Insurer Hot Seat: State Farm Fights Not To Pay You

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Michigan no fault insurance providers like State Farm emphasize how quickly they will help you settle your claims. But last year, a court released 77,000 internal documents showing just the opposite.

State Farm is There

State Farm emphasizes how quickly it responds after an accident. There’s a reason for that: you haven’t had a chance to talk to a lawyer or discover the extent of your injuries. The Winter 2015 edition the Michigan Association for Justice (MAJ) Journal exposed State Farm’s tactic of getting to you first and holding you to what you say before you fully know what is going on. That’s why an experienced auto accident attorney should be one of your first calls – before you talk to your insurance provider.

The “Independent” Medical Examination

According to the Michigan Insurance Fraud Awareness Coalition only 10% of claims involve any padding or false claims. And yet, since 1995, State Farm has increased its use of “independent” medical examinations (IMEs) to as many as 90% of its cases.

Adjusters use IMEs to challenge the validity of your claim. Instead of trusting your doctors, State Farm’s claim adjusters get copies of all of your medical records and give them to one of 40 “approved” medical examiners. The examiner then does a very brief physical exam and creates a report.

Several IME doctors have admitted that their reports are mostly forms. The doctors answer to vendors like Exam Works, which emphasize keeping their clients – the insurance providers – happy. That’s why only 2-5% of one doctor’s IMEs recommended surgery or injections.

Insurance adjusters take the IME doctor’s word over your own doctor as far as what treatments are reasonable and necessary. If you disagree, they are willing to go to trial and lose rather than pay you what your doctors say you need.

The Bottom Line

State Farm’s internal documents revealed that since 1995, they have used IMEs and aggressive negotiation strategies to cut down on how much they pay out in claims, even legitimate ones. According to one document featured in the MAJ article, “active involvement in the claim would cut pay-out in half.” Another document counted $30,000,000 in claims paid by State Farm that they would have avoided using IMEs.

With no-fault insurers fighting not to pay medical benefits under Michigan law, you should get an attorney involved as soon as possible. The experienced auto accident attorneys at Christensen Law have been helping motorists for over 20 years. They can help you fight back against the insurance company and get the medical benefits you need to recover. If you have been injured in a car crash, contact Christensen Law today for a free consultation.