After an accident, most people assume the insurance company is there to help them. But the reality is far more complicated. In this episode, Clarke explains how insurance companies operate behind the scenes, why adjusters evaluate claims the way they do, and why having an advocate on your side can dramatically change the outcome of a case.
We also break down the different types of auto insurance coverage people may encounter after a crash, including liability coverage, collision, uninsured motorist coverage, underinsured motorist coverage, MedPay, and umbrella policies. Clarke shares real-world examples of how serious injuries can quickly exceed minimum policy limits and explains why many drivers don’t realize they’re underinsured until it’s too late.
Here’s what we discuss in this episode:
🚗 Insurance Basics: Understanding how coverage works
⚖️ Claims Process: Insurance companies protect their interests
💸 Underinsured Risks: Minimum coverage often isn’t enough
🏍️ Serious Accidents: Motorcycle injuries can escalate quickly
🧩 Policy Protection: UM/UIM coverage matters more than people realize
Featured Keyword & Other Tags
Insurance claims, auto accident claims, uninsured motorist, personal injury, liability insurance, medpay insurance, umbrella policy
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Transcript (Click To Read)
Clark: I’m Clark Speaks, the catastrophic injury lawyer. Welcome to the verdict, Mr.
Carson Grace Toomer: Speaks. We’ve kind of touched on the insurance’s role, um, but within, you know, an auto accident. Can you explain to me what part the driver’s insurance takes when defending an auto accident claim?
Clark: Sure, yeah. Um, and really this works the same whether it’s ah, you know, generally whether it’s an auto accident or a, you know, case where somebody falls at a business or it’s a, you know, somebody’s injured at someone else’s home where there’s liability or a dog bite or something like that. But the idea is that, um, because people may be responsible for the damage and injuries they cause other people, a lot of times we have insurance, right? We have insurance on our cars, insurance on motorcycles, insurance on boats, insurance on our homes, insurance is on our business. The, the idea is that those things, those policies require you to pay a premium and in exchange they provide insurance coverage, coverage that pay in the event someone else is hurt, your house or your business or by your car. So you know, we’ve all seen, you know, their ads, the ideas like a good neighbor or, you know, you’re in good hands or whatever. The idea is, um, if there’s a unfortunate situation where someone is injured and it’s your fault, this policy is responsible for covering the amount of that loss. And so, um, insurance companies then, and there’s, you know, what, a dozen that we’re all familiar with, probably another dozen that are sort of second tier, second tier company, but we work with all of them in different ways. Um, but these insurance companies do two things. They collect premiums. So every month you send in your premium, they pool all that money together and they run their business and they pay claims. So their revenue is the premiums they collect. And their expenses are the people they have to employ, their facilities, their offices, their phone system, their electricity and all that. And then the biggest piece of their, uh, expense is the claims that they have to pay. So every month thousands or hundreds of thousands or millions of people pay their premiums. And then every month some percentage of those claims of those insureds have to pay claims, a small percentage. So they collect in the premiums and they pay out the claims. So any business in our society, the objective of the business is to maximize revenue and minimize expenses, right? That’s how you make a profit. You maximize revenue, you minimize expenses. So insurance companies are maximizing the amount of money they can collect in the form of premiums and minimizing the amount of money they have to Pay out in terms of claims, in terms of expenses. That’s their job. And so they employ insurance adjusters. And the insurance adjusters, that person collects the information, evaluates the claim, and pays according to what they evaluate. They would view themselves as being objective in the sense that they don’t necessarily have an agenda. In my experience, they do have an agenda. They are trying to minimize the payment for their employer. It wouldn’t make any sense for them to maximize the payment for their employer. Right. You don’t want to. I mean, and so they’re evaluated based on their ability to resolve claims. And so they’re not necess. They’re not going to lie, cheat and steal. But if you don’t include things that might be helpful to your claim, they’re not going to remind you, right? So if you don’t submit lost wage information, they’re not going to go, hey, don’t forget to set your lost wage, wage information. They’re not going to, uh, say, hey, are you sure this is all the medical providers that you’ve seen? Or do you have any future medical expenses? Or do you have any future? So their job is to resolve your claim in the best interest of their employer, the insurance company. And so, uh, that’s why it becomes important for you to have an advocate on your side, somebody on your side to be able to tell your story. And also they know generally how much claims settle for. Um, they know, you know, what the reasonable settlement value is because they do it all day, every day. For example, um, if I was going to get a, uh, estimate, ah, from somebody to paint my house, I would not know whether that should be $1,000 or. I just, I don’t know. I haven’t done that in a long time. I don’t know how much it should cost, you know, but somebody who walks around and estimates every day, all day, and that’s all they do is estimate how much it costs. And just imagine if it was to paint, uh, a battleship or a football stadium, you know what I mean? The more complex it is, the more difficult it is. Like, how would you even begin to figure that out? So if you have a person who values it from the other perspective, from the other point of view, uh, every day, all day, then you’re more likely to come to an accurate figure rather than just have to depend on your instincts and your, just your general smarts in order to figure, figure out it’s impossible. Like it would be impossible for me to figure out how much is it going to cost to paint Panther Stadium you know, I mean, I heard like a. Recently, uh, uh, the owner is asking for like a remodel of $1.6 billion or something like that. And to me, I’m like, that doesn’t m. You know, you could probably build the whole thing for you. But that’s because I don’t do it, you know, So I wouldn’t know where to start. But in an injury claim, I can calculate that, you know, how much something is worth and the value of a claim, because I’ve done it all day, every day for 30 years.
Carson Grace Toomer: Right. And you spoke about, you know, the more complicated things may get. Uh, what are different kinds of, you know, insurance I may interact with, you know, when I’m maybe in the situation. What are. What are those types of coverage that I can interact with?
Clark: Sure. Yeah. So there’s, um. So, for example, in a car wreck. In a car wreck, you’ll have. You may have. So if you have a insurance policy of your own, you know, you drove here, you know, you’re, uh, you have auto insurance. The law requires that you have auto insurance. You probably have liability insurance. Liability insurance protects you in the event that you injure someone else. You have collision. Maybe you have collision insurance. Not everybody has it. You’re not required to have it. But some people have collision insurance. That means if you wreck and it’s your fault, your insurance company should pay for your, uh, you know, pay to repair or replace your car. Uninsured motorists, that’s. This is a. This is a big deal. People need to have uninsured motorists. And you generally have uninsured motorists with your policy. That means if somebody else is driving their car and they don’t have insurance, they let their policy lapse. But they, uh, they wreck into you and cause you damage. Cause damage to your car and hurt you physically, and so that you have medical expenses and those types of things. Your uninsured motorist coverage will step in and say, because that driver was uninsured, we’ll step into his shoes and pay that claim as if we were him or her. Does that make sense? And then there’s also underinsured coverage. That means the person has insurance, but they just don’t have enough insurance. Maybe they have a minimum policy of $30,000 or starting in January, $50,000. And maybe the damage to you or your, um, you know, medical bills and all that add up to be $200,000. You know, for example, this happens a lot in motorcycle. So motorcycle accidents are a little bit different because there’s no real fender benders in motorcycles. Motorcycles don’t have seat belts. You know what I mean? You can see like, uh, it just, it concerns me when I see people driving down um, the highway and they’re flying on these motorcycles or they’re even driving normal speed on a motorcycle because cars just don’t see them, you know, and it’s just so dangerous. Like I’ve seen this so many times over the years. And then somebody will pull right into them m and hurt them. And sometimes they get hurt really bad. And that person only has $30,000 insurance. Well, you got medical bills of $200,000. That $30,000 insurance is going like that. You know, it’s just a drop in the bucket. So um, underinsured motorist coverage becomes very important. Uh, and that’s if the person has insurance but just not enough. And a lot of people, you know, get real upset. They’re like, I don’t want to use my insurance, I want their insurance. Well if they don’t have enough insurance and they’re judgment proof, which is usually the case. It’s not, it’s usually not. Rich people that don’t have underinsured under, I mean enough insurance is poor people that don’t have enough. So they don’t have, so you can’t get blood from a turnip. So we don’t have any way of getting money from a person who doesn’t have any money. So that’s why that underinsured motorist coverage becomes very important and so we can access that. So everybody, especially people that you know, um, you know, have jobs and have the ability and have, you know, they need to have underinsured motorist coverage. And then uh, there’s also med, ah, pay coverage, MedPay coverage might be anytime you’re in a wreck and you have medical uh, bills, it’ll cover that, uh, those medical bills and you can get them in 5, 10, 2,000, 5,000, 10,000, 50,000, $100,000 you can get in all kinds of different increments. It costs a little more. Uh, and then also a lot of people have umbrella policies. So for example, a person who uh, uh, has a good well rounded insurance plan, might have collision, might have liability insurance, might have collision, might have uninsured coverage, might have underinsured coverage, might also have med, um, pay and might have an umbrella policy. So if all that is exhausted, ah, if their liability coverage is exhausted, for example, uh, they get in a wreck, they really seriously hurt somebody and they have liability insurance coverage of $500,000 but somebody dies as a result or they’re permanently injured or whatever, and all those medical bills and future lost wages and future medical bills and all that add up to more than that. The umbrella policy might protect them from, uh, having their assets exposed to seizure, uh, and collection and all that kind of stuff. So that’s where the umbrella policy fits in. Thanks for joining us. Don’t forget to subscribe and follow us to stay up to date with our weekly episodes. We’ll see you next time.
