Auto Insurance Adjusters: When To Call And What To Expect

An insurance adjuster, also known as a claims adjuster, is a person who investigates an insurance claim to determine if the insurer should pay for damage or injuries, and if so, how much they should pay. They are not on your side. Their job is to make sure you get compensated as little as possible. They work for the insurance company, not for you, and they will try to resolve the case for as little compensation as possible. They will try to convince you that their initial settlement offer is the best you can get, but this is rarely the case. It is advisable to consult a lawyer before speaking with an insurance adjuster or signing anything.

How to identify an insurance adjuster

An insurance adjuster, also known as a claims adjuster, is a person who investigates an insurance claim to determine if the insurer should pay for damage or injuries, and if so, how much they should pay. They work for the insurance company and their job is to ensure that the company pays out a minimum amount on claims.

• An insurance adjuster will contact you soon after an accident has occurred. They will want to review the details of the accident and your insurance policy to determine the company's liability.
• They will interview those involved, including the claimant, any other drivers, passengers, and witnesses. They may also review police reports, accident reports, photos, video footage, and other documents related to the incident.
• Adjusters will inspect the damage to your property, such as your vehicle or home, to assess the cost of repairs. They may do this themselves or request estimates from a certified repair shop.
• They will communicate the insurance company's settlement offer to you and guide you through the process of accepting or denying the offer.
• Adjusters may try to convince you to accept less money than your claim is worth. They may also try to access your medical history to claim that you had pre-existing conditions that contributed to your injuries.
• It is important to remember that the adjuster is not your advocate and is working to protect the interests of the insurance company. They are trained negotiators and may use friendly conversation to encourage you to make statements that could damage your claim.
• Adjusters often work as freelancers and are hired by the insurance company to handle specific claims.

What to say to an insurance adjuster

Dealing with insurance adjusters can be tricky, especially after a car accident. Here are some tips on what to say and what to avoid saying when speaking to an insurance adjuster:

• Remain Calm and Polite: It's important to keep your cool and remain professional, even if you're angry about the accident. Avoid taking out your frustration on the adjuster, as their goodwill may benefit you during the claims process.
• Provide Basic Personal Information: Share your full name, address, phone number, and employment details. However, avoid giving unnecessary information about your work, schedule, income, medical history, or anything else that isn't directly related to the claim.
• Stick to the Facts: When discussing the accident, stick to the basic facts, including the location, date, time, type of accident, and vehicles involved. Avoid speculating or guessing about any details you're unsure of.
• Report Injuries Cautiously: Inform the adjuster that you sought medical attention and are under professional care. However, refrain from providing specific details about your injuries until you have a comprehensive medical evaluation.
• Provide Supporting Evidence: Mention any witnesses, police reports, or photographic evidence that can strengthen your claim.
• Be Firm but Polite: If the adjuster pressures you to accept a quick settlement or provide a recorded statement, politely decline. Stand your ground and let them know that you have done your research and will provide all necessary information in writing.
• Involve Your Attorney: If you have an attorney, inform the adjuster that your attorney will be in touch to discuss your claim and provide the necessary information.

What Not to Say to an Insurance Adjuster:

• Admitting Fault: Avoid saying anything that could be construed as an admission of guilt or responsibility for the accident. Even a simple apology can be used against you.
• Minimizing Injuries: Don't downplay or underestimate your injuries. The full extent of your injuries may not be apparent immediately after the accident.
• Describing Injuries in Detail: It's best not to discuss your injuries in detail with the adjuster. Refer them to your attorney or medical provider for more information.
• Speculating About the Accident: Stick to what you experienced directly and avoid speculating about what happened. You don't want to accidentally blame yourself or provide information that could be used against you.
• Providing a Recorded Statement: You are not legally required to provide a recorded statement, and it could potentially harm your case. Adjusters may use your statements against you or misinterpret your words.
• Discussing Prior Injuries or Accidents: Focus only on the injuries directly related to the current accident. Providing details about previous injuries or accidents may be used to downplay your current claims.
• Discussing Settlement Expectations: Avoid discussing settlement figures or expectations with the adjuster, as their goal is to minimize payouts. Let your attorney handle negotiations on your behalf.

What not to say to an insurance adjuster

An insurance adjuster is the person who decides how much money to offer you as compensation. It is important to remember that they are not on your side and are instead looking to minimise the insurance company's liability. Here are some things you should avoid saying to an insurance adjuster:

Admitting Fault

Avoid any language that could be construed as apologetic or that admits fault, even partial fault. Phrases like "I'm sorry" or "It was my fault" can be used against you and may reduce or eliminate your compensation. Even if you feel you are at fault, wait for the official investigation to determine what happened.

Discussing Injuries and Prognosis

Do not discuss your medical condition or downplay your injuries by saying things like "I'm fine" or "It's okay". The full extent of your injuries may not be apparent yet, and you do not want to risk reducing your settlement offer. It is enough to say that you are being treated by a doctor for injuries related to the accident.

Discussing the Circumstances of the Accident

Stick to very basic details of the accident, such as the date, time, location, vehicles involved, and names of any witnesses. Avoid speculation or providing additional information beyond what you experienced directly. You do not want to accidentally implicate yourself or provide information that could be used against you.

Providing a Recorded Statement

You are not legally obligated to give a recorded statement, and it is one of the major pitfalls when talking to an insurance adjuster. They can use pieces of your conversation out of context to cast doubt on the legitimacy of your claim. Instead, politely refuse and consult with a lawyer.

Accepting the First Settlement Offer

The first settlement offer is usually much lower than the true value of your claim. Do not accept any offers until you have consulted with a personal injury attorney, who can help you understand your rights and ensure you receive fair compensation.

When an insurance adjuster will call

An insurance adjuster will call soon after an accident has occurred. The first contact from the other side's insurance company might come as soon as the first few days after the incident, but it will almost certainly come in the first few weeks.

Adjusters prefer phone calls because they think a live call will give them a sense of how comfortable you are with the injury claim process, including how likely you are to fight for a fair result. They also use a live call to try to get you to say something about the accident or your injuries that could hurt your claim, or that might be difficult to walk back later on. They also take the opportunity to pressure you into accepting a too-early (and too-low) settlement offer, often before you even have a sense of the nature and extent of your injuries.

The insurance adjuster will call to assess the circumstances of an accident and the damages to your vehicle. They will interview the claimant, the other driver or drivers, and any witnesses. They will also consult police reports, accident reports, photos, and other documents to make a determination regarding fault. They may also visually inspect your car themselves or request estimates from a certified repair shop.

After the estimate is complete, the adjuster communicates the insurance company’s settlement offer to you and guides you through the process of accepting or denying the offer.

How to avoid a rejected claim from an insurance adjuster

It's important to know how to navigate the process of filing a claim with an insurance company to avoid having your claim rejected. Here are some tips on how to avoid a rejected claim from an insurance adjuster:

Understand the role of insurance adjusters

Insurance adjusters are assigned to your case to help you move the claims process forward. However, it's important to remember that they work for the insurance company, not for you, and their goal is to resolve the case with as little compensation as possible. Adjusters are motivated to settle claims quickly and will try to "clear" or close the claim file as soon as possible to manage their caseloads.

Provide complete and accurate information

Make sure you provide the adjuster with all the necessary documents to support your claim. This includes medical records, police reports, bills for medical treatment, and proof of lost earnings, such as pay stubs or a letter from your employer. The adjuster will also need your name, address, and phone number, and it is advisable to speak to an attorney before revealing any other detailed personal information.

Be mindful of the adjuster's tactics

Adjusters may try to stretch out the claims process, knowing that the longer they drag out your case, the more pressure you will feel to accept a lower settlement offer. They may also try to take advantage of your desperation by offering a quick but low settlement. Remember that you don't have to accept their first offer, and it's important to remain calm and amicable during correspondence with the adjuster.

Consult with an attorney

Consider consulting with a reputable personal injury attorney who can skillfully negotiate a fair settlement on your behalf. An attorney can review your case and supporting documents, explain your rights, and help you draft an effective demand letter. They can also deal with the insurance company on your behalf, and most insurance claims adjusters take phone calls from lawyers more seriously than calls from claimants.

Know your rights and the appeals process

If you feel that your claim has been unfairly rejected, you can appeal the insurance company's decision. Gather evidence, such as police reports, eyewitness information, photographs, and medical reports, to support your appeal. Draft an appeal letter explaining why you disagree with the insurance company's decision and providing as much detail as possible. You may also consider hiring an attorney to help you with this process.

Frequently asked questions