7 Common Insurance Adjuster Tactics and How to Defend Your Claim

See examples of tactics insurance adjusters use to deny or minimize car accident payouts. Learn how to defend the value of your injury claim.

When you’re injured in a car accident, you get compensation by filing a claim with the at-fault party’s insurance company.

You’ll need a personal injury attorney for serious injury claims. Most car accident lawyers offer a free case evaluation, so it costs nothing to get an expert opinion.

If you recover quickly from minor injuries, you can probably settle your injury claim on your own. With a little know-how, there’s no reason you can’t negotiate a fair settlement with the insurance company. Here are some tactics to watch out for when negotiating with the insurance adjuster.

Common Claims Adjuster Tactics:

  1. Asking Leading Questions
  2. Minimizing Your Injuries
  3. Arguing Your Lost Wages
  4. Making Lowball Offers
  5. Blaming You for the Accident
  6. Denying their “Authority” to Pay
  7. Downplaying Your Pain and Suffering

Bonus: Wrapping Up a Fair Settlement

To help you understand the claim negotiation process and how to defend against adjuster tactics, we’ll use the sample car accident scenario below.

Sample Claim: Injuries from Rear-End Auto Accident

Sharon Moore has worked in the local school’s cafeteria for 20 years. She lives alone and spends her free time knitting and watching her favorite TV shows.

One afternoon, Sharon was heading home from work when she stopped behind a car that was waiting to turn left. Suddenly, her compact car was struck from behind by an SUV driven by Chelsea Lewis.

The impact threw Sharon forward, then slammed her back into her seat, violently snapping her head and neck. It all happened so fast, Sharon sat stunned in her seat. As she realized what just happened, she began to feel sick and dizzy.

A man appeared at her window and said, “Lady, just stay still. I saw what happened and called 911. They’ll be here in a minute.”

Police and EMS arrived within minutes. Sharon’s neck was immobilized with a brace, and she was transported to the hospital.

The man who called the police told the investigating officer that he saw the accident happen right in front of him. He said the SUV didn’t even slow down, and he saw the driver was reaching into the back seat when she crashed into the back of the smaller car.

Chelsea Lewis admitted to the police that she’d been distracted by her child in the back seat. She didn’t see the car in front had stopped until it was too late to avoid the crash.

At the hospital emergency room, Sharon had x-rays of her neck and an MRI. Sharon was diagnosed with neck and shoulder strain, in addition to a brain concussion.

Sharon couldn’t return to work for ten days. Her medical bills and lost wages totaled $7,000.

When Sharon recovered from her injuries, she sent a demand packet to the insurance company asking for $25,000 in compensation.

Russel Thompson is the claims adjuster assigned to Sharon’s car accident claim. Like many car insurance adjusters, Russell is always suspicious of “whiplash” injury claims.

Russell is a tough negotiator. He’s proud of the bonuses he’s gotten over the years for minimizing payouts for soft-tissue injury claims. He’s primed and ready to handle Sharon’s injury claim.

Follow along with our fictional car accident victim as she defends her claim while negotiating with an aggressive insurance adjuster. We’ll highlight some insurance claim adjuster secret tactics as Sharon works through the personal injury claim process.

1. Asking Leading Questions

Adjusters often ask questions to prompt the claimant to say something that hurts their claim. These questions often seem safe to an unsuspecting claimant who doesn’t realize they’re making statements that could reduce their compensation.

Claimant: Hello?

Adjuster: Sharon Moore? My name is Russel Thompson, and I’m calling to discuss your claim with Traditional Insurance Company. How are you this morning?

Claimant: Hello, Mr. Thompson. I’m ready to talk about my injury claim. Have you looked at the packet I sent to your company last week?

Sharon avoided a common negotiation mistake by side-stepping the adjuster’s greeting. If she had said, “I’m fine” when Russell asked how she was, he could have used that as an “admission” that she had no lingering effects from her injuries.

2. Minimizing Your Injuries and Treatment

Insurance companies don’t want to pay any more than they have to for your injuries. The adjuster will likely try to minimize the seriousness of your injuries or say your treatment was excessive.

Adjuster: I’ve reviewed the packet, and I’m having a hard time getting some of the medical bills approved. We can’t see any reason for such an expensive MRI on top of all those X-rays, or why you made three visits to a specialist for sore muscles.  

Claimant: Well Sir, if you look at the reports from the paramedics and emergency room physician, you’ll see that in addition to a neck injury, I had signs of a traumatic brain injury. The emergency room doctor was following the correct protocol when he ordered the MRI to check for a skull fracture and then referred me to a neurologist.

Carefully study your medical records before negotiating your injury claim. Be ready to explain the reasons for your medical treatment, imaging tests, and medications.

3. Arguing Your Lost Wages

Some injured claimants will “milk” their time off work after an injury. Adjusters can be so jaded that they think everyone does this. Make sure you can verify the days you missed work with doctor’s orders and a statement of lost wages from your employer.

Adjuster: All right. I don’t know what this doctor was thinking, but after looking at the entries on your chart I will go ahead and pay for the MRI and neurologist visits.

That brings us to this ridiculous wage claim. Your boss might let you get away with slacking off for two weeks, but we don’t have to pay for it.

Claimant: Sir, my time off work was ordered by my primary care doctor and the neurologist based on their knowledge and experience. It was no treat for me to be suffering from daily headaches, blurry vision, and neck pain and stiffness because your insured failed to keep her eyes on the road.

Read the doctor’s notes written on the same days as the work slips. I wasn’t even allowed to drive until my vision cleared, and between the neck injury and brain injury, I was in no condition to rush around a commercial kitchen handling hot foods, sharp utensils, and dangerous kitchen equipment.

For the record, I’ve had nearly perfect attendance at work for the last 20 years. I’m sure my supervisor would be happy to testify that I’ve never “slacked off” on the job.

Don’t lose your cool if the adjuster is rude or downright insulting. Every adjuster has their own negotiation style, and some are bullies. The adjuster might be trying to trick you into getting angry as a way for them to get the upper hand.

Auto insurance adjusters won’t hesitate to challenge lost wage claims. It’s a common tactic to treat claimants like malingerers. Be ready to point to evidence in your medical treatment records to confirm the need for your time off.

4. Making Lowball Offers

The initial settlement offer will likely be much lower than you deserve. Again, don’t get upset or lash out at the adjuster. It’s just business to them.

Adjuster: Okay. Against my better judgment, I’m willing to pay all your hard costs, including the wage claim, so that we can settle this. I’m willing to pay you $7,500, and we’ll call it a day.  

Claimant: Well, that offer is pretty low, but I’ll think about it over the weekend and get back to you.

Most adjusters start with a lowball offer to see if you’re desperate enough to settle, or don’t have the stomach for further negotiations. Don’t get upset or overreact to a low offer. Calmly reply that you think the offer is too low, but you will review it and get back to the adjuster.

Sharon had no intention of accepting such a low settlement offer. She deliberately waited until the following Tuesday to call, so the adjuster would know she’s patient and persistent.

Always Negotiate Down From Your Demand, Not Up From Their Offer

After you get the adjuster’s first offer, don’t negotiate up from there. Always go back to your original demand and negotiate from that number.

Claimant: Hello, Russell. I thought about the offer you made last week and decided it’s just too low for me to accept. However, in the spirit of compromise, I’m willing to lower my demand to $21,000.

Sharon knows a smart negotiator works down from their last demand, never up from the adjuster’s last offer.

5. Blaming You for the Accident

Adjusters often try to reduce injury claim payouts by trying to pin some of the blame for the car accident on the victim.

Adjuster: I made you a good offer, including some consideration for your inconvenience. After all, you were stopped in the middle of the road.

Claimant: I have a copy of the police report in front of me that says your insured was solely to blame for the accident. You have a copy of the same report. I was obeying all traffic laws, including stopping because the car ahead of me was waiting to turn.

Ms. Lewis admitted she wasn’t looking where she was going. She was ticketed for failing to keep a lookout and following too closely.

If not for the negligence of your insured, I wouldn’t have been injured. My world has been turned upside-down because of this, through no fault of my own.

Pointing to the insured’s fault is an effective way to push back against an adjuster who acts like they’re doing you a favor with a low offer. The car accident police report carries a lot of weight with insurance carriers. Police officers are unbiased experts who are trained to determine fault in vehicle crashes.

6. Denying Their “Authority” to Pay Your Demand

An adjuster’s “authority” is a predetermined monetary amount they’re not allowed to go beyond. They may say that they can’t pay your demand because the amount exceeds their authority.

Adjuster: The thing is, Ms. Moore, I can’t come close to what you’re asking. That is not even close to my authority.

Claimant: Well, this case certainly merits your obtaining the authority to pay me a fair settlement.

Adjusters use their limited “authority” as a secret tactic to avoid paying the fair value of your claim. The adjuster’s “authority” is the amount they are authorized to pay without additional approval from a supervisor. Even when this is true, they can request a higher authority from their supervisor.

The adjuster’s authority is not the same as the insurance policy’s liability limits. State laws establish the minimum insurance coverage limits for auto policies.

7. Downplaying Your Pain and Suffering

Adjusters will always try to reduce the amount they pay for non-economic damages, also known as pain and suffering. There are no objective measurements, like bills or receipts, to quantify these damages.

Using descriptive language to describe the emotional impact of your injuries is one way to persuade the adjuster to pay more for your pain and suffering.

Adjuster: We already paid for your property damage and agreed to pay your hard costs, including the full amount of your time off from work. That’s just about the highest we usually go for soft-tissue injuries like yours.

Claimant: You have no idea how terrifying it was to hear the screech of tires followed by crumpling metal on impact. I didn’t know what hit me. I couldn’t think straight. I hurt and I felt sick to my stomach. The paramedics had to lift me out of the car. I was so confused, but I remember how mortified I was after throwing up in the ambulance. I cried and cried.

Adjuster: I don’t doubt you were affected by your injuries, but you’re asking us to pay you an excessive amount for an upset stomach. I can’t agree to that.

Claimant: I don’t know why your offer continues to be so low. The police report makes it clear that Ms. Lewis caused my injuries. Anyone looking at my medical records can see I had more than a few days of sore muscles and upset stomach. I suffered a traumatic brain injury with ongoing symptoms.

Look at the records from the emergency room. I was only released from the hospital because my son and his wife agreed to stay with me for at least 48 hours and follow the doctor’s instructions for monitoring brain injuries.

My daughter-in-law had to wash the vomit out of my hair and help me bathe. I was so embarrassed. The pain and stiffness in my neck was enough to keep me out of work for two weeks, but the brain injury is a big concern.

I still have headaches. I can’t focus enough to knit, and I get so tired that I have to take naps. I’ve never had to live like this before. The neurologist says it can take months for brain injuries to heal, and I might be at higher risk of dementia later because of this accident.

Your insured’s negligence left me with constant headaches and a significant fear for my future health.

I wanted to settle this claim on my own, but maybe I need to hand this over to a personal injury lawyer. 

Adjuster: You don’t want to hire an attorney. Why throw money away? I want to get this done for you. Let me see what I can do and call you back.

It’s reasonable to consider hiring a personal injury attorney if the adjuster won’t come off a too-low settlement offer.

The adjuster is supposed to protect their insured from litigation. When you’ve got a strong case, they’ll increase your compensation for pain and suffering to keep you from taking the at-fault driver to court.

Wrapping Up a Fair Accident Settlement

Sharon did her homework before she sent her demand for compensation to the insurance company. She calculated what her claim was worth and knew that both sides would have to compromise to reach a fair settlement.

Adjuster: Ms. Moore, after talking it over with my manager, we’re offering you $19,000 for your hard costs and your pain and suffering, if we can settle this claim today.

Claimant: Thank you. I’m willing to accept that amount.

Adjuster: You should have the release and settlement agreement in a few days. We’ll send your check as soon as you return the signed agreement.

Sharon invested the time to organize her car accident paperwork and learn everything she could about the claims process. Her diligence paid off, and she successfully settled her insurance claim for more than 2.5 times the amount of her hard costs.

Details Count When Finalizing Your Settlement Agreement

Always follow up with written confirmation of the settlement amount and terms. You can send a letter or an e-mail confirmation to the adjuster.

It’s your responsibility to review the settlement agreement before signing to be sure it matches your verbal agreement. If you don’t understand anything in the agreement, consider hiring a personal injury attorney for an hour or two to look it over for you.

Charles R. Gueli, Esq. is a personal injury attorney with over 20 years of legal experience. He’s admitted to the NY State Bar, and been named a Super Lawyer for the NY Metro area, an exclusive honor awarded to the top five percent of attorneys. Charles has worked extensively in the areas of auto accidents,... Read More >>