From IPE: The Top Ten Tips for Working with Insurance Companies

The Top Ten Tips for Working with Insurance Companies

Guest author: Leonard D. Zaccagnino, Esq. and Gail Galfo, Paralegal

Click here to join the IPE mailing list.


I have been practicing law for over 33 years, focusing my practice on representing individuals who have been injured in accidents. A great deal of my time, and my paralegals’ time, are spent communicating with insurance company representatives in an effort to resolve claims. The top ten list which follows has been put together in conjunction with my paralegal extraordinaire, Gail Galfo who, along with myself, have over 60 years of experience working with insurance companies in an effort to resolve claims. I say with no hesitation that without the assistance of the paralegals in my office, we could not have had the success and great results we get for our clients.

Tip 1: Get all the Facts.
Before you can effectively communicate your clients’ position to the insurance company, you must have an all-encompassing understanding of your client’s claim and position. In order to do this, you must meet with your client at length to get all the facts and details necessary to negotiate your client’s claim.

To accomplish this in our practice, we have the client meet with both myself and my paralegal, if possible. We have developed a comprehensive intake sheet that sets forth all the information we need from background information, name, address, telephone numbers and other details and specific facts relevant to the client. We list the date of the incident, what happened, any witness information, investigations performed, injuries and damages sustained, and the like. The more information we have at the outset, the better we will be able to support our client’s position and obtain a favorable result for our client.

In addition, by using the same intake sheet over and over, we are sure to get all the information necessary. It also creates a duplicatable intake process that is used throughout the office with all attorneys and staff. We can amend the intake sheet as we continue to learn with each case we handle. I like to call this CNI

Constant, Never-ending, Improvement

Tip 2: Begin with the end in mind.
Once you get a handle on the facts and issues involved in a particular case, make sure the client understands the issues and what is necessary to prove their claim. Talk about the outcome that is desired. It may be too soon to have concrete damage numbers in mind, but the point is to discuss with the client what factors are considered in determining damage compensation. Explain to the client at the outset that regardless of the extent of damages, in most cases, the amount of damages will be limited to the extent of available insurance.

Make your demand to the insurance carrier as soon as possible to disclose their policy limits. If the client has the insurance policy, get the full policy and familiarize yourself with its provisions, especially the amount of coverage.

Tip 3: Do a thorough investigation as soon as possible.
Make sure that the paralegal and the attorney determine at the outset what, if any, investigation is necessary. Do you need to hire an investigator to take statements, find witnesses, take photographs? Do you need to hire an expert to determine whether or not you have a claim? Move as quickly as possible before evidence disappears and memories diminish.

You will use all this information as the foundation for all discussions you have with the insurance company representative.

Remember, knowledge that is applied is power!

Tip 4: Determine all available sources of insurance and the amount of coverage.
The amount of coverage will dictate the whole tenor of how you will proceed with your client’s claim. If the injuries are bad, the liability is clear, and the insurance coverage is minimal, you do not want to over-spend in pursuing the claim. In most cases, if liability is clear and the injuries are severe, and the coverage is minimal, pre-suit settlement is possible.

Tip 5: Be nice.
When dealing with the insurance company representative, always be nice. Believe it or not, at the end of the day, both your client and the insurance company have the same goal in mind – to resolve the claim.

Nice doesn’t mean weak. Nice means communicating with kindness and respect. Speak the truth, and don’t hold back on facts – good or bad.

You want to connect with the insurance company’s representative. “Connect” is different that “communicating.” Connect means to speak from your heart, tell the truth, and develop a mutual respect for one another’s position, including differences.

Do not be disrespectful, nasty, rude, condescending or sarcastic.

Remember: One gets more flies with honey than vinegar!

In our practice, we have actually gotten to the point where many insurance company representatives have told us that they enjoy working with our office. When people like you, they will try to help you.

Tip 6: Provide the insurance company representative with all of the information that you have, whether favorable to your position or not.
Make sure you provide the insurance company with all of the available information that applies to your case. Don’t hold anything back because if you do, the adjuster will find out and your credibility will be destroyed.

Embrace the weaknesses of your claim, and make them your strength. Be transparent in all you do; speak the truth for the truth will set you free.

Explain that you will continue to provide the insurance company with all pertinent information as you obtain it, including updated medical records, diagnostic imaging studies and the like.

Tip 7: Stay in constant communication with your client so that you understand what they are going through.
You must be proactive in connecting with and communicating with your client. Explain to your client the importance of being updated with respect to any issues involving their claim.

You must step into the shoes of your client in order to understand the full impact of their claims. If possible and pertinent, make arrangements to meet with your clients at their home to see how the damages they have sustained have affected their lives.

Tip 8: Listen.
The best communicator is the best listener. Listen to what your client tells you; listen to what the insurance claims representative tells you. If you develop a good working relationship with the claims representative, they will tell you, in many different ways, what their position is, why their position is what it is, and what is needed to support to client’s claim.

Tip 9: Tell the claims representative what you want to resolve your claim for, and why.
At some point, you must tell the claims representative what you want to resolve your client’s claim for. Always explain, verbally and in writing, that any discussions regarding settlement are without prejudice and for settlement purposes only. Explain, verbally and in writing, that if the claim is not resolved, all bets are off.

Put all settlement demands and offers in writing so that you have a record of the same, and so that there will be no misunderstanding as you move forward.

Make sure you keep your client in the loop as negotiations proceed. Make sure your client is in agreement with your negotiation strategy and goals.

Tip 10: Develop the reputation of being fair, but well able to present your case to a jury.
If you say something, mean it and stand behind it. Do not waffle in your position. The paralegal and attorney must continue to work together and keep each other apprised of all progress being made with the claim.

Develop a reputation of integrity. Having integrity means doing the right thing in a reliable way. Integrity stems from the Latin word “integer,” which means whole and complete. Integrity requires an inner sense of wholeness and consistency of character. When you deal with others with integrity, people should be able to visibly see it through your actions, words, decisions, methods and outcomes.

I guarantee that if you act toward the insurance company with integrity, you will be able to resolve your client’s claim and, in the process, set the stage for a working relationship that will be mutually beneficial to all concerned.

Leonard D. Zaccagnino is the senior partner in Shaw & Shaw, P.C. He is a member of the New York State Trial Attorneys Association and Association of Trial Attorneys of America. Mr. Zaccagnino’s practice focuses in civil litigation, specializing in personal injury litigation representing people that have been seriously injured. Mr. Zaccagnino has spoken at various training seminars for other attorneys in the area of personal injury law.

View Full Article… [cToolsOfTheTradeMay2017.htm]

Leave a Reply