Get the inside story on how to deal with insurance adjusters to boost your personal injury compensation. Here’s what you should know before filing your claim.
Sooner or later, most of us end up dealing with an insurance adjuster. Most often we deal with an adjuster after a car accident.
Besides auto accident claims, people are injured by falls, dog attacks, defective products, and other causes that are covered by the at-fault party’s homeowners insurance or business liability insurance.
Whether you decide to hire an attorney or handle an injury claim on your own, it pays to know how to deal with insurance adjusters.
What Insurance Claims Adjusters Do
Insurance adjusters go through extensive training before they’re allowed to handle injury or property damage claims. Many states require adjusters to meet specific licensing or certification requirements.
Every adjuster working for an insurance company also receives ongoing training on the company’s policies and procedures for handling claims.
An insurance adjuster’s job is to:
- Investigate accidents
- Determine fault for the accident
- Calculate the claim’s value according to company protocol
- Negotiate and settle claims with accident victims
5 Tips for Dealing With a Claims Adjuster
You can’t avoid speaking to an insurance adjuster unless you’re represented by a personal injury lawyer. Once you are represented by counsel, direct phone calls from the adjuster must stop. All communications will go through your lawyer.
If you’ve recovered from relatively minor injuries, only missed a few days from work, and liability is clear, you can probably reach a fair settlement by dealing directly with the insurance adjuster.
When you’ve been seriously injured, have lingering effects from your injuries, or could share some of the blame for the accident, you should consult an attorney.
If you decide to handle your own injury claim, you’ll hear from the adjuster shortly after filing your claim. The adjuster may call or write, and may even offer to meet with you at your home.
1. Be Prepared for First Contact
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. Don’t be fooled by a pushy adjuster. You are not legally required to give a statement or sign the insurance company’s medical release form.
If you choose to give a statement, be careful. You’ll be bound by what you say. If you’re not ready, politely tell the adjuster you need a few days. Never give a recorded statement while you are tired, upset, in pain, or taking pain medications.
2. Never Confide in an Insurance Adjuster
Anything you say to the insurance adjuster can be used against you, and the adjuster is trained to trick you into saying the wrong things.
Never confide in an insurance adjuster. They don’t need to know you’re going through a divorce, caring for an elderly parent, or struggling financially. Your difficulties signal that you’ll settle for less, out of desperation.
3. Read Medical Release Forms Carefully
Be just as careful when it comes to medical release forms. Insurance companies often use “standard” forms that allow them to get copies of all your medical and mental health records going back five or ten years.
The adjuster will search your records for preexisting injuries or other conditions they can use as an excuse to reduce your claim value. You or your attorney can prepare an alternate release that limits the insurance company to medical records directly related to your current accident injuries.
4. Keep Appropriate Lines of Communication
Tell the adjuster you’ll continue treatment and keep them 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 says that although the insurance company has agreed to discuss the personal injury claim with you, they haven’t officially accepted liability for the accident or your injuries.
5. Organize Your Documents
You’ll get lots of letters and notices from the insurance company. Create a claim file to organize your documents related to the accident. You want everything at your fingertips when it’s time to begin negotiating a settlement.
While continuing treatment, keep the adjuster up to date by sending copies of your medical bills, out-of-pocket expenses, and statement of lost wages. Your adjuster is likely handling dozens of claims at the same time. By maintaining contact and sending documentation, you’re acting in good faith and reminding them of your claim.
Handling Negotiations with the Adjuster
You and the 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 fully compensated for your damages, and the adjuster wants to close out your claim as quickly and cheaply as possible.
You must convince the adjuster that their insured was at fault for the accident and that you suffered verified injuries because of their insured’s negligence.
Good settlements don’t just happen, they take work. Consider using a Claim Negotiations Checklist to help you stay on track.
Starting the Negotiation Process
Once you’ve completed medical treatment for your injury, you can begin the negotiation process with the adjuster.
Calculate the value of your injury claim by adding up your medical bills, out-of-pocket expenses, and lost wages. Add one or two times that amount to account for pain and suffering. The final total is a reasonable amount to demand for compensation.
Write a detailed settlement demand letter that explains who caused the accident, why they should pay for your damages, and the amount of money you want for compensation.
Assemble a settlement packet that includes your demand letter along with proof of the at-fault person’s negligence and liability, and documentation of your injuries. Mail the packet to the adjuster, then wait for a response.
Back and Forth Negotiations
After receiving your demand packet, the adjuster will get back to you with a counteroffer for settlement. This will likely be much less than your demand. The adjuster may give various reasons for their low offer. These may include:
- You share liability for the circumstances leading to your injuries
- Testing or treatments for your injuries were excessive or unreasonable
- Your injuries arise from a preexisting condition
- You made your injuries worse by delaying treatment or failing to follow doctor’s orders
- The number of days you missed work isn’t justified
Be prepared to politely reject a low settlement offer after your initial demand. You must be able to counter their arguments. You can take some time after hearing their offer to prepare your counter. Always work down from your demand, a little at a time. The adjuster will work up from their first low-ball offer.
Insurance adjusters have different negotiating styles and tactics. Some may act like they’re doing you a big favor, and others may seem sympathetic and friendly. Watch out for the friendly ones. The adjuster is not your friend.
Claims adjusters appreciate dealing with claimants who are prepared, polite, 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.
Professional negotiators understand that both sides must give a little to reach a compromise settlement agreement. Always know your bottom line. With patience and persistence, you should arrive at an acceptable settlement amount.
Reaching an Agreed Settlement
When you reach an agreement, send a follow-up letter confirming the amount and terms. Carefully review the final settlement agreement before signing, to confirm the terms match your verbal agreement.
A Note on Car Accident Claim Adjusters
Depending on the circumstances of your vehicle accident, you could have to deal with more than one insurance adjuster. Serious or complicated claims should be handled by an experienced car accident attorney.
Motor vehicle accident claims involve adjusters who handle:
- Personal injury liability claims for the at-fault driver’s insurer
- Property damage liability claims for the at-fault driver’s insurer
- Personal Injury Protection (PIP) or MedPay claims with your insurance company
- Uninsured Motorist Bodily Injury claims with your insurance company
- Collision coverage or uninsured property damage claims with your insurer
In no-fault insurance states, you must first turn to your own auto insurance policy for PIP injury coverage. Injuries that meet the severity threshold for your state may be filed against the at-fault driver’s policy, but you’ll need a local car accident lawyer to succeed.
Working with your own insurance company is often easier than dealing with the adjuster from the at-fault driver’s insurance company. Using your no-fault PIP coverage for injury claims, or your collision coverage for vehicle repairs, means you won’t have to prove the other driver caused the accident.
Working with the Adjuster on Car Repairs
Some people prefer to file a first-party claim with their own insurance company to take care of vehicle repairs under their collision coverage. In turn, their company will recover the costs from the at-fault person’s insurance carrier.
If you don’t want your insurance to handle your car repairs, you’ll need to work with an adjuster from the at-fault driver’s insurance company. While it may not be the same adjuster who contacted you about your injury claim, they do work together, so be careful of what you say.
Many insurance companies will suggest using their “preferred” auto repair shop to have your car fixed because they’ve negotiated special rates with that shop. You can take your car to a repair shop you trust. So long as the repair shop charges reasonable rates, the insurance company should accept them.
You have the right to ask the at-fault driver’s insurance to cover the cost of a rental car while your car is in the shop. The adjuster may pay the rental car agency directly or ask you to submit rental receipts for reimbursement.
Unless you insist on an out-of-the-way rental car company, the adjuster should take care of rental expenses, so you aren’t paying out-of-pocket.
What If I Get a Bad Insurance Adjuster?
Rest assured that up until you’ve signed a settlement agreement, you have the right to speak to a personal injury attorney for legal advice about your claim.
Most insurance adjusters will work with you to settle a claim in good faith, particularly when you’ve got good documentation and are asking for a reasonable amount of money.
Unfortunately, not all adjusters are equally professional and competent. Some even stoop to using bad faith practices.
If the adjuster lets your claim languish, or won’t negotiate your claim in good faith, don’t hesitate to protect your interests. You can speak with their supervisor, file a complaint with your state insurance board, and if that doesn’t work, you can hire an attorney.
Sometimes hiring a personal injury attorney is all it takes to get a difficult adjuster to pay attention and offer a fair payout. Most injury attorneys offer a free consultation to victims. There’s no cost to finding out what an experienced attorney can do for you.
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