How Insurance Companies Undervalue Catastrophic Injury Claims

When someone suffers a catastrophic injury—such as a spinal cord injury, traumatic brain injury, or amputation—the consequences extend well beyond the initial hospital visit. Recovery usually involves lifelong care, therapy, assistive devices, home modifications, lost earning potential, and emotional trauma. Yet insurance companies often make offers that barely scratch the surface of these real costs.

Here’s how they minimize claims—and what you can do to protect your rights.

1. Early “Lowball” Settlement Offers

Insurers frequently extend a quick, low-dollar offer right after the accident—often before the full extent of injuries and future costs become clear. This tactic pressures victims into accepting cash prematurely, closing the case before high long-term expenses emerge.

2. Discounting Long-Term Needs

Adjusters tend to base settlements on immediate expenses only, ignoring escalating costs like lifetime medical care, adaptive equipment, vocational retraining, or home modifications. That gap can result in massive unmet needs later.

3. Using “Paper Reviews” and Disputing Injuries

Some claims are evaluated solely via written records by insurance-affiliated doctors, without ever examining the injured person. This practice allows insurers to downplay or dispute injuries—especially subjective or invisible ones often associated with catastrophic outcomes.

4. Delay, Deny, Defend

A classic strategy: insurers delay payments, deny valid claims, and defend their position aggressively. Known as the “delay, deny, defend” approach, it aims to wear down victims emotionally and financially until they settle for less.

5. Misrepresenting Policy Language

Complex or vague policy terms can be used to justify claim denials or reduced payouts. Insurers may twist coverage definitions to favor their bottom line unless a claimant’s attorney steps in. This is why careful policy review is essential.

6. Blaming Pre-Existing Conditions or Partial Fault

Adjusters may claim the injury was due to a pre-existing condition or argue you bear partial responsibility—especially if there are gaps in documentation or treatment. Even baseless suggestions can lower a settlement by shifting fault.

How to Fight Back

• Consult an experienced catastrophic injury attorney before accepting any offer. That legal expertise helps you resist lowball tactics and counters insurer arguments effectively.

• Engage experts—medical specialists, life-care planners, economists—to document current and future needs comprehensively.

• Don’t let a fast offer shut the door. Wait until you reach Maximum Medical Improvement so your full recovery path is known.

• Your case should be prepared for trial—even if you hope to settle. That positions you as serious and tough to dismiss.

Wrap-Up

Insurance companies don’t typically offer fair compensation after catastrophic injuries unless pushed—and that push comes from expert attorneys armed with evidence, determination, and understanding of long-term impacts.

If you or a loved one has suffered a catastrophic injury in Pennsylvania, Pisanchyn Law Firm stands ready to fight for the full compensation you need to rebuild your life. Schedule a free consultation today.