Common Defenses Insurance Companies Use in TBI Claims… and How to Fight Back

Traumatic brain injuries (TBIs) can have life-altering effects, impacting memory, cognition, emotional stability, and physical health. When pursuing compensation after an accident that caused a TBI in California, victims often face a common obstacle: insurance companies that attempt to minimize or deny claims. These insurers are for-profit entities with teams of adjusters and lawyers whose goal is to protect their bottom line. Understanding the defenses they commonly use and how to counter them is critical to ensuring fair compensation. Learn more below, and contact the California trial attorneys at Kalfayan & Merjanian to review your case with a team of skilled and dedicated California traumatic brain injury attorneys.

1. Claiming the Injury Was Not Serious

One of the first strategies insurers often use in TBI claims is to downplay the injury. This is especially true in cases involving mild traumatic brain injuries (mTBIs) or concussions, which might not appear on standard CT scans or MRIs. Insurance adjusters may argue that because no visible damage shows up on imaging, the claimant is exaggerating symptoms.

How to Fight Back

• Medical documentation is key. Detailed records from neurologists, neuropsychologists, and rehabilitation specialists provide objective evidence of injury.
• Neurocognitive testing can demonstrate memory, attention, or problem-solving deficits, even when scans appear normal.
• Ongoing treatment records show that the injury has real, measurable impacts on daily life.

2. Arguing Pre-Existing Conditions Were the Cause

Insurers may claim that your TBI symptoms existed before the accident or are the result of prior injuries or conditions. This defense seeks to shift blame away from the liable party and onto the victim.

How to Fight Back

• Provide thorough medical history documentation to show your baseline before the accident.
• Obtain expert testimony linking the current symptoms directly to the traumatic event.
• Highlight timeline evidence: emergency room notes, first reports of symptoms, and early medical evaluations establish causation.

3. Suggesting the Victim Was at Fault

Insurance companies may try to invoke comparative negligence, arguing that the victim’s own actions contributed to the accident. For instance, they might claim the injured person was not paying attention, failed to wear a seatbelt, or engaged in risky behavior.

How to Fight Back

• California follows a pure comparative negligence system, meaning damages are reduced only by the percentage of fault assigned.
• A skilled attorney can gather evidence, such as witness statements, surveillance footage, and expert reconstruction, to show that the insured party’s negligence was the primary cause.
• Highlighting the dangerous conditions or actions of the other party can help minimize any assigned fault.

4. Denying Long-Term Effects or Future Damages

TBIs can have long-term consequences, including cognitive impairment, emotional changes, and difficulty returning to work. Insurance companies often argue that future damages are speculative and should not be compensated.

How to Fight Back

• Use life care plans and vocational experts to document the expected long-term medical, therapeutic, and occupational needs.
• Present testimony from rehabilitation specialists and neuropsychologists explaining why future care and accommodations are reasonably necessary.
• Include personal testimony and daily life documentation to show how the TBI has affected your ability to function, work, and engage in relationships.

5. Claiming Treatment Was Inadequate

Another tactic is to argue that the claimant did not seek treatment promptly, failed to follow medical advice, or missed appointments, suggesting that the injury is either exaggerated or worsened by the victim’s actions.

How to Fight Back

• Seek immediate medical attention after the accident and maintain all treatment records.
• Document any reasons for delays, such as difficulty finding specialists, mobility limitations, or initial misdiagnosis.
• Maintain a consistent record of ongoing care, including therapy, medications, and check-ups, to demonstrate responsible management of the injury.

6. Questioning the Credibility of the Victim

Insurance adjusters may attempt to paint the claimant as unreliable, exaggerating symptoms, or untruthful about the accident and its effects.

How to Fight Back

• Keep a daily log of symptoms, limitations, and treatments to provide a clear timeline.
• Gather witness statements from family, friends, and coworkers to corroborate changes in behavior, mood, or abilities.
• Consistency in your statements to medical providers, attorneys, and insurers strengthens credibility.

The Importance of Experienced Legal Representation

Dealing effectively with the defenses put up by insurance companies in TBI cases is complex. Insurance carriers have teams trained to minimize payouts and exploit legal loopholes, but victims do not have to face them alone. An experienced California personal injury attorney can:

• Gather and organize medical evidence and expert testimony.
• Handle communications with insurers to prevent misleading statements from being used against you.
• Anticipate common defenses and develop strategies to counter them effectively.
• Ensure all damages—both economic and non-economic—are fully documented and presented.

Contact the California Trial Attorneys at Kalfayan Merjanian Today

Insurance companies often employ a range of defenses to reduce or deny TBI claims. From minimizing injuries to questioning the victim’s credibility, these tactics can make pursuing compensation daunting. However, with thorough medical documentation, expert testimony, and strategic legal guidance, victims can fight back and secure the compensation they deserve.

If you or a loved one suffered a traumatic brain injury in California because of another party’s negligence, the attorneys at Kalfayan Merjanian, LLP, are ready to help you navigate insurance defenses and advocate for full and fair compensation. Contact us today and get started with a free consultation to evaluate your case.