When Insurance Companies Call You a Liar (And How We Beat It)
You are dealing with real pain. Real medical appointments. Real limitations that have changed how you live, work and interact with your family. Then you find out the insurance company hired a doctor who wrote a report saying you are faking it. That your symptoms are exaggerated. That your injuries are not as serious as your own treating physicians say they are.
Few things feel more devastating than being called a liar when you are genuinely suffering. And that is exactly what the insurance industry is counting on. They hope the accusation alone will pressure you into accepting a fraction of what your case is worth or walking away entirely. This article explains how the malingering defense works, why insurance companies use it so frequently, what to watch out for in your own case and how experienced trial attorneys fight back when your credibility is under attack.
A Real Case: How We Beat the Malingering Defense and Won a $6.9 Million Verdict
The tactics insurance companies use are not hypothetical. Our trial attorneys Jessica McBryant and Jared Mazzei faced every one of them in a single case, and the outcome demonstrates what happens when a well-prepared legal team refuses to let an insurance company get away with calling their client a liar.
The Incident
Our client was shopping at a Kohl’s store shortly after it opened for the day. A store employee had been removing adhesive COVID-era decals from the floor near the self-checkout area using a chemical solvent similar to Goo Gone. Store policy required the employee to place caution signs during this work and to wash the floor with soap and water afterward. Neither step was taken. The employee simply wiped the area with a paper towel and moved on to the next decal.
Our client was the first customer to walk through the area. When she turned a corner, her feet went out from under her. The right side of her face struck a display end table and she fell backward, hitting her head on the tile floor. The entire fall was captured on the store’s surveillance cameras.
The Injuries
Beyond the immediate physical trauma, our client developed a combination of injuries that proved both serious and permanent. She suffered a mild traumatic brain injury that led to visual dysfunction, specifically convergence spasms that made it difficult to track moving objects. She developed occipital neuralgia from nerve damage, requiring ongoing stem cell injections for pain management. Both conditions were deemed permanent by her treating physicians.
She also developed functional neurological symptom disorder (or FND), a well-documented but relatively rare condition that causes involuntary movements, impaired walking and disrupted speech patterns. Within 10 days of the fall, a neurologist diagnosed the condition. Multiple additional specialists confirmed the diagnosis and its permanence over the months that followed. Our client had no history of any psychological condition before this incident.
The Defense Attack
The defense initially denied liability before eventually admitting fault. But their real strategy was to attack our client’s injuries. The insurance company retained a neuropsychologist who first claimed our client’s symptoms stemmed from pre-existing anxiety and depression. When that theory collapsed because our client had zero prior psychological history, the expert shifted to a far more aggressive position: she accused our client of outright malingering, claiming she was faking everything for money.
The defense expert pointed to our client’s personal journal, a detailed 1,700-page diary the client had kept on her own initiative after receiving it as a Christmas gift. The expert highlighted entries about vacations, trips to Costco and other activities as “proof” our client was not really impaired. She described our client’s life in condescending terms, essentially arguing that someone who still went shopping could not possibly be suffering.
The expert based her malingering conclusion on psychological testing, specifically the validity scales from the test battery she administered. She testified that the scores indicated our client was faking. There was one major problem with that testimony.
How We Fought Back
Our attorney Jared Mazzei purchased the actual test manual for the MMPI-3 and worked with our rebuttal neuropsychologist, a specialist in functional neurological disorders, to build a side-by-side comparison. On one side: what the manual says specific scores mean. On the other side: what the defense expert claimed those same scores meant. The two did not match.
During cross-examination, Mazzei confronted the defense expert directly. He asked whether she was truly the only person in this case, out of every neurologist, every physical therapist, every specialist who had treated or evaluated this woman over hundreds of appointments, who believed she was faking. The expert confirmed she was.
“You’re the only one that cracked the code?” Mazzei asked. The expert said yes. That moment crystallized the absurdity of the defense position for the jury.
Our team also presented videos that the client’s husband had taken while she was hospitalized. The footage showed her FND symptoms in full: her back arching involuntarily, her legs failing to support her as she tried to walk, her speech coming out in a stilted, robotic cadence as she struggled to form words. These videos made it nearly impossible for anyone watching to believe this woman was performing for the cameras.
Our rebuttal neuropsychologist, Dr. Angela Eastfold, testified as the final witness in the case. She walked the jury through exactly what the test scores meant according to the published manual, systematically correcting every misrepresentation the defense expert had made. By the time she was finished, the malingering accusation had been thoroughly dismantled.
The Verdict
The jury awarded $6,945,040: $650,000 in economic damages, $1,000,040 in non-economic damages and $4,875,000 in physical impairment. After the verdict was read, the jurors lined up to hug our client, something our attorneys said they had never seen happen before in any trial.
The defense tried to reduce our client’s life to a series of Costco receipts and vacation photos. In closing, our team reframed the argument: the defense was asking for a 69% discount on our client’s life, like one of Kohl’s famous coupons. All we were asking the jury to recognize was the 31% permanent impairment that the medical evidence supported.
Past results do not guarantee future outcomes. Every case is different.
What Is Malingering? (And Why Insurance Companies Love This Word)
Malingering is the clinical term for intentionally faking or grossly exaggerating physical or psychological symptoms in order to obtain some external benefit, such as financial compensation or time off from work. The definition comes from the DSM-5, the standard reference manual used by mental health professionals across the country.
It is a serious accusation. When an insurance company’s hired expert puts “malingering” in a report, they are not saying your injuries are less severe than you think. They are saying you are deliberately lying to doctors, to the court and to the jury. They are calling you a fraud.
Here is what makes this tactic so dangerous. There is a critical difference between malingering, factitious disorder and functional conditions like somatoform disorder or conversion disorder. Malingering means you are consciously, intentionally faking for financial gain. Factitious disorder means you are faking to assume the role of a sick person. Functional neurological conditions mean you are experiencing real, documented symptoms that may not have a clearly identifiable structural cause on standard imaging, but that does not make them any less real or any less debilitating.
Insurance companies deliberately blur these lines. They take injuries that are genuinely difficult to diagnose or explain through conventional testing and reframe them as proof that you are lying. The logic is simple but dishonest: “We cannot easily explain your symptoms on a scan, therefore you must be making them up.” It is one of the most common defense strategies in traumatic brain injury, chronic pain, PTSD, and psychological injury cases.
The financial incentive driving this tactic is significant. Defense medical experts who testify regularly for insurance companies can earn hundreds of thousands of dollars per year in expert witness fees. They are paid to find problems with your claim, not to help you recover. That does not mean every defense expert is dishonest, but it does mean you need to understand whose interests they serve.
The Playbook: How Insurance Companies Build a Malingering Case Against You
Insurance companies do not accuse you of faking on a whim. They build their case methodically over weeks or months, assembling pieces of evidence they will use to undermine your credibility at trial or during settlement negotiations. Here is how the playbook works.
The “Independent” Medical Examination
The first tool in the insurance company’s arsenal is the so-called independent medical examination, or IME. Despite the name, there is nothing independent about it. The insurance company selects the doctor, pays the doctor and schedules the appointment. The doctor’s role is to produce a report that helps the defense minimize or deny your claim.
During the IME, the examining physician is looking for inconsistencies between what you report and what they observe. They watch how you walk into the office, how you sit in the waiting room, how you get on and off the examination table. If you report severe back pain but appear to move comfortably in the parking lot, that observation will appear in the report. Some IME examinations last only minutes, yet the reports run pages long and reach sweeping conclusions about your injuries.
The IME report often concludes that your initial treatment was “reasonable” but that everything after a certain point was excessive, unnecessary or unrelated to the incident. It may state that you have no permanent impairment and need no future treatment. In some cases, the examiner will go further and assert that you are exaggerating or fabricating your symptoms entirely.
Defense Neuropsychological Testing
When psychological injuries are involved, such as traumatic brain injury, PTSD, anxiety or chronic pain syndromes, insurance companies frequently hire a neuropsychologist to administer standardized testing. These test batteries include “validity scales” designed to detect whether a person is giving honest effort or exaggerating their symptoms.
The most widely used of these instruments is the MMPI (Minnesota Multiphasic Personality Inventory), now in its third edition. The test includes embedded measures that flag unusual response patterns. But here is where things get complicated and where defense experts sometimes cross the line. The interpretation of these validity scores is not black and white. The test manual provides specific cutoff scores and guidelines for what different results mean and defense experts do not always follow them accurately.
In our experience, we have seen defense neuropsychologists misrepresent what the test manual says a score indicates, apply incorrect cutoff values or draw conclusions the test was never designed to support. They take a score that might suggest mild inconsistency and use it to claim outright fraud. When the opposing attorney does not understand the testing well enough to challenge this, the flawed interpretation goes unchecked in front of the jury.
Surveillance
Private investigators hired by insurance companies may follow you for days or weeks, filming your daily activities from a distance. They capture you carrying groceries from your car, bending to pick up a package, walking without a visible limp or playing with your children in the yard.
What surveillance footage never shows is the aftermath. It does not capture the three days of increased pain that followed 20 minutes of yard work. It does not show you lying in bed unable to move the next morning. It does not document the medications you took or the therapy appointments you scheduled because you pushed yourself too hard for one afternoon.
In one of our cases, an insurance company hired a PI to follow our client for weeks. They captured footage of her sweeping her porch and reaching up to clear cobwebs. The defense planned to use this footage to prove she was not really injured. Our managing partner, Randy Manning, successfully argued the surveillance should be excluded because the defense had improperly disclosed it, a ruling that proved to be a turning point at trial.
Social Media Mining
Insurance adjusters and defense attorneys routinely review your Facebook, Instagram, TikTok and other social media profiles looking for anything they can use against you. A photo of you smiling at a family birthday party becomes “evidence” that your pain is not as bad as you claim. A post about a weekend trip becomes proof that your injuries are not limiting your life.
Context does not matter to them. The fact that you took pain medication to get through your daughter’s birthday or that you spent two days in bed recovering from a short vacation never appears in their presentation to the jury. They only show the highlight reel, not the reality behind it.
Cherry-Picking Your Medical Records
Defense experts frequently highlight isolated entries in your medical records that suggest improvement while ignoring the broader pattern of suffering. One “good day” noted by a physical therapist can be pulled out of context to suggest you have recovered, even when hundreds of other entries document ongoing pain and limitation.
Gaps in treatment are another favorite target. If you missed appointments because you could not afford the copays, because you were too exhausted to drive or because you were told to wait for insurance authorization, the defense will frame those gaps as proof you were not really hurt. Sometimes the defense team does not even provide their own hired expert with your complete medical history, giving that expert an incomplete picture that makes it easier to reach a favorable conclusion for the insurance company.
Red Flags That You Are Being Set Up for a Malingering Accusation
If you are currently dealing with a personal injury claim, certain developments should alert you that the insurance company may be preparing to attack your credibility. Recognizing these signs early gives your attorney time to prepare a defense before the accusation gains momentum.
You should pay attention if you are told to attend a medical examination with a doctor you have never seen, selected and paid for by the insurance company. Be aware if the examination feels rushed, lasting only a few minutes, but the resulting report is lengthy and reaches broad negative conclusions about your injuries.
Watch for requests that you undergo neuropsychological testing, particularly if you are dealing with a brain injury, chronic pain or psychological symptoms. Notice if you see unfamiliar vehicles parked near your home or if the same car seems to follow you to appointments. Take note if the insurance adjuster begins asking unusually detailed questions about your daily activities, hobbies, exercise routines or social life.
These are not reasons to panic. They are reasons to call an attorney immediately if you do not already have one. The earlier your legal team knows a malingering defense is being built, the more effectively they can prepare to dismantle it.
How to Protect Yourself
There are concrete steps you can take right now to protect your claim against malingering accusations, whether or not you believe the insurance company is planning to use this tactic.
Be Honest, Always
This is the single most important thing you can do. Be completely truthful with your doctors, your attorney and during any examinations or depositions. Exaggerating your symptoms gives defense experts the ammunition they need to question everything you say. Understating your pain is equally harmful because it creates a record that contradicts your actual experience. Describe your symptoms accurately, including the fact that pain levels fluctuate from day to day, which is perfectly normal.
Follow Your Treatment Plan
Gaps in treatment are the easiest thing for a defense expert to exploit. Every missed appointment, every unfilled prescription, every lapse in physical therapy attendance becomes a data point they will use to argue you are not as injured as you claim. Attend every appointment your doctor recommends. If you cannot make it, reschedule and document the reason.
Be Thoughtful About Documentation
Pain journals can be powerful evidence of what your daily life looks like after an injury. But they are also a double-edged sword. In the Kohl’s case described above, our client’s 1,700-page journal became a central piece of evidence that both sides used. The defense pulled entries out of context. Our team used the journal to show the full scope of daily suffering that the defense ignored. If you choose to keep a journal, discuss the approach with your attorney so that your documentation strengthens your case rather than creating vulnerabilities.
Lock Down Your Social Media
Set all profiles to private immediately. Do not post about your case, your injuries, your medical appointments, or your daily activities. Do not post photos of yourself at social events, on trips, or engaged in physical activity. Tell family and friends not to tag you in posts or photos while your case is ongoing. Insurance adjusters and defense attorneys monitor social media routinely, and a single out-of-context post can do real damage.
Do Not Give Recorded Statements Without an Attorney
If an insurance adjuster calls you asking for a recorded statement, do not agree until you have spoken with a lawyer. Adjusters are trained to ask questions designed to create inconsistencies between what you say now and what you said previously, or between your reported symptoms and your daily activities. Those inconsistencies become building blocks for a malingering accusation later.
Get Legal Representation Before the IME
If the insurance company has scheduled an independent medical examination, you need an attorney involved before you walk through that door. An experienced personal injury lawyer can prepare you for the examination, attend with you in most jurisdictions and challenge an unfavorable report using your own medical evidence and, when necessary, rebuttal experts who can expose flawed methodology.
Why Having a Doctor-Lawyer on Your Side Changes Everything
Malingering cases are fundamentally about medicine. The insurance company is making a medical argument: this person is not really hurt, or their symptoms are psychological rather than physical, or the test scores suggest they are exaggerating. Beating that argument requires attorneys who understand the medicine as deeply as the experts testifying against you.
At Ramos Law, our founder Dr. Joseph Ramos brings physician-level understanding to every case. He can review diagnostic imaging, interpret neurological findings, evaluate treatment protocols and identify the gaps in a defense expert’s reasoning with the same clinical precision as the doctors on the other side. When a defense neuropsychologist misrepresents test results or a defense physician dismisses real symptoms as fabricated, our team has the medical knowledge to catch it and the trial skills to expose it.
The $6.9 million verdict in the Kohl’s case did not happen because we got lucky. It happened because our attorneys Jared Mazzei and Jessica McBryant invested the time to understand the medicine, purchased the actual test manuals, worked with specialists who could explain complex diagnoses in plain language and prepared a rebuttal so thorough that the defense’s malingering accusation collapsed in front of the jury.
That level of preparation is what separates firms that settle for whatever the insurance company offers from firms that win at trial when your credibility is on the line.
Frequently Asked Questions
Can an insurance company really say I’m faking my injuries even if my doctors believe me?
Yes. Insurance companies often hire their own medical experts to challenge injury claims, even when your treating physicians support your diagnosis. These defense experts may argue that your symptoms are exaggerated, unrelated to the accident or intentionally fabricated. That is why strong medical documentation and experienced legal representation are so important.
What should I do if the insurance company schedules an “independent” medical examination?
Treat the IME seriously. The doctor performing the examination is chosen and paid by the insurance company, and their report can heavily impact your case. Be honest, stay calm, answer questions accurately and avoid exaggeration. Most importantly, speak with a personal injury attorney beforehand so you understand what to expect and how to protect yourself.
Can my social media posts really hurt my injury claim?
Absolutely. Insurance companies and defense attorneys regularly monitor Facebook, Instagram, TikTok and other platforms looking for photos, videos or comments they can take out of context. Even a smiling photo at a family gathering can be twisted into “proof” that you are not injured. It is usually best to avoid posting anything about your activities, health or case while your claim is ongoing.
Why do malingering accusations happen more often in brain injury or chronic pain cases?
Conditions like traumatic brain injuries, chronic pain syndromes, PTSD and functional neurological disorders are sometimes harder to measure with standard imaging or lab tests. Insurance companies exploit that uncertainty by arguing that symptoms are subjective or exaggerated. But invisible injuries are still real injuries, and experienced attorneys know how to use medical experts, diagnostic evidence and testimony to prove it.
What happens if a jury believes the insurance company’s malingering argument?
If a jury believes you are exaggerating or faking your injuries, it can dramatically reduce the value of your claim or eliminate compensation altogether. Credibility is one of the most important parts of any personal injury case. That is why preparation, consistent medical treatment and skilled trial advocacy are critical when the defense attacks your honesty.
If You Are Being Accused of Faking, We’ve Been Here Before
Being told you are faking your injuries is one of the most frustrating experiences a person can go through after an accident. You know what you feel. Your doctors know what they have diagnosed. Your family sees how your life has changed. And the insurance company is spending thousands of dollars to convince a jury that none of it is real.
You need attorneys who have beaten this defense before, in court, in front of a jury, with millions of dollars on the line. Ramos Law has done exactly that. We fight for injury victims across Colorado, Arizona, Wyoming and more states to come. And we do not back down when insurance companies attack your credibility.
Disclaimer: This article is for informational purposes only and does not constitute legal advice. Laws may change and individual circumstances vary. Consult with a qualified attorney about your specific situation.