Navigating The Claims Process: Strategies For Dealing With Insurance Adjusters

Dealing with insurance adjusters can be a tricky business. Adjusters are paid by insurance companies to settle claims as quickly and cheaply as possible, so they will often employ a range of tactics to get claimants to accept a lower settlement than they are entitled to. Here are some tips to help you navigate the process and get a fair outcome:

- Understand their role and goals: Adjusters are not objective parties; they work for the insurance company and their primary goal is to minimise the amount of compensation paid out. They also want to settle claims as quickly as possible, so they may pressure you to accept a swift but lowball offer.

- Know how they may try to minimise compensation: Adjusters may use a range of unethical tactics to irritate claimants and increase the likelihood they will accept reduced settlements. These include avoiding phone calls, delaying action, requesting more details, issuing lowball offers, and threatening or intimidating claimants.

- Take your time: Don't be rushed into accepting a settlement offer. Take time to review it carefully and seek legal advice if necessary. Remember that once you've signed a settlement, you can't go back and ask for more compensation later.

- Reject lowball offers in writing: Sending a written rejection of an unacceptable offer shows the insurance company that you intend to fight for a fair settlement. It's a good idea to work with a lawyer on this, as a letter from a lawyer is more effective than one from a non-legal professional.

- Finish any necessary treatment before accepting a settlement: The adjuster will want to settle the claim quickly, but don't let them pressure you into accepting a settlement before you know the full extent of your injuries and treatment needs.

- Report unethical behaviour: If an adjuster is acting unethically or unprofessionally, report them to their employer. Bullying claimants or using unethical tactics to coerce them into accepting a lowball offer is serious misconduct that may result in disciplinary action.

- Be careful what you say: Avoid admitting fault or suggesting that you are to blame for the incident or your injuries. Don't give a recorded statement or submit documents without consulting a lawyer first.

- Hire a lawyer: One of the best ways to deal with insurance adjusters is to hire a lawyer to handle communications and negotiations on your behalf. A lawyer can help you maximise your claim and ensure your rights are respected.

Understand their role: prevent fraud, settle claims quickly, and cheaply

When dealing with an insurance adjuster, it is important to understand their role and priorities. While they may appear friendly and professional, it is crucial to remember that their allegiance lies with the insurance company, and their primary objectives are to prevent fraud, settle claims for a low amount, and settle claims quickly.

Insurance adjusters are tasked with examining personal injury or property damage claims to determine the compensation amount owed to the claimant. They receive and process claims, acting as the primary point of contact for the injury victim during the claim process. They review physical injuries or property damage, interview witnesses and claimants, analyze evidence, calculate payments, and negotiate settlements.

To achieve their goals of minimizing compensation and expediting the claims process, adjusters may employ various tactics. They may try to avoid your phone calls, delay action, request unnecessary details, or issue lowball offers. Understanding these strategies can help you navigate the process more effectively.

It is important to remember that you have the right to reject their initial offer and negotiate for a fair settlement. Take your time to review and counter their offer, preferably with the assistance of a knowledgeable attorney. By demonstrating advanced knowledge of your case, backed by evidence, you can gain an advantage in the negotiation process.

Avoid giving lots of details about the accident or your damages

When dealing with an insurance adjuster, it is important to remember that they are not on your side. They are employed by insurance companies and their main goal is to settle claims quickly and for the lowest possible amount. They will use various tactics to achieve this, including avoiding your phone calls, delaying action, and requesting more details.

• Keep the conversation concise and avoid giving specific details about the accident.
• Do not make guesses or speculate about what happened.
• Never admit partial liability or apologise, as this can be used against you.
• Get a quote for vehicle damages from your own auto-repair shop, not the shop suggested by the insurance adjuster.
• Avoid giving a lot of details about your injuries. Simply state that you are seeking medical treatment and that you will send a written summary of your injuries with your lawyer.
• Do not sign anything or give a recorded statement without consulting a lawyer first.
• Do not give the adjuster access to your medical files, as they may try to argue that your condition was pre-existing.
• Be careful about what you say, as the adjuster will use your statements against you.
• Do not feel pressured to accept a lowball settlement offer. You have the right to reject their offer and request a fair settlement.

Don't admit fault or suggest blame

When dealing with an insurance adjuster, it is important to remember that their goal is to settle your claim as quickly and cheaply as possible. They are not on your side and will use various tactics to get you to admit fault or suggest blame. Here are some tips to avoid falling into this trap:

• Do not admit fault or apologise, even if you think you may be partially to blame. Any admission of fault can be used against you to reduce your compensation.
• Avoid giving recorded statements or detailed descriptions of the accident or your injuries. Insurance adjusters are trained to look for statements that can be used against you or twisted to suggest you are at fault.
• Do not sign a medical release form. Insurance adjusters may use your medical history to argue that your injuries were pre-existing or unrelated to the accident.
• Be careful with your choice of words. Even a simple phrase like "I'm fine" can be used to downplay the seriousness of your injuries.
• Do not feel pressured to accept a quick or low settlement offer. Insurance adjusters may try to rush you into accepting a lower amount than what you deserve. Take your time to review the offer and seek legal advice if necessary.
• Be patient and persistent. Insurance adjusters may try to avoid or delay communication to frustrate you into accepting a lower settlement. Do not let them pressure you into impulsive decisions.
• Understand your insurance policy and coverage claims. Knowing your rights can help you recognise unfair dismissals or setbacks.
• Keep all relevant documents, receipts, and evidence organised and readily available. This can help you support your claim and avoid unnecessary delays.
• Consider hiring a lawyer. A lawyer can handle all communication with the insurance adjuster, protect your interests, and help you maximise your claim.

Don't sign anything or give a recorded statement without legal advice

Signing documents or giving recorded statements without legal advice can be detrimental to your claim. Here are some reasons why you shouldn't sign anything or give a recorded statement without legal advice:

• Recorded statements can be used against you: Insurance companies will try to use your recorded statement against you to deny your claim or reduce your payment. They will look for inconsistencies between your recorded statement and other sources of information like the accident report, witness statements, and what you told police officers at the scene. They will also try to downplay the severity of your injuries by using your own words against you. For example, if you said, "I felt fine" soon after the crash, they will take that as evidence that you weren't injured.
• Recorded statements are less precise than written statements: When you provide a written statement, you can plan out exactly what you want to say and review it with your lawyer. Recorded audio statements, on the other hand, are done on the spot and it's easy to say something that might appear unimportant but later comes back to hurt your claim. For example, saying "I'm fine" or "I'm sorry" can be used to make it seem like you weren't injured.
• Insurance adjusters are trained to get you to divulge information: They will ask vague or specific questions that you don't have definitive answers for to make you sound uncertain and cast doubt on your claim. They will also try to get you to reveal information about prior injuries or other activities to discredit and devalue your claim.
• You are not legally obligated to provide a recorded statement: If the insurance company represents the other driver, you are not required by law to provide a recorded statement. Even if it is your own insurance company, you have the right to postpone giving a recorded statement until you have consulted with a lawyer.
• You may not know the full extent of your injuries: Immediately after an accident, you may not know how serious your injuries are. If you give a recorded statement and later discover that your injuries are more severe than you thought, the insurance company can use your earlier statements against you to paint your claim as untruthful.
• You could inadvertently admit fault: Insurance adjusters will try to get you to admit partial liability for the accident. For example, if you forgot to put on your signal during the accident, the adjuster may try to use this against you even if the other driver was at fault.
• You could sign away your rights: Once you accept a settlement, you sign away your right to pursue any other related damages. This holds even if your injuries are more severe than originally thought.

In summary, it is always best to consult with a lawyer before signing anything or giving a recorded statement to an insurance company. A lawyer can advise you on your rights and help you protect your claim.

Negotiate and don't settle for the first offer

Negotiating with an insurance adjuster can be a tricky business. It's important to remember that they are trained to reduce compensation and deny liability. They are incentivized to pay out as little as possible, so it's crucial to do your research and be prepared when negotiating. Here are some tips to help you negotiate and not settle for the first offer:

• Understand their role and goals: Insurance adjusters are hired by insurance companies to investigate claims and determine how much compensation, if any, the company should pay out. Their primary goals are to prevent insurance fraud, settle claims quickly, and keep payouts as low as possible. Knowing this can help you anticipate their tactics and strategies.
• Know your rights and policy: Learn the intricacies of your insurance policy and coverage claims. Being well-informed about your rights can protect you from unwarranted claim dismissals or setbacks. Understand your policy's exclusions and limitations to avoid making statements that may suggest you are to blame for the damage or loss.
• Take your time: Don't feel pressured to accept the first offer or rush into a settlement. Insurance adjusters often use delay tactics and try to frustrate claimants into accepting lowball offers. Take your time to review the settlement offer thoroughly and seek legal advice if needed. Remember that you have the right to reject their offer and request a higher settlement.
• Gather evidence and do your research: Compile all relevant documents, such as repair bills, property damage estimates, police reports, eyewitness statements, photos, and videos of the incident. Research the value of your property or vehicle to determine a fair settlement amount. Get multiple estimates for repairs or comparable vehicles in your local market to support your claim.
• Negotiate with evidence: When countering the adjuster's offer, use your evidence to support your arguments. Ask the adjuster to justify their low offer and provide specific reasons for it. Respond to each of their points with a well-prepared counter-argument.
• Know your bottom line: Determine the minimum settlement amount you are willing to accept before negotiating. This number should reflect the true value of your losses and damages. Don't let the adjuster talk you into accepting less than what you deserve.
• Get it in writing: Always get the final settlement offer in writing to protect yourself and ensure everyone agrees on the terms. This helps set clear expectations and reduces the risk of misunderstandings.
• Consider hiring a lawyer: If you feel overwhelmed or unsure about negotiating with the insurance adjuster, consider seeking legal assistance. A lawyer can guide and represent you during the negotiation process, ensuring your rights are protected. They can also help you gather evidence, draft demand letters, and navigate the complex insurance claims process.

Frequently asked questions