5 Tricks Insurance Companies Use to Deny And Devalue Medical Malpractice Claims
Medical malpractice claims can be hard to resolve when an insurance company disputes what went wrong. Patients may face unpaid bills, lost income, and ongoing health problems while trying to recover damages.
Knowing these five tricks that insurance companies use to deny and devalue medical malpractice claims can help patients protect their rights.
1. Claiming the Healthcare Provider Did Nothing Wrong
An insurance company may argue that a doctor or nurse gave proper care, even when a patient suffered serious harm.
Not every poor medical result is malpractice. Patients must show that the provider failed to meet the accepted standard of care and that this failure caused an injury.
Insurers may hire medical experts to defend the treatment. Patients often need their own experts to explain what went wrong.
Texas also has strict rules for expert reports. Under Texas Civil Practice and Remedies Code Chapter 74, patients must generally serve an expert report within 120 days after each defendant files an answer to the lawsuit.
The report must explain what proper care is required, how the provider failed to meet that standard, and how the failure caused harm. Missing this deadline can lead to dismissal of the claim.
2. Blaming an Existing Health Condition
An insurer may argue that a patient’s injury came from a health problem they already had. For example, a patient may develop serious problems after surgery. The insurer might claim that an existing illness caused those problems rather than poor medical care.
However, having a prior health condition does not prevent someone from filing a malpractice claim. A provider may still be liable if negligent care caused a new injury or worsened an existing condition.
Medical records can help show the patient’s health before and after treatment. Expert reviews may also help explain whether the provider caused additional harm.
3. Offering a Quick Settlement Before the Full Costs Are Known
Some insurance companies offer settlements before patients know how much treatment they will need. An early payment may seem helpful when medical bills are growing. However, some injuries require more surgery, long-term care, or time away from work.
Once a patient accepts a settlement, they usually cannot seek more money for the same claim.
Texas also limits certain damages in medical malpractice cases. These limits apply to losses such as pain, mental distress, and loss of enjoyment of life.
Medical bills and lost wages are not subject to the same limits. Patients should review both current and future losses before accepting an offer.
4. Using Recorded Statements Against Patients
An insurance adjuster may ask a patient to give a recorded statement about their treatment and injuries.
If the patient’s answers differ from medical records, the insurer may use those differences to challenge the claim. Patients should not discuss the cause of their injuries or whether the healthcare provider was at fault with the insurance company.
Medical records and expert opinions are better sources of evidence about what caused the harm.
5. Delaying the Claims Process
Medical malpractice claims often take time because they involve medical records, expert reviews, and disputes over who caused the injury. However, some insurers may prolong the process by asking for more documents, challenging expert findings, or delaying settlement talks.
These delays can put pressure on patients who need money for medical bills and daily expenses. Patients should keep copies of letters, emails, and other messages from the insurance company. These records can help track how the claim was handled.
It is also important to watch filing deadlines. Texas generally gives patients two years to file a medical malpractice lawsuit. There is also an absolute ten-year statute of repose.
The deadline may depend on when the treatment occurred or when the course of care ended. Texas also has rules about giving notice before filing suit.
Insurance delays do not mean patients can ignore these deadlines.
Call The Law Firm of Alton C. Todd Personal Injury Lawyers to Arrange a Free Consultation With a Friendswood Medical Malpractice Lawyer
Insurance companies may dispute medical evidence, blame past health problems, offer early settlements, question patient statements, or delay claim decisions.
Knowing how these tactics work can help patients respond to claim disputes and protect their rights. Medical records, expert opinions, and a clear record of the insurer’s actions can help support a Texas medical malpractice claim.
Please contact an experienced medical malpractice lawyer at The Law Firm of Alton C. Todd Personal Injury Lawyers to get a free initial consultation today. We have offices in Friendswood and Galveston, Texas:
The Law Firm of Alton C. Todd Personal Injury Lawyers – Galveston Office
2101 Mechanic St. Suite 253
Galveston, TX 77550
(409) 207-9299
The Law Firm of Alton C. Todd Personal Injury Lawyers – Friendswood Office
312 S. Friendswood Dr.
Friendswood, TX 77546
281-992-8633
