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The #1 Trick Insurance Companies Use to Deny Personal Injury Claims
- Jeremias Duarte, D.O.
- 4 days ago
- 3 min read
Understanding How Insurance Companies Judge Your Injuries
After an accident, the insurance company’s goal is simple: pay as little as possible. To do that, they use a specific set of strategies to evaluate your injuries - and often to challenge them.
Knowing how they think helps you protect your health, your claim, and your settlement.
At Brighter Health, we help patients understand the process and provide strong medical documentation to support their personal injury claims.
1. They Look for “Objective Evidence”
Insurance companies rely heavily on medical records, including:
Imaging (X-rays, MRIs, CT scans)
Physical exam findings
Range-of-motion tests
Neurological exams
Doctor’s notes and treatment plans
The more objective evidence you have, the harder it is for them to downplay your injuries.
2. They Analyze the Timing of Your Medical Care
One of the FIRST things insurance adjusters examine is when you got treated.
They look suspiciously at:
Delayed treatment
Gaps in treatment
Missed appointments
If you waited too long, they argue your injuries “weren’t serious.”
3. They Compare Your Story With the Medical Documentation
Adjusters cross-check:
What you told the police
What you reported to your doctor
What you told the insurance company
Any inconsistency becomes a reason to reduce your payout.
4. They Evaluate the Severity of the Accident
Insurance companies use the “mechanism of injury” to judge your claim.
They look at:
Vehicle damage
Speed at impact
Airbag deployment
EMS records
Whether you reported pain at the scene
If the crash looks “minor,” they try to dismiss your injuries - even though low-impact collisions often cause real damage.
5. They Track Your Treatment Consistency
Insurance companies expect:
Regular follow-ups
Consistent care
Proof that you are improving (or worsening)
If you skip appointments, they claim you’re not truly injured.
6. They Scrutinize Your Past Medical History
Adjusters look for pre-existing conditions to argue:
“Your injuries weren’t caused by this accident.”
Proper clinical documentation is essential to show what’s new, what’s aggravated, and what’s related to the accident.
7. They Examine Your Daily Functioning
Insurance companies watch for signs that contradict your injury claims, such as:
Social media posts
Daily activities
Work attendance
Physical behavior
They use anything they find to minimize your compensation.
8. They Value Your Claim Based on Your Medical Records
Your medical documentation determines:
How serious your injuries appear
How long treatment is expected
What your long-term limitations may be
Whether you’ll need future medical care
Clear, thorough notes = a stronger case.
9. They Rely on “Pain Scales” and Symptom Reporting
If you don’t report pain accurately - and consistently - they argue:
“The patient didn't complain, so it must not be serious.”
Good doctors know how to document this correctly.
10. They Rely on Medical Professionals to Strengthen or Deny Your Claim
Some insurance companies send you to an IME (Independent Medical Exam) - a doctor hired by them to minimize your injury.
The best defense is having your own medical provider who documents:
Mechanism of injury
Objective findings
Ongoing symptoms
Functional limitations
Treatment response
This documentation carries significant legal weight.
How We Help Protect Your Case
At Brighter Health, we understand how insurance companies evaluate injuries - and we document your case accordingly.
We provide:
Detailed exam findings
Imaging and diagnostic testing
Progress notes
Treatment plans
Attorney-ready reports
Final evaluations and impairment ratings
Your medical records are your strongest protection.
If you’re injured, don’t let the insurance company decide your outcome.
Call Brighter Health at
770-559-3186
Your health matters—and so does your case.
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