What You Need to Know About Dealing with Insurance Claim Adjusters

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Insurance claim adjusters go through extensive training courses and work in various capacities for insurance companies. During their careers, they participate in continuing education to stay up to date with trends and practices in their industry.

An adjuster's primary duties are to:

  • Investigate accidents
  • Advise the insurance company of liability
  • Determine appropriate compensation
  • Negotiate and settle claims with accident victims

Adjusters fall into three basic categories:

  1. Independent Adjusters: Freelancers who work for themselves, or for private firms under contract with insurance companies.

  2. Public Adjusters: Freelance adjusters who offer their services to the public instead of insurance companies.

  3. Claims (or 'Staff') Adjusters: Full-time employees of insurance companies. They are responsible for investigating accidents and negotiating settlements with victims.

Car Accidents And Staff Adjusters

Depending on the circumstances of your accident, you could have to deal with adjusters from up to three separate divisions of an insurance company:

  1. Personal injuries resulting from auto accidents

  2. Property damage to vehicles and their contents

  3. Vehicles considered total losses (when a car is "totaled")

Within moments of filing an insurance claim, your information will be transferred to a claims adjuster. She'll enter it into a software program used for claims handling. You should hear from an adjuster within a day or two of reporting the accident.

As much as you might like to have your claim settled quickly, for a high amount, it probably won't happen that way. Negotiating effectively with insurance claim adjusters takes hard work and preparation. They're professionals who have likely handled hundreds, if not thousands of accident claims.

First Contact With The Adjuster

In your first contact, the adjuster will probably request your recorded statement and ask you to sign a release for access to your medical records. You will be bound by what you say in the statement, so if you're not ready, politely tell the adjuster you need a few days.

No law requires you to give your statement the first time you speak with the adjuster. By requesting more time, you are letting her know you're in no rush to begin negotiations. This communicates you're serious about your claim and willing to take your time.

Tell the adjuster the names of your doctor(s). Assure her you'll continue treatment and keep her updated on your progress. You do not want to discuss any settlement offers until you're fully healed or released from treatment by your doctors.

Ask the adjuster to send you a letter confirming your conversation and that you reported the claim. If you don't already have it, get the claim number.

Following this conversation, you will probably receive a Reservation of Rights letter from the insurance company. The letter basically says that although the insurance company has agreed to discuss the claim with you, they haven't officially accepted liability for the accident or your injuries.

During the course of your claim and settlement, you'll receive several letters. File the letters in your claim folder, along with all other documentation related to your claim.

Vehicle Repairs and Interim Transportation

Take your car to a repair shop you trust. You're not required by law to seek more than one estimate. As long as the repair shop charges reasonable rates, the insurance company should accept them. Tell the adjuster you want only original equipment manufactured (OEM) parts used on your car, not the less expensive substitutes.

If you're filing a first-party claim, and your policy includes rental coverage, request a rental car. If it's a third-party claim, you can demand a rental car while your car is being repaired.

Preparing to Negotiate

Immediately after the accident, start preparing a settlement packet. Keep all of your papers organized in files, and use a notebook to write down general notes and summaries of your conversations with the adjuster.

In separate tabbed sections keep your:

  • Medical bills
  • Receipts for medications
  • Proof of lost wages
  • Car repair invoices
  • Estimates for personal property damage
  • Proof of miscellaneous expenses

While continuing treatment, keep the adjuster up to date by sending her copies of your medical bills, out-of-pocket expenses, and lost wages. Your adjuster is likely handling dozens of claims at the same time. By maintaining contact and sending documentation, you're helping her stay organized and reminding her of your claim.

Claims adjusters appreciate dealing with claimants who are prepared, polite, and professional, and who base their settlement demands in reality. If you fit that mold, you'll increase your chances of getting a higher settlement in a shorter period of time.

Insights into Settlement Negotiations

Good settlements don't just happen, they must be earned. You can't settle your claim without the adjuster, and she can't settle it without you. You and your adjuster have a mutual interest in settling your claim promptly and fairly; but each of you will have different ideas of what's fair.

You want to be fairly compensated for your damages, and the adjuster wants to close out your claim as quickly and cheaply as possible. You need the money, and she needs to move on to other claims.

An insurance adjuster's job is to settle claims for as little as possible. Promotions are highly tuned to results, and consistently making lower settlements leads to a successful career. Remember, insurance companies exist to make money.

Your job is to make sure you're being treated fairly. Be informed, persistent, and committed to negotiating a settlement that's fair for you.

The Adjuster's Conflict of Interest

If you live in a no-fault state, or have PIP (Personal Injury Protection) insurance, you'll be negotiating with your own insurance company. This is called a first-party claim.

The truth is, the claims adjuster for your own company will treat you the same as in a third-party situation. It's a conflict of interest, because your insurance company wants their adjuster to settle your claim for the lowest possible amount.

It's not personal, it's just business. Even in a first-party claim, you have to be prepared to defend your position and negotiate for the highest settlement you can get.

Final Negotiations

Once you've completed medical treatment for your injury, you can enter into negotiations with the adjuster. Mail your completed settlement packet, with your demand letter and copies of all documentation relating to your personal injury claim.

Be realistic when making your first demand. Asking for roughly three times the total of your medical bills, plus out-of-pocket expenses and lost wages, is realistic for a typical soft tissue injury. Asking for 10 times the amount of your medical bills, in hopes the adjuster will split the difference, is the wrong approach, and will set back negotiations.

Finish negotiations as you began them. Be professional, prepared and committed. The result should be a settlement you're happy with.

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