Part 3: Sample Dialogue with the Claims Adjuster…
It’s possible to get compensation for injuries from a dog attack without filing a dog bite lawsuit. Negotiating with insurance claims adjusters can be difficult, but with a little know-how you can get a fair settlement without hiring a personal injury attorney (who will take 33% of your final settlement).
This page gives a sample dialogue between a dog attack victim and the claims adjuster for the dog owner’s insurance company.
Let’s start by describing a hypothetical dog attack incident which we’ll use as a basis for the dialogue…
James has worked as a professional chauffer for over ten years. The company he works for has only three other employees, with James as the fourth. Due to the low number of employees, his employer is not legally bound to have Workman’s Compensation insurance. She offers each employee medical and dental benefits through a contributing health plan.
Last month James was assigned to pick up long-time client Mrs. Hathaway. She was leaving for a vacation on a flight to Europe later that day. Although James had driven Mrs. Hathaway to the airport many times before he never encountered a problem with her two Rottweiler dogs. As always, the moment James pressed the doorbell Mrs. Hathaway’s dogs, Glume and Dume, started barking loudly and continuously.
As James stepped into the foyer and reached for the first two pieces of luggage Glume suddenly appeared from behind, jumping up and biting hard into James’ right forearm and hand. The pain was so immediate and intense he almost passed out. As Mrs. Hathaway tried pulling the dog away it dug its teeth deeper and deeper into James’ forearm. Although Mrs. Hathaway attempted a valiant rescue effort, her efforts were futile.
James was the victim of a vicious dog attack. His injuries required over 30 stitches on his right hand and arm.
Because James’ job tasks include lifting heavy luggage and driving with two firm hands on the steering wheel he cannot work while recovering. The treating physician ordered at least a two week recovery period at home, stating any undue pressure on the right hand and arm might result in the stitches opening.
Regrettably, because James’ employer will have to hire another driver to take his shifts he will not be able to pay his salary during the recovery period. James’ medical bills totalled $2,500 and his lost wages totaled $3,000. He incurred $500 in further out of pocket expenses.
After a couple of days at home James received a call from a person identifying herself as a claims adjuster from Mrs. Hathaway’s homeowners insurance company. James had already decided he was not going to hire a personal injury attorney, but rather would try to represent himself.
James is about to begin negotiatiing a settlement for his medical bills, out-of-pocket expenses, lost wages, and the pain and suffering he endured. We’ll presume Mrs. Hathaway’s failure to control her dogs established clear liability. As a result, in an effort to avoid a dog bite lawsuit her homeowners insurance company has agreed to negotiate a settlement for the injuries James sustained.
Below is a typical insurance settlement negotiation dialogue between an Adjuster and a dog attack victim – based on the scenario described above. Although case specific this dialogue represents the form and substance of most successful dialogues between Adjusters and Injured persons. Using it as a rough guideline will help you keep on track in your own claim negotiations.
Following this dialogue will not guarantee the financial settlement you think you deserve, but it may go a long way toward helping you achieve that goal.
Sample Dialogue for a Dog Bite Injury Claim…
Notes: The original demand preceding this negotiation was a reasonable four times the amount of medical bills, plus lost wages and out-of-pocket expenses totaling a demand of $13,500. That amount would be very reasonable for a serious injury such as a double dog attack.
(Keep in mind that attacks such as these can often result in permanent scarring, which may increase the demand significantly. However for the purposes of our example it does not apply.)
ADJUSTER: “I’ve taken a hard look at this and I can’t come close to what you’re asking. That amount is not even close to my authority.”
INJURED: “Well tell me what your authority is so I can tell you if we are even close.”
Notes: The adjuster will evade the subject, not wanting to show her hand. If she does, she knows you will ask for one dollar less, and if her authority is just too low you will then confirm you really are still miles apart on the amount. Knowing her authority puts you in a better bargaining position and saves you the otherwise wasted time of offers and counter offers.
Some think an Adjuster won’t take you seriously because she knows you’re not a lawyer; that she won’t give your case fair consideration because you don’t have the one piece of leverage Attorneys have – the ability to file a proper dog bite lawsuit and pursue it through depositions, interrogatories and all other pre-trial and trial matters.
That’s why Adjusters exist, they’re there to try and settle a claim for less than it would cost if a dog bite lawsuit was filed. With personal injury attorneys involved, every day which goes by costs more and more in attorney’s fees and other costs. Adjusters know a layperson’s ability to file and pursue a lawsuit doesn’t extend much past Small Claims Court.
Adjusters also realize that their investment of countless hours investigating and negotiating each case will be for naught if their settlement position is perceived by the victim as non-negotiable.
Experienced adjusters know how far they can “push” a victim before they decide to hire an attorney. In some ways it’s similar to a police detective interviewing a suspect at the police station. A smart and experienced detective knows how far he can push a suspect before the suspect “lawyers up.”
Insurance Adjusters face a similar problem. If the Adjuster pushes too hard and the victim finally throws her hands up and says, “That’s enough, I’m going to hire a lawyer,” the Adjuster will have in essence wasted their own time, the insurance company’s time, and the victim’s time. Therefore most Adjusters will treat non-attorney victims with a degree of professionalism and respect.
ADJUSTER: “I don’t see anything in the file supporting your demand. I’ve already fully agreed to pay your hard costs, including all your medical bills. I also don’t have a problem reimbursing you for the lost wages reported to us by your employer. And although some of your out of pocket bills stretch the bounds of reasonableness we’ve agreed to compensate you fully for them. My problem is with your total demand for settlement in the amount of $13,500. It’s just more than we think this case is worth.”
INJURED: “I don’t know if you’ve ever been terrorized and repeatedly bitten by two attack dogs. If you did then you might have some empathy. You should understand what it’s like to feel totally helpless watching as your right arm and hand are being mauled. I am right handed. You don’t realize how much you depend on your dominant arm and hand. While I was recovering I had terrible difficulty doing everything with my left hand, including eating, writing, driving and taking care of my personal needs.”
“One minute I was feeling great, about to drive my client to the airport, and the next minute I’m fighting for my life, bleeding profusely and enduring severe pain. I still wake up nights in a cold sweat. In my nightmares I see my arm being torn off and blood flying everywhere.”
ADJUSTER: “I have no doubt what happened that day affected you. After looking over the case again I feel comfortable raising my offer to $7,500.”
Notes: The Adjuster now moves from “I can’t come close to what you are asking” to offering $7,500 dollars.
INJURED: “I think that offer is still way too low but I will think about it over the weekend and get back to you early next week.”
Notes: The Adjuster wants to settle the case. Telling the Adjuster her offer was too low, and then telling her you’ll get back with her next week is a clear sign she’s not going to buy you off quickly or cheaply. Your actions show the Adjuster you’re taking this matter seriously. Telling her you need time to think it over takes any emotion out of the negotiations. That’s a good thing. Patience can certainly be a virtue when negotiating an injury settlement.
INJURED: (next week arrives) “I gave your offer a good deal of thought and must tell you it’s substantially lower than I can accept.”
ADJUSTER: “Well, how much would you accept?”
INJURED: “In the spirit of compromise and to move this case along I can reduce my demand to $11,000. (This equals 3 times the Hard Costs plus Out-of-Pocket expenses and Lost Wages.)
ADJUSTER: “I don’t have authority for anything near that.”
INJURED: “Well this case certainly merits your going to get it.”
ADJUSTER: “I don’t see anything this week that is any different from last week.”
INJURED: “I can’t seem to understand why you continued to insure this woman. I mean, I checked with the City Animal Control Center and the City Attorney’s Office. Mrs. Hathaway had already been cited 3 times for her dogs’ excessive barking at all hours of the night. I was then shocked to learn the Hathaway’s dogs had bitten the mailman, seriously injuring him a little over a year ago. Those dogs could have killed me and no one has done a darn thing about them. I’m starting to wonder if I settle my case and say nothing, the next time an unsuspecting person walks up to the Hathaway house they may be killed!”
Notes: This is an excellent ploy on the part of the injured. It’s good because it may be true and you are honestly concerned about something more important than the money – a human life. Something worse could happen to the next dog attack victim.
ADJUSTER: “Look, I’ll tell you my limit is $10,000. It looks like we aren’t close. I’ve been doing this for sixteen years and I can tell you I don’t remember a case like this settling for anything close to what you’re asking.”
INJURED: “I don’t know why your offer continues to be so minimal. While recovering I did some research into our State’s court records. It’s amazing what you can find on the internet. Do you know what the average jury verdicts for dog bite lawsuits similar to mine have been? Some have settled for 6 and 7 times costs. There were some lower and some higher. The highest verdicts were those in which the insured had prior warnings for barking and biting incidents, and therefore had been forewarned about the danger their animals posed to the public.”
ADJUSTER: “But we’re not talking about jury verdicts. First, dog bite lawsuits can take years to get to trial, and then if we lose the case it’s usually appealed. That means you might not see any money for years.”
INJURED: “I want to settle this case, but the settlement must be fair. Although I’m not considering hiring a lawyer right now, I’m starting to wonder if I may have to.”
Notes: At this point in the negotiation there seems to be a stalemate. That’s quite normal. Now is the time to turn it up another notch with mention of hiring a personal injury attorney.
ADJUSTER: “You don’t want to hire an attorney. You know they will take one third of any settlement, and to be honest, I’m not prepared to offer any more money just because an attorney becomes involved.”
Notes: The Adjuster is now concerned because for the first time the issue of a personal injury attorney has come up. Although you were smart enough not to say you hired an attorney, you have at least let her know you are considering doing so.
The Adjuster is not panicking, but she is starting to give serious consideration to all the time and effort she’s already invested in this case. Now, after all this time she realizes she’s very close to losing this negotiation to the legal department. That’s something she wants to avoid. She’s paid to settle cases, not knock them around for a while just to finally turn them over to the legal department.
The Adjuster knows if she doesn’t settle this case now (after you’ve already investigated the facts behind this case), and the case goes from her hands to the legal department, then there’s a good likelihood you will also
hire an attorney
At that point the insurance company has already lost the case. The time and money invested by the adjuster has been squandered and the attorneys will no doubt begin fierce discovery proceedings, turning up the heat on you and turning up the legal fees for their employer – the big bad insurance company.
At this point you should be quite proud. You’ve negotiated your case having utilized almost every negotiating tool available to you. Your introduction of evidence against the insured included items even some attorneys might not have been smart enough to introduce.
ADJUSTER: “Okay, I’ve now been authorized to offer you a total settlement offer of $11,000.”
Notes: The offer is three times the medical costs plus out of pocket expenses and lost wages. Take it!
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