The phone call often comes when you are at your most vulnerable. In the days following a serious car accident, while you are trying to manage pain, medical appointments, and the disruption to your life, a representative from the other driver’s insurance company will contact you. They will sound professional, concerned, and perhaps even friendly. They will say they just want to “get your side of the story” and “help resolve things quickly.”

This initial interaction is a pivotal moment in your personal injury claim, and it is the first move in a carefully orchestrated strategy. The person on the other end of the line is a trained insurance adjuster, and their primary loyalty is not to you or to fairness, but to their employer’s financial interests.

Who is the Insurance Adjuster and What is Their Primary Goal?

An insurance adjuster is an investigator for the insurance company. Their official job is to assess the facts of an accident, determine who was at fault, and evaluate the extent of the damages. However, their performance is often measured by how much money they save the company. This creates a fundamental conflict of interest. While you are focused on healing and getting fair compensation for your losses, the adjuster is focused on minimizing or eliminating the amount the insurance company has to pay.

Their objectives can be broken down into a few key points:

• Find reasons to deny the claim entirely.
• Attribute fault to you, the victim, to reduce the payout under West Virginia’s comparative negligence laws.
• Dispute the severity of your injuries.
• Challenge the necessity and cost of your medical treatment.
• Pressure you into accepting a fast, low settlement before you know the full value of your claim.

Every tactic they employ is a step toward achieving one or more of these goals.

Tactic 1: The Recorded Statement Trap

One of the first things an adjuster for the at-fault party will ask for is a recorded statement. They will frame it as a routine formality needed to process your claim. In reality, it is a tool designed to find inconsistencies in your story and to get you to say something that can be used against you.

Adjusters are trained in asking leading, confusing, or overly broad questions. A simple, polite answer can be twisted later. For example:

• Adjuster: “How are you feeling today?”
• You: “I’m doing okay.”
• How it is used: The adjuster will note that you said you were “okay,” using it as evidence that your injuries are not as painful or serious as you later claim.
• Adjuster: “Can you tell me what happened?”
• You: “I’m not exactly sure, it all happened so fast.”
• How it is used: This statement can be used to suggest you are uncertain about the facts or that you may share some of the blame for the accident.

You are under no legal obligation to provide a recorded statement to the other driver’s insurance company. The best response is to politely decline and inform them that all future communications will be handled by your attorney.

Tactic 2: Pressuring for a Quick, Lowball Settlement

It may seem like a relief when an adjuster offers you a check for a few thousand dollars within a week of the accident. They will present it as a gesture of goodwill to help you with your immediate bills. This is a calculated tactic. The insurance company wants to close your case for the lowest possible amount, and they know that the full extent of your injuries and financial losses may not be apparent for weeks or even months.

Soft tissue injuries can worsen over time. A doctor may later recommend surgery or long-term physical therapy. You may be out of work for longer than you initially expected. By accepting a quick settlement, you permanently sign away your right to seek any further compensation for this accident, no matter what future medical needs or costs arise. Never accept a settlement offer until you have completed all your medical treatment and have a clear picture of the total damages.

Tactic 3: Requesting Unrestricted Medical Authorization

To evaluate your injury claim, the adjuster will need to see your medical records related to the accident. However, they will often send you a blanket medical authorization form to sign. This form gives them the right to access your entire medical history, from childhood to the present day.

Their goal is to go on a fishing expedition. They are searching for any pre-existing conditions or prior injuries they can use to argue that your current pain is not a result of the accident. If you had back pain five years ago, they will argue that the accident did not cause a new injury but merely aggravated an old one, a position they will use to drastically reduce the value of your claim.

While West Virginia law follows the “eggshell plaintiff” rule—meaning the at-fault party is responsible for the full extent of the harm they cause, even if the victim had a pre-existing vulnerability—insurers still use prior medical history to confuse the issue. An experienced attorney can provide the insurance company with only the relevant medical records, protecting your privacy and preventing them from taking your history out of context.

Tactic 4: The “Delay, Deny, Defend” Strategy

This is a well-known industry strategy designed to wear down claimants until they become desperate enough to accept a low offer or abandon their claim altogether.

• Delay: The adjuster may take an unreasonable amount of time to respond to your calls or emails. They might repeatedly ask for the same documents you have already sent or claim they are waiting on some internal review. These delays are often intentional, designed to increase your financial and emotional stress.
• Deny: The company will then find a reason, however flimsy, to deny your claim. They might incorrectly cite an exclusion in the policy, blame a pre-existing condition, or allege you were partially at fault for the accident.
• Defend: If you persist, their final move is to force you into a lawsuit. They know that litigation is expensive and time-consuming, and they bank on the hope that you will not have the resources or the will to fight them in court.

Tactic 5: Using Your Social Media Against You

In the modern age, adjusters have become digital investigators. They will thoroughly search your social media profiles—Facebook, Instagram, X, and others—looking for anything that can contradict your injury claim.

• A photo of you at a family cookout could be presented to a jury as “proof” that you are not in pain.
• A post where you mention going for a walk could be used to argue your physical limitations are exaggerated.
• Even a “check-in” at a restaurant could be spun to suggest your life has not been seriously impacted.

It is vital to assume that anything you post online will be seen by the insurance company. The safest course of action is to set all your profiles to the highest privacy settings and to stop posting any updates or photos until your case is resolved.

Tactic 6: Disputing Necessary Medical Treatment

Even if you have a clear diagnosis from your doctor, the insurance adjuster may still challenge the treatment you receive. They might argue that your physical therapy sessions are excessive, that a recommended MRI is not needed, or that you should have recovered much sooner.

In some cases, the insurer will demand you attend an “Independent Medical Examination” (IME). The name is misleading. The doctor performing the IME is chosen and paid by the insurance company. While some of these doctors are professional, many have a long history of producing reports that favor the insurance companies that hire them. These reports are then used as a basis to deny payment for further treatment and to devalue your claim.

How Can You Protect Yourself from These Tactics in West Virginia?

Leveling the playing field against a powerful insurance company requires a proactive and cautious approach. From the moment an accident occurs, you can take steps to protect your rights and the value of your claim.

• Prioritize Medical Care: Seek immediate medical attention after an accident, even if you feel fine. Adrenaline can mask serious injuries. Follow all of your doctor’s orders, attend every appointment, and fill all prescriptions. This creates a clear and uninterrupted medical record.
• Do Not Speak with the Other Insurer: You are not required to talk to the at-fault party’s insurance adjuster. When they call, politely get their name and contact information and tell them your lawyer will be in touch.
• Do Not Sign Anything: Never sign any documents from an insurance company without having them reviewed by an attorney. This includes medical releases and, most importantly, any settlement offer.
• Document Everything: Keep a journal of your daily pain levels, medical treatment, and how the injuries affect your life. Keep receipts for all related expenses, including medications and transportation to doctor’s appointments.
• Stay Off Social Media: Refrain from posting any details about the accident, your injuries, or your daily activities until your claim is fully resolved.

Experienced Legal Advocacy for Your West Virginia Personal Injury Claim

The insurance adjuster has a playbook, a supervisor, and the full financial backing of a major corporation. Their goal is to pay you as little as possible. The legal team at Powell & Majestro, P.L.L.C., is dedicated to holding negligent parties and their insurers accountable. We handle the communications, gather the evidence, and build a strong case designed to counter the insurance company’s strategies. We investigate every detail of your accident and work to secure the full and fair compensation you are owed for your medical bills, lost income, and the pain and suffering you have endured.

Contact us for a free, no-obligation consultation to discuss your situation. Call our office today at (304) 346-2889 or reach out to us through our online contact form to learn more about your legal options.