Strategies and tactics for dealing with personal injury claims handled by insurance companies

Handling traffic accidents, workplace injuries, or injuries in public places in Hong Kong.Personal injury compensationAt that time, the insurance company, as the actual payer of compensation, has its core objective as...To close the case at the lowest cost and fastest speedThey employ a series of market-proven business strategies, which, while legal, can put the injured party at a disadvantage if they are unaware of the full story, leading them to accept compensation far below reasonable levels.

The following analysis delves into common insurance company strategies and provides highly practical solutions to help you protect your rights.

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Seven common strategies employed by insurance companies (and the logic behind them)

1. Lowball Offer – Testing the Waters

• Operating techniquesThe initial quote is often only a reasonable amount of compensation. 10%–30%(For example, for a case with a reasonable valuation of 500,000, initially report 50,000 to 150,000).
• Underlying logicTest whether the injured personUrgently needing money, lacking legal knowledge or professional representationIf the injured party contacts the insurance company on their own and appears anxious, the insurance company will continue to try to lower the price.
• ExamplesIn a case involving a leg fracture requiring surgery, the insurance company may initially only be willing to reimburse medical expenses and a small amount of PSLA (pain relief), completely ignoring up to six months of lost income and rehabilitation costs.

2. Delay Tactics – These tactics drain your patience and resources.

• specific means:
• The submitted evidence is "slowly reviewed," and responding to emails can take weeks.
• Repeated requests for documents already provided (such as sick leave certificates, receipts).
• The injured are required to undergo a designated "independent medical assessment," which often takes months to schedule.
• PurposeMany injured peopleEconomic pressure (no income, out-of-pocket medical expenses) Forced to accept a lower settlement. Delay could also lead to the injured party being brought closer to... 3-year statute of limitationsThis increases their anxiety.

3. Questioning the causal relationship and the injury (Challenge Causation & Severity)

• Common conversation techniques:
• "Your neck pain is likely a pre-existing condition and is unrelated to this accident."
• "The medical report shows that you have recovered and do not require further treatment."
• "Our doctors assess that your disability percentage is very low."
• operateInsurance companies often hire their partner medical experts to issue reports. "Independent" but tends to underestimate the injury. The report was used to counter the opinions of the injured person's attending physician, thereby significantly reducing... PSLA and Future income loss The computational basis.

4. Time-Limited Settlement Pressure

• Typical scenariosMidway through negotiations, the insurance company suddenly proposed a "slightly increased" amount, with additional conditions:"This offer is only valid for 7 days. It must be withdrawn after the expiration date, and a settlement agreement must be signed immediately."
• riskThis move was intended to force the injured to...A hasty decision made without adequate legal adviceOnce signedComplete and final settlement agreementEven if the injury worsens or new sequelae are discovered in the future, it will be impossible to recover the money.

5. Undervaluing Future Losses

• Targeted measures:
• Future income lossAssuming the injured person can quickly change careers or recover, a more conservative disability impact assessment is rejected.
• Nursing and medical expensesI only agree to reimburse the expenses already incurred; I will not reimburse the doctor's recommendations.Long-term rehabilitation or future surgery costsThey raised questions and demanded that the claim be made "only when it actually occurs."
• Work injury casesThis is especially common when attempting to suppress the benefits under the Employees Compensation Ordinance.Percentage of permanent disabilityThis directly reduces the statutory compensation amount.

6. Amplifying Litigation Risks

• Common arguments:
• "A lawsuit could drag on for 3-5 years, can you wait that long?"
• Even if you win, the court-ordered damages might be lower than what we're paying now.
• "The risk of legal costs is very high, and you may have to bear part of the lawyer's fees yourself."
• RealityExperienced lawyers can usually 12–24 months The settlement or judgment is reached through legal procedures.Court-ordered damages are usually closer to legal principles and case value.Furthermore, the winning party's litigation costs can usually be borne by the losing party.

7. Exploiting Information Asymmetry

• Targeting vulnerable injured personsIf the injured party is experiencing financial difficulties, lacks legal representation, or is unfamiliar with legal English, the insurance company may:
• Use complex documents filled with legal jargon.
• Apply pressure during phone conversations, but avoid leaving written records.
• This implies that "this is the industry standard, and there's no room for negotiation."

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Response strategies: Self-protection and countermeasures of the injured

Step 1: Never rush to sign any documents.

• Core Principles: In the absence ofIndependent legal opinionforward,Do not sign any settlement agreements, authorization letters, or medical assessment consent forms..
• Special attentionBefore signing any documents, make sure you clearly understand whether the terms include... "Complete and final settlement" Words.

Step Two: Systematically Collecting and Organizing Evidence

• Medical evidence chain:

1. Records of immediate medical attention following an accident (emergency room or clinic).
2. Detailed medical records and regular follow-up reports from the attending physician.
3. Specialist (e.g., orthopedic, neurosurgery) reportIt clearly explains the causal relationship between the injury and the accident, the treatment plan, and the prognosis.
4. Occupational therapist or physical therapist assessmentQuantify the impact on work ability and daily functioning.

• Financial evidence:
• Tax returns, pay stubs, and employer verification letters for the past three years.
• Receipts for all medical, transportation, and assistive device purchases.
• Mandatory Provident Fund (MPF) contribution records to prove the loss.
• Accidental evidencePolice report, scene photos, dashcam footage, and eyewitness contact information.

Step 3: Hire an experienced "plaintiff personal injury claims lawyer".

• Why it is importantLawyers specializing in this field have a deep understanding of insurance company strategies and possess:
• Bargaining chipsThey are not afraid to take the case to court, and insurance companies know that these lawyers will stick to it.
• Case databaseIt can accurately assess the value of your case based on similar precedents.
• Expert NetworkWe can recommend reliable independent medical and professional assessment experts.
• Fee ArrangementThe vast majority provide "No success, no fee" The arrangement is that legal fees are usually deducted from the final compensation amount according to the agreement, and you do not need to make any upfront investment.

Step 4: Adopt a professional attitude in negotiations

• All communication is conducted through a lawyer.Avoid dealing directly with insurance companies to prevent being tricked into revealing information or being pressured.
• Insist on written communicationAll quotations and justifications must be sent via email or letter to maintain a complete record.
• Countering low ball bids: Request the insurance companyA written explanation of the detailed calculation basis for its quotation.This often exposes errors or omissions in their estimates.

Step 5: Make good use of programs and third-party resources

• Apply for legal aidIf you meet the financial requirements,Legal Aid Agency lawyersThey can provide strong representation, and insurance companies are generally more cautious about legal aid cases.
• Considering the barrister's opinionFor complex or high-value claims (such as those exceeding 1 million), it is advisable to hire [a legal expert/person].Barristers provide written legal advice or participate in negotiations.This can significantly enhance your bargaining power.
• Do not rely too much on TAVASWhile this may solve your immediate problem, remember this money.Ultimately, it needs to be deducted from civil compensation.This should be viewed as transitional assistance, not as part of reparations.

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Situation Response Quick Reference

Insurance Company Strategy	Your immediate response	Long-term action
Received extremely low quote	The polite reply was: "Received, will be submitted to legal counsel for review."	Engage a lawyer to prepare a detailed counter-advice, along with supporting evidence and case examples.
The other party delayed replying	Set a reasonable timeframe and clearly state that if there is no response, further legal action will be taken (such as setting a negotiation deadline).	A lawyer can issue a statement to the other party. "A reasonable settlement proposal must be submitted by the deadline, otherwise the matter will be taken directly to court." The letter.
Required to conduct its designated medical assessment	We should not refuse, butHe insisted on having his own lawyer arrange appointments and accompany him.And obtain a copy of the report immediately after the assessment.	You can also arrange for your own experts to conduct an evaluation at the same time, so that you can debate the two reports if they contradict each other.
Received a "limited-time offer"	The response was clear: "An independent legal and medical evaluation requires a reasonable amount of time (such as 14 days), and a decision cannot be made under pressure."	If the other party insists on withdrawing its offer, it is considered a lack of sincerity in negotiations. The lawyer can then push the litigation more aggressively, which often forces the other party to make a higher offer later on.
The other party questioned the injury.	Provide more fromDifferent specialtiesThe medical reports form a cohesive body of evidence.	Consider making arrangements Joint Medical Experts MeetingThe experts from both sides were invited to discuss the matter face-to-face and seek a consensus.

Final reminderThe insurance company's strategy is based on business calculations, not personal grudges. The injured party's biggest bargaining chip is...Professional legal representation, complete evidence, and the determination to let the case be decided by the court.With a strong and well-prepared response, the final settlement amount exceeded the initial offer. 50% to several times Such cases are common in Hong Kong judicial practice.

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