This is your Member Reference Number (MRN). You’ll need to provide this when you make an appointment with an EAP counselor or contact your EAP by phone.

Anthem provides automatic translation into multiple languages, courtesy of Google Translate. This tool is provided for your convenience only. The English language version is considered the most accurate, and in the event of a discrepancy between the translations, the English version will prevail. This translation tool is not controlled by Anthem, and the Anthem Privacy Statement will not apply. Please read Google's privacy statement. If you want Google to translate the Anthem website, select a language.

Benefits with The Local Choice

Your EAP offers these great resources.

Negotiating With an Insurance Company

How to succeed in negotiating your insurance claim.

Whether you have a personal injury claim, were in a car accident, or were on the receiving end of medical malpractice, after you submit a demand letter to an insurance company, it's time to negotiate.

If you have presented an insurance company with an organized demand letter and the proper supporting documents (see Nolo's article Write a Winning Demand Letter), your claim negotiation process will probably consist of nothing more than a few phone calls with an insurance claims adjuster. Following is a brief explanation of how negotiations usually work and some suggestions to help you succeed during the various stages of the process.

How the Negotiation Process Works

During the first call with the insurance adjuster, you and the adjuster will each make your points about the strengths and weaknesses of your claim. Then the adjuster will make an offer to settle your claim for an amount lower than what you requested in your demand letter. You will counter with a figure higher than the adjuster's offer but lower than your original figure. Typically, after two or three phone calls you will agree on a settlement figure somewhere in between.

Have a Settlement Amount in Mind

As part of putting together your demand letter, you should have determined what you believe your claim is worth. (For more information, see Nolo's article How Do Insurers Value an Injury Claim?) Within that range, and before you speak to an adjuster about your demand, decide on a minimum settlement figure that you will accept. This figure is for your own information so you can keep your bottom line in mind when under the pressures of negotiating but it is not something you should reveal to the adjuster.

You do not, however, have to cling to the figure you set for yourself. If an adjuster points out some facts you had not considered but that clearly make your claim weaker, you may have to lower your figure a bit. And, if the adjuster starts with an offer at or near your minimum, you may want to revise your figure upward.

Do Not Jump at a First Offer

When the insurance adjuster makes you a first offer, it may be so low that it is just a tactic to see if you know what you are doing (see below). Or, it may be a reasonable offer but too low. If the offer is reasonable, you can immediately make a counteroffer that is a little bit lower than your demand letter amount. This shows the adjuster that you, too, are being reasonable and are willing to compromise. A little more bargaining should quickly get you to a final settlement amount you both think is fair.

Get the Adjuster to Justify a Low Offer

If an adjuster makes a first offer so low that it is obviously just a negotiating tactic to see if you know what your claim is really worth, do not immediately lower the amount you put in your demand letter. Instead, ask the adjuster to give you specific reasons why the offer is so low, and make notes of what he or she tells you. Then write a brief letter responding to each of the factors the adjuster has mentioned.

Depending on the strength of any of the adjuster's reasons, you can lower your demand slightly, but, before lowering the amount very far, wait to see if the adjuster will budge after receiving your reply.

The next time you speak with the adjuster, begin by asking for a response to your reply letter. The adjuster should now make you a reasonable offer upon which you will be able to bargain and arrive at a fair settlement figure.

Emphasize Emotional Points

In these negotiations, don't bother to go over all the facts again. Just emphasize the strongest points in your favor for example, that the insured party was completely at fault, that you had a very painful injury, that your medical costs were reasonable, and/or that you had long-term or permanent physical effects.

However, it may help to mention any emotional points supporting your claim. If, for example, you have sent the adjuster a particularly strong photo of a smashed car or a severe-looking injury, refer to it. If your injury interfered with your ability to care for your child, mention that your child suffered as a result. Even though there is no way to put a dollar value on emotional factors, they can be powerful in getting an insurance company to settle a claim.

Put the Settlement in Writing

When you and the insurance adjuster finally reach agreement, immediately confirm the agreement in a letter to the adjuster. This letter can be short and sweet, stating the amount for which you settled, what injuries or damages the settlement covers, and the date by which you expect to receive settlement documents from the insurance company.

More Information About Negotiating Your Claim

For more details on negotiating an insurance claim, including sample letters to insurance companies, suggestions for handling negotiations, and strategies for dealing with an insurance company that refuses to make a good offer, see How to Win Your Personal Injury Claim, by Joseph L. Matthews (Nolo).

http://www.nolo.com/legal-encyclopedia/negotiating-with-insurance-company-29765.html

More about this Topics

  • Asylum or Refugee Status: How to Apply

  • Cell Phones, Texting, and Driving: State Laws

  • Damages in Medical Malpractice Cases

  • Sponsoring a Fiancé or Spouse for a Green Card

  • The Many Benefits of Sharing

Other Topics

    • Product Liability Claims Involving Medical Devices
    • Toxic Torts FAQ
    • The Credit Card Act: More Protection for Cardholders
    • Defective Product Liability Claims: Who to Sue?
    • eBay and Online Auctions: Tips for Buyers and Sellers
    • Small Claims Court: Part 2
    • Small Claims Court: Part 1
    • Warranties
    • Consumer Tips on Funerals
    • File a Consumer Complaint: Part 2