Insurance adjusters are not responsible for telling a claimant the truth. Their job is to reduce the amount their employer will pay on your claim. Often, they are bound only by the limits their employer places on them. This means anyone with a legitimate claim for losses could face headwinds and the underhanded techniques adjusters and their large corporate employers commonly employ.
What Role Does an Insurance Adjuster Play in Claims?
An insurance adjuster, or claims adjuster, investigates any claims that the insurer makes.
Their job involves several tasks, which may include:
- Interviewing the person filing a claim
- Interviewing any witnesses who may have additional information about a claim
- Collect all relevant reports, including police or medical reports
- Inspection of property damaged in an accident
- Negotiating a final settlement
- Save the insurance company money
- Settle claims as quickly as possible
Remember, the insurer will likely provide the adjuster with some preliminary information to investigate. Additionally, the adjuster may acquire more information while investigating a claim to deliver to the insurance company for review.
Common Investigation Tactics Employed by Adjusters
Remember, insurance adjusters have broad powers when investigating a claim, so there are some things you should avoid when you are planning to file a claim or are in the process of filing a claim.
Some of the areas where you want to use caution include:
- Recorded statements – Insurers will often suggest you need to provide a recorded statement regarding any claim. This is false. Never record a statement with an insurer. They can use the information on those recordings to minimize your claim.
- Social media – Use extreme caution on social media. Insurance adjusters will scour your social media accounts for ways to minimize your claim. Some of the items they will look for include activities you may be participating in, signals that you are “feeling fine,” or indications you may have been partially at fault for the accident.
- Asking for signatures on release forms – An adjuster may provide you with a form for your medical records. They may ask for records pertaining to the claim you submitted, but giving them full access to your medical records means they are looking for preexisting conditions to reduce their liability. Never sign any documents provided to you without an attorney’s advice.
- Claim a lack of coverage for certain expenses – When you submit your claim, the insurance company may come back to you and say they cannot pay the full amount because the person responsible for your injuries does not have the right coverage. Do not fall for this tactic, as it is generally a way to reduce what they pay you.
- Asking for your Social Security number – Some adjusters will tell you they cannot process a claim without this information. This is false. Never provide your social security number. If you were in a car accident which resulted in an injury, the goal might be accessing your driving record.
Keep in mind that there are few lines an adjuster will hesitate to cross if it means helping their employer. They are not there to protect you in any manner.
Four Important Things to Remember When Dealing With Adjusters
There are four critical factors that every accident victim should remember when dealing with an insurance adjuster.
These hints could be helpful when you are dealing with an adjuster who is simply trying to get you to accept a low-ball offer.
- The adjuster is not on your side – The job of an adjuster is not to protect you. They take the job with the understanding their primary goal is to protect the insurance company.
- You do not have to accept an initial settlement offer – No matter what the insurance company tells you, you do not have to accept any settlement offer from an adjuster. The adjuster is likely to tell you that any offer they make is final and the maximum. Neither is likely wholly accurate.
- Your claim is likely worth more than the adjuster will admit – All insurance adjusters will tell a claimant their claim is worth less than they submit. Do not get talked into this because as soon as you admit that you think the claim is less valuable, you are giving up your options for a reasonable settlement.
- You should hire a lawyer – Insurance adjusters will nearly always attempt to convince you that you need not hire a lawyer. They know that your final settlement will increase if you hire a car accident lawyer. That is because a lawyer understands how insurers negotiate settlements to get out of paying a full claim.
Your words and actions following an accident matter. Even at the accident scene, before you seek medical care, an insurer will scrutinize your comments, so statements to law enforcement, witnesses, and even another person in an accident could decrease your final settlement.
Why Adjusters Do Not Like Working With Victims Who Hired an Attorney?
Insurance adjusters know that if the victim works with an attorney, they must negotiate the claim. The insurance company is not required to tell you any of the laws about your injury. They know that the less you understand California personal injury law, the more likely you will accept a lesser settlement.
Many adjusters will advise a victim to avoid hiring an attorney claiming that it is too expensive.
Here are some things you should know when working with an adjuster:
- Consultations with accident injury lawyers are free.
- An accident injury attorney can evaluate your case and tell you your legal options.
- Most accident victims can hire an attorney on a contingency fee basis. This means you owe nothing if you don’t receive a settlement or judgment.
- Your lawyer will take over the negotiations on your behalf. This usually means a faster reasonable settlement.
- They like to run down the clock. California’s statute of limitations on personal injury claims is two years from the date of the accident. Adjusters will drag their feet, claiming they are still investigating until they run the clock out, especially if you reject their first offer.
While most attorneys who handle personal injury claims feel a well-informed client is the best client, an insurance adjuster knows that the more you know, the less likely you will fall for a quick low-ball settlement.
Every Claim is Unique, and Every Settlement is Different
Accident victims of all kinds usually try to determine how much their claim is worth. However, there is no easy answer to this question.
Here are some of the factors which can play a part in determining the value of a claim:
- The age of the victim – An injury suffered by someone who is 50 and someone who is 20 could be similar but have very different recovery times. Similar injuries could result in additional issues for the victim and more time out of work recovering which could mean a larger settlement.
- The type of injury – Injuries are visible and invisible. The victim who suffers a brain injury may not show any outward signs of injury. The fact is that a brain injury victim will probably require additional care and recovery time which could result in a more significant settlement.
- The victim’s history – An accident victim who did not work before an injury and a victim who did work will be unlikely to see a similar settlement. You can demand lost income in a claim.
- Insurance caps – The amount of an insurance policy that could limit claims. Discuss this with the attorney handling your case.
These factors will determine the best possible settlement for any accident injury case.
Filing a Claim at the Right Time Matters for a Full Settlement
Some accident victims believe the sooner they file a claim, the better off they will be. However, most attorneys may recommend reaching certain milestones before you file a lawsuit.
- Reaching maximum recovery from an injury – When a doctor advises an accident victim that no further treatment will make a difference in their long-term prognosis, the time to file a claim has approached. However, failing to wait for this to occur could mean a victim has filed a claim before they know how their injury fully affected their life, ability to work, or the cost of their treatment.
- Prepared to return to work – Only when a doctor clears a victim to return to work can a lawyer properly account for the income and benefits they lost while recovering. Without this accounting, the claim may fall short of ensuring a victim has not suffered financially following an injury.
- Final prognosis and long-term treatment – When a doctor puts a plan for long-term treatment of an accident victim, there is sufficient information to help determine future medical expenses associated with the injury.
These are a few things an accident victim may not even consider when filing a claim. If you file a claim too soon, you could recover a lower settlement than you deserve.
Working With an Experienced Attorney Can Make a Difference
While some accident victims think they can go it alone, there are some solid reasons why it makes good sense to hire a lawyer following an accident.
Some of these include:
- An experienced lawyer has the knowledge you do not have
- Most lawyers have trained investigators available to help them properly evaluate accidents.
- Legal firms have staff members who are accustomed to insurance company tactics.
- Law firms can secure statements from witnesses under oath.
- Lawyers will have access to experts who can help them determine the value of a claim.
- Victims can focus on their physical recovery while letting their lawyer handle negotiations.
- If negotiations with insurance companies fail, you will be ready to make a case on your behalf in court when you have hired a lawyer.
- The playing field levels off because you have an advocate to preserve and protect your rights.
Insurers never want a victim to have a lawyer because they know they will have to avoid many of the common tactics they use to minimize claims. They also know that since you hired an attorney, you are serious about holding the person responsible for the injury financially accountable.
When Hiring a Lawyer, Experience Counts?
When you consider hiring an attorney, a proven track record of fighting for clients is essential. Prior case results are not always a perfect indicator of the success a law firm may or may not have in the future. Knowing that the law firm has a well-earned reputation for standing up to insurance companies and getting settlements for their clients can make all the difference to an accident victim.
Whenever you or a family member suffers an injury because of the negligence of another party, you should contact a personal injury lawyer to find out more about your rights and your legal options.