengthy, expensive and emotionally draining process. Proper legal assistance can alleviate these burdens. Please consider a consultation with our personal injury and workers’ compensation attorneys to discuss you or your loved one’s traumatic brain injury.

FREE CONSULTATION – Contact our office today to schedule a free case review.