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What Does an Insurance Adjuster Do?

Written by Tom Crosley
Feb 11, 2021 Car Accidents, Personal Injury
  1. 1. What Does an Insurance Adjuster Do?
  2. 2. Common Tactics Insurance Adjusters Use to Diminish Case Value
  3. 3. How to Protect Yourself in a Personal Injury Claim
  4. 4. Crosley Law Can Help You Work With Insurance Adjusters to Get the Best Settlement

What Does an Insurance Adjuster Do?

If you’ve been in a car accident, you know how overwhelming and traumatic the process can be. Recovering from your injuries and dealing with lost wages, medical bills, pain and suffering, and other damages is a lot to deal with. Making sure that you do everything right to file a successful claim can seem impossible.

After the accident, you will be contacted by an insurance adjuster. Insurance adjusters may go by different titles, like claims representative or claims specialist, but they all do the same thing: evaluate insurance claims made by customers.

At Crosley Law, we want you to be prepared with the right information and tools to help your case. It’s important to understand what an insurance adjuster does, common tactics insurance adjusters use to diminish the value of a case, and how you as the claimant can protect yourself and your claim.

What Does an Insurance Adjuster Do?

Insurance companies use insurance adjusters to settle claims brought against the company. Keep in mind that the insurance adjuster assigned to your case works for the insurance company either directly or as a third-party contractor. Their ultimate goal is to do what is best financially for the company they represent, which likely means it is not financially best for you.

Once you file a claim for your losses, you become the claimant. The person or company that you file against is the policyholder, and their insurance company goes on defense to back their client. Before talking to you, the insurance adjuster assigned to the case will talk with the policyholder and review any police or accident reports to familiarize themselves with the case.

Next, the insurance adjuster will reach out to you, the claimant. It’s important to be prepared. They will request things such as statements on what happened, proof of losses (i.e., medical bills), tax returns, and proof of earnings. It’s common for the insurance adjuster to do some research on you to see if they can find a history of other personal injury claims, or any other potentially damaging information.

The first offer is not the final offer. You have a right to reject or counter the offer until you are satisfied with what the insurance company is offering you.

Once the insurance adjuster has carefully looked through all these documents, they will present you with a settlement offer. This offer is the sum of the exact calculated loss (a straightforward number computed from objective losses such as lost earnings and medical bills) and more subjective loss (typically referred to as pain and suffering). The first offer will likely be less than what the insurance adjuster knows the case is valued at. It is normal for the original offer to be a set percentage of the case’s value, leaving room for any negotiations from the claimant.

The first offer is not the final offer. You have a right to reject or counter the offer until you are satisfied with what the insurance company is offering you.

Common Tactics Insurance Adjusters Use to Diminish Case Value

Working with an insurance adjuster seems straightforward: You file the claim, the insurance adjuster investigates the claim and makes a settlement offer. You either accept, reject, or counter their offer until both parties can agree. Easy enough, right?

It gets more confusing and subjective when you remember that the insurance adjuster is not working with your best interests at heart. Many insurance adjusters use tactics to diminish the value of your case to save their company as much money as possible. Keep your eye out for these practices the insurance adjuster might employ:

  • Claiming they will settle fairly. The insurance adjuster might say things like “we accept responsibility” or “we will settle this fairly” to put you at ease. However, remember that your idea of what’s fair will probably not line up with what they think is fair. While the insurance adjuster might genuinely be a nice human being, remember that they know a friendly approach—especially after the trauma of an auto accident — will lower your guard.
  • Encouraging the claimant to not speak to an attorney. When a claimant works with an attorney, they net more money than when going in unrepresented. Insurance adjusters know this and might try to discourage you from bringing in legal help to increase their own chances of diminishing your claim.
  • Dismissing damages. The insurance adjuster might try to push damages or losses sustained as a result of the accident aside by either dismissing their severity or accrediting them to pre-existing conditions. Our client, Joe H., faced this situation after a horrible car crash. The negligent driver’s insurance company blamed injuries sustained in the crash on Joe’s previous back injury. Crosley Law stepped in to help Joe get the settlement he needed.
  • Apportioning responsibility. If the insurance adjuster is able to apportion some responsibility off of their policyholder and onto the claimant, they can justify offering less money on the settlement. Do not accept responsibility or make any statements that could be interpreted as taking fault, even if it seems harmless.
  • Scheduling an independent medical examination. An insurance adjuster might refer you to an independent medical examination (IME). The point of an IME is to get a straight and unbiased look at any physical injuries sustained in the accident and to get an idea of what the medical expenses will be. The doctor, while intended to be objective, is chosen by the insurance adjuster. Know that there isn’t medical confidentiality in these situations, and anything throughout the appointment can be used to either help or hurt your claim.
  • Settling too quickly. While it seems advantageous to receive a payoff as quickly as possible, settling too fast can leave you on the hook. The full extent of damages may not yet be fully realized, meaning any future medical expenses or lost wages might go underestimated in the settlement.

How to Protect Yourself in a Personal Injury Claim

Knowing tactics commonly used by insurance adjusters puts you a step ahead when making a personal injury claim. There are ways to further protect yourself and your claim, giving you the best shot at a fair settlement.

  • Do your own research to determine an estimate of what you are owed. Having an idea, even if it’s vague, of what you are owed is important to discerning if the settlement offer is fair.
  • Don’t give a recorded statement. A recorded statement is not required for the settlement, though the insurance adjuster may try to make it seem like it is. Leading questions might be aimed at getting you to admit fault and could be disguised as harmless inquiries into your well-being. Even casual conversation with the insurance adjuster can leave your case vulnerable to twisted comments, meaning your statements should be planned and purposeful. Working with an attorney to direct your statements can help you avoid any unintended consequences when speaking with the insurance adjuster.
  • Don’t delay getting medical treatment. Waiting to get medical treatment and leaving gaps in your case and timeline can hurt your chances of getting a fair settlement
  • Write a demand letter. This formal charge to the insurance adjuster details the exact amount of money you are requesting in the settlement. Lay out why the policyholder is at fault (and you are not), the details of any injuries and the extent of both the exact and subjective loss. Lean into the firsthand details of the accident, as well as the consequences you’ve experienced since then. An attorney’s input can help to make the letter as thorough and impactful as possible.
  • Negotiate: The insurance adjuster’s first offer likely has room for negotiation built in. If you don’t negotiate the settlement, it’s a win for the insurance company. Having the ballpark estimate of what your damages and losses cost can help you to leverage your claim against a low offer.
  • Get everything in writing. Take notes and get anything promised or offered to you in writing. Don’t take words at their face value, as you may want written evidence of them to use in your case down the line. Keep any receipts, statements of work, or bills from repairs to use as proof of damages and cost.
  • Account for the whole recovery process when reviewing the settlement offer. Insurance adjusters often undercompensate for important and necessary treatments for recovery such as physical therapy and chiropractor visits. Keep an eye out for how these visits are accounted for in the settlement offer to ensure your recovery and treatment will not be ignored.

Crosley Law Can Help You Work With Insurance Adjusters to Get the Best Settlement

Having insight into what insurance adjusters do, as well as common tactics they use in their favor, and extra measures you can take to protect yourself in your claim will take you far in the personal injury claim process. However, insurance companies know that claimants without representation are likely to settle for less than if they had legal backing.

Crosley Law has successfully handled thousands of personal injury claims over the years. With our specialities in trucking, motorcycle, car, bicycle, and drunk driving accidents, we have a wide range of expertise and resources to settle your claim in your favor. We are proud that many of our new cases come from personal referrals, meaning that both our legal prowess and our philosophy of treating every case as our most important case is obvious to our clients.

Reach out for a free consultation and case evaluation by calling us at 210-LAW-3000 | 210-529-3000 or completing our online form.

The content provided here is for informational purposes only and should not be construed as legal advice on any subject.

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