Dealing With Insurance After a NY Car Accident

BY STEVEN SCHWARTZAPFEL

Within days of a car accident, the insurance companies will begin contacting you. The other driver’s carrier will call. Your own carrier will send forms. An adjuster will ask you to describe what happened. You will be asked to give a recorded statement and to sign authorizations. These requests sound routine. They are not. Understand that the insurance adjuster’s job is to protect the insurance company. The adjuster’s job is to pay you nothing or as little as possible. Every word you say and every form you sign becomes part of the permanent record the carrier uses to evaluate — and minimize — your claim.

Most people dealing with their first serious car accident have never interacted with a claims adjuster before. The conversation feels professional and helpful. The adjuster is courteous and sympathetic. The questions seem reasonable. The forms seem standard. None of that changes what is actually happening: the carrier is conducting an investigation, and the investigation has one purpose, which is to reduce the amount the carrier will pay.

The other driver’s carrier wants your recorded statement — do not give one

The other driver’s liability carrier is not calling to help you. It is calling to gather information it will use to reduce its exposure. A recorded statement locks you into a version of events before you know the full extent of your injuries, before you have seen the police report, and before you understand what happened from the other driver’s perspective. Adjusters are trained to ask open-ended questions that produce quotable answers — “how are you feeling?” rather than “are you currently experiencing any symptoms related to the accident?” If you say “I feel okay” three days after the accident and then develop significant neck pain a week later, that statement is in the file forever. The adjuster will use it to argue that your injuries are not as serious as you claim.

You are not legally required to give a recorded statement to the other driver’s insurance company. You can decline. Saying “I am not going to give a statement, thank you, and goodbye” is a complete and legally sufficient response. There is no penalty for this. There is no consequence to your claim. There is only upside — you avoid making a statement based on incomplete information that becomes part of the permanent claim record and is later compared with your medical records, your deposition testimony, and any surveillance footage.

If the adjuster becomes insistent or suggests that declining will slow the claim, that pressure itself tells you the statement is not for your benefit. A routine administrative step would not require pressure. Decline politely, end the call, and refer the adjuster to your attorney if you have one.

Your own carrier’s statement is different — but still matters

Your own insurance company may request a statement as part of the no-fault claims process. Under the terms of your policy, you generally are required to cooperate with your own carrier’s reasonable investigation. This obligation is part of the contract between you and your carrier. Failing to cooperate can give your own carrier grounds to deny benefits. But cooperation means answering the questions asked, truthfully and specifically. It does not mean volunteering information, speculating about what happened, or guessing at medical details you do not yet know.

Answer what is asked. Do not add what is not. If you do not remember something, say you do not remember. If you do not understand a question, ask for clarification. If the adjuster asks a compound question, ask to take it one part at a time. A no-fault examination under oath (EUO) — a formal recorded interview conducted by your own carrier’s counsel — is a more structured version of the same process and should be conducted with your attorney present.

Medical authorizations can give the carrier more access than you intend

Insurance companies routinely send authorization forms that allow them to obtain your medical records. Some of these authorizations are broadly worded and permit the carrier to access your entire medical history going back years — not just the records related to the accident. The carrier is looking for pre-existing conditions it can use to argue that your current injuries are not new. A prior back injury, a prior neck complaint, a prior visit to a chiropractor from five years ago, a prior workers’ compensation claim — the carrier will use any prior treatment to argue that the accident did not cause the condition you are claiming.

A properly limited authorization allows access to records related to the accident and the injuries claimed, within a specified time window. A broad authorization opens your entire medical history to the carrier’s review and frequently produces material the carrier uses to defend the claim. HIPAA requires specific consent for medical record disclosures, but the carrier’s form is drafted to obtain the broadest possible consent. Do not sign a medical authorization without understanding what it covers. An attorney can redraft the authorization to limit it appropriately before it is signed.

Early settlement offers are designed to close the file cheaply

Some carriers make settlement offers within weeks of the accident, before the injured person understands the full extent of their injuries. These offers are designed to close the file at a low cost. The carrier knows that medical treatment is ongoing, that the full extent of the injury is unknown, and that the case will be worth more once the medical picture is complete. The carrier also knows that an injured person dealing with medical bills, lost wages, and financial stress may be tempted to take the money now.

Once you accept a settlement and sign a release, you cannot reopen the claim if your condition worsens, if you need additional surgery, or if you discover that your injuries are more serious than you initially believed. The release is permanent. There is no exception for unexpected developments. Do not accept a settlement offer before your medical condition has stabilized and the full value of your damages is known.

What you post on social media is evidence

Insurance companies monitor social media routinely in serious injury cases. A photograph of you at a family event, a post about a weekend activity, a check-in at a gym, a vacation photograph — the carrier will use any public post to argue that your injuries are not limiting your activities as you claim. The evidence does not need to be fair or in context. A photograph of you smiling at a birthday party does not mean your back does not hurt. But the carrier will use it to argue that it does.

Assume everything you post publicly will be seen by the adjuster and used against you. The safest approach is to stop posting entirely during the pendency of your case. Privacy settings are not a guarantee — courts have generally allowed discovery of relevant private social media content in litigation. Do not delete posts after the case begins because deleting evidence can create a spoliation issue that is worse than the original post.

Do not listen to the adjuster’s advice about your claim

The adjuster may tell you that you do not need a lawyer. The adjuster may tell you that hiring a lawyer will slow things down or reduce your recovery because the lawyer takes a percentage. The adjuster may tell you that the offer on the table is fair and that an attorney will just delay the resolution. You should ignore the adjuster’s advice and consult an attorney. The insurance company’s own research shows that settlements in cases where the injured person is represented by an attorney are significantly higher than settlements where the person handles the claim alone. The adjuster knows this. The adjuster is giving you advice that benefits the carrier, not you. That is not a criticism of the adjuster — it is a description of the adjuster’s role in the system.

The same logic applies to advice from friends and family who have their own stories about insurance claims. Every case is different. The facts of the accident, the nature of the injuries, the available coverage, and the specific carriers involved all affect the outcome. Do not make decisions about your claim based on what happened to someone you know.

How Schwartzapfel Holbrook manages insurance communications

At Schwartzapfel Holbrook, we handle all communications with the insurance carrier on behalf of our clients. That means the adjuster speaks with us, not with the injured person. We control what information is provided, when it is provided, and in what format. We review every authorization before it is signed and limit it to what is appropriate for the claim. We do not allow our clients to give recorded statements to the other driver’s carrier. We do not discuss settlement until the medical picture is complete and the full value of the damages is known. Do not allow the insurance company to intimidate or bully you into making decisions before you understand your options.

Schwartzapfel Holbrook / Fighting For You