Soft Tissue Injury Fraud

soft tissue injury fraud

There is a common idea among insurance adjusters that the majority of soft tissue injury claims are fraud.

Let me put my opinion out there.  As an injury adjuster for years, I saw almost every type of injury claim out there, including a lot of soft tissue injuries.  For those of you who don’t know, soft tissue injuries are injures that do not include any breakage of the skin or bones.  They are normally describes as strains or sprains.  Anyway, here is why adjusters think there is such rampant fraud. . . .

Attorneys and chiropractors solicit accident victims.  I have seen it many times and the victim is an innocent bystander to the actual fraud.  Here’s the common scenario.

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HYPE! hehehe

IT IS COMING! ! ! Watch for the WORLDWIDE RELEASE of a comprehensive new e-book that details the industry of auto claims!

If you ever wanted to know how a total loss is calculated, or what the adjuster is taught in preparation to take their license exam, or even if an adjuster has to be licensed, or how an insurance company determines what to charge you, or if that small accident is going to affect your rates and why, or how to avoid your rates from increasing, or how a salvage lot works, or who is really in charge in the claims department, or what the real adjuster’s rules are, or how insurance companies find such “shady” individuals to be adjusters, or that obscure case siting that supports your unusual accident scenario or . . . or. . . . or. . . . you get the idea, right?   This book is comprehensive from beginning to end and covers more than the average person would ever want to know about automobile claims, automobile insurance, automobile adjusting, and everything related to those subjects. . .I assure you that after you read it, you will want it by your side if you ever have to deal with an automobile claim.  From how to negotiate with the “hardnosed” adjuster, to insider tactics that claims executives would never tell you.  It’s almost like I’m that guy in the black mask revealing all the “secrets” behind the best magic tricks around.

Auto Accidents – An Insider’s Commentary is coming soon!  It will only be available for purchase directly from Petty Details, LLC.  Watch for the release before the end of 2009! !  It’s going to generate a lot of talk in adjuster’s circles, and I’ll probably never be able to get a job as an adjuster with an insurance company again!

Written by Justin Petty (the rugged, intelligent adjuster, ha!)

Yes sir, officer, well you see. . . I was testing out my new “turbo-boost”
button, you know, like Night Rider’s, me and my dad built it, but anyway. . .
here’s what happened. . . . .

Texas Small Claims Court

If I had a nickel . . . .

Okay, so you have run into a brick wall and can’t get justice served, right?  If you live in Texas, if justice means recovering money from somebody or company that owes you $10000.00 or less, then you can probably force the issue to a head by doing a little research on the Small Claims court rules.  They are located in the Texas Government Code, Chapter 28.  The rules of battle are clear and simple enough for most to understand with just a little research.

Here are some general tips:

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Injury Claims – How much are they worth?

In deciding to try and help auto accident victims I seem to have created some enemies, hehe.  Oh well.  I will continue to give honest and straightforward answers to the questions that accident victims have.  Recently I have had quite a few questions that relate to how to calculate how much a minor injury claim is worth.  In response to the numerous questions, I wrote an e-book which is available for purchase by clicking on the title of this posting.  I will also answer questions for free if you e-mail me or call me, but if you want it in writing to refer to when I am not personally available, you’ll have to make a very small investment.  Although I won’t give away all of my secrets here on the blog, I will offer some free tidbits and general information that will compliment the e-book.

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Rental Car Companies, Tricky Tricky

I recently wrote an in-depth article about the perils of renting a rent car.

Let me recap. . .

1.  If you don’t purchase the damage waiver, beware.
2.  Make sure your insurance will really cover “contract” liability.  There are some newer policies that specifically exclude coverage for rental car damages under contract language.
3.  If you didn’t purchase the damage waiver, insist upon a written inspection report on the vehicle to be rented prior to leaving in the vehicle.

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Proper Use of Resources

For a small to medium sized auto insurance claims department, the best method for maximizing subrogation recovery and reducing claims severity is to hire one specialist for every 500 subrogation potential claims that are open at any one time.  Then train that specialist to promptly and effectively recover the easy money claims while sending out the “hard dollar” claims to a specialty vendor, not a subrogation mill.  By specialty vendor, someone or company that can demonstrate the ability to recover money from uninsured motorists, not a company that works for a lot of large carriers (they count on the carrier missing easy money and in my experience don’t do a good job at recovering from uninsured motorists).  The prime scenario would also include utilizing the “hard dollar” specialist to audit subrogation demands and specialty demands for proper payouts.

This scenario which is hard to find, is where my company specializes.  By utilizing a company such as ours (the only one that exists), a small to medium sized company can kill two birds with one stone and maximize uninsured motorist recovery while at the same time minimizing the amount of money they pay out on subrogation and related matters like diminished value.  By specializing in these niches, Petty Details,LLC provides the most bang for a company’s buck!

What can you do with an adjuster’s license?

If you are wondering what you might be able to do with an adjusting license, you are not alone.  Outside of being a desk adjuster for an insurance company (a pretty good option for a lot of people as one can earn upwards of $50k per year after just a short while in the industry), there are not many other great options if you have no experience.  First of all, don’t let anybody tell you that you can become a catastrophe adjuster with no experience.  Many aspiring adjusters think they can just fall into this career because it does pay pretty well, but only during catastrophe’s, and it is just not that easy.  A cat adjuster is somebody that goes out and evaluates damages to property on behalf of an insurance company.  These adjusters are also called independents.  A property and casualty license in Texas will allow you to “qualify” for this type of work, but it takes much more than just a license.  Additionally, other certifications will likely be required, such as those required to evaluate and adjust flood damages.  On top of the specialized training you will need, you will also have to invest in a great computer, great wireless technology, and great estimating software.  Even then, if you don’t have some contacts in the construction and insurance industries, you will likely fall by the wayside very quickly.  Anyway, so cat adjusting is something I would not suggest unless you are just hell bent on it.  The other options you have are limited.  I have been adjusting insurance claims of one type or another for nearly 15 years, and there are not that many opportunities to make more than $60K or $70K per year unless you are well up there in the experience range.  It is experience more than education that speaks to one’s adjusting ability and prowess.  If you are very well disciplined, then you might move up the line into litigation or some other specialty within 5 to 10 years, but you will have to work your way up the ladder.  I have seen few exceptions to this rule, and those exceptions were based on “politics”.  You know, like knowing somebody high up on the ladder.  The other option I see is self employment.  You would have to get some specialty licensing and I would still suggest having experience of at least 5 years before trying to delve into a business of auditing and specialty adjusting.  It is difficult to master all the nuances of claims adjusting without hands on experience.  If you still have questions or want more detailed information on how to become an adjuster, visit my official site and give me a call or shoot me an e-mail.  I will be more than happy to tell you what I know.

Texas Driver License Suspensions

Why can’t people just look up the law on their own?  I cannot figure out why some people can’t help themselves.  I guess that is why I exist, hehe.

Really though, if you are getting calls or letters from an insurance adjuster or subrogation specialist, you would do yourself good to follow my articles on E-zines.

Texas Driver License Suspensions – Can you be suspended due to an auto accident?

If you have a Texas Driver License and somebody has called you or sent you a letter threatening the suspension of your driver license over an auto accident, it is highly possible that it could actually happen, but it is just as probable that the person making the threat doesn’t actually understand the rules as they apply in Texas. Only the Texas Department of Public Safety can suspend your driver license (and the DPS doesn’t call people to advise of a pending suspension, they will send a written notice). What an individual, insurance, or subrogation company can do is request the suspension of your license in accordance with Chapter 601 of the Texas Transportation Code, and there are a lot of exceptions and rules that have to be followed (it is notable that if you don’t have a license, a proper request will keep you from getting one, and the suspension is supposed to affect your registration, too).

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Texas Diminished Value Claims

Where do some of these “diminished value experts” people get off?

I agree that insurance companies are not so inclined to pay diminished value, and people sometimes get dollar signs in their eyes when they are involved in an accident that is not their fault.  The reality is that diminished value exists, but it is definitely hard to prove. There are arguments that adjusters use all the time to try and dismiss a valid claim and save a few bucks.  The problem is that most of the “diminished value experts” out there have never actually been adjusters.  Through a little research of my own, I have found that at least four of the companies that heavily advertise diminished value services have never even had an adjuster’s license, much less actual experience adjusting.

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