Meeting The Adjuster: Strategies For A Smooth Insurance Claims Process

Meeting an insurance adjuster is a normal part of making an insurance claim after a loss. When you file a home insurance claim, your insurance company sends an adjuster to your location to assess the property and cause of loss, calculate damage, and help decide on the next steps for processing your claim. The adjuster works for the insurance company paying the claim and will review what happened and estimate the claims payment. It is important to remember that the adjuster does not advocate for you; they are paid to calculate the lowest possible compensation on your insurer's behalf.

Be prepared for first contact

When preparing for first contact with an insurance adjuster, it's important to remember that they do not advocate for you. The adjuster is paid to calculate the lowest possible compensation on behalf of the insurance company. Here are some tips to help you prepare for this first interaction:

• Be calm and polite: Although you may be angry about the incident and your injuries, taking out your anger on the insurance adjuster won't help you get a fair settlement. Keeping your cool and staying professional can work in your favour.
• Get their details: Before discussing anything, ask the adjuster for their full name, phone number, email address, the name of the insurance company they work for, and the name of the person or business the company insures.
• Provide limited personal information: Share your full name, address, phone number, the type of work you do, and where you are employed. Avoid discussing anything else about your work, schedule, income, medical history, or other personal details.
• Refuse to give details about the incident: Politely refuse to give a statement about how the accident happened or engage in conversations about it. You can say that your investigation is ongoing and that you will discuss the facts at a later, more appropriate time.
• Don't provide injury details: Only state that you are "still treating" and leave it at that. Avoid giving a detailed description of your injuries until you know the full extent of them.
• Resist the push to settle immediately: Insurance adjusters may offer a settlement during the first few interactions to save the company work and get you to settle for less before you understand the extent of your injuries and claim value. Make it clear that you won't be discussing settlement offers over the phone.
• Set limits on conversations: Let the adjuster know that you will not be discussing much on the phone and that you will provide necessary information in writing when you are ready.
• Refuse to give recorded statements: You are not legally required to agree to have any conversation recorded. Politely decline the adjuster's request and state that you are not comfortable with any kind of recording.
• Get help if needed: If you've been severely injured or are still recovering, consider seeking help from a personal injury attorney who can protect your interests and ensure a fair outcome.

Don't confide in them

When dealing with insurance adjusters, it is important to remember that they are not your friends. They are trained to get you to settle for less money and to use your statements against you. Here are some reasons why you should not confide in an insurance adjuster:

• They don't work for you: Insurance adjusters work for the insurance company, and their goal is to protect their employer's bottom line. They are not looking out for your best interests.
• They will use your statements against you: Anything you say to an insurance adjuster can be used to reduce your claim value. They are trained to trick you into saying the wrong things and admitting fault or partial liability.
• They will try to get you to settle quickly: Insurance adjusters often offer a quick and low settlement before you fully understand the extent of your injuries or damages. Don't let them pressure you into accepting a lowball offer.
• They will try to get as much information as possible: Insurance adjusters will ask you a lot of questions to gather information that can be used against you. You are not legally obligated to answer all their questions or give a recorded statement.
• They will try to minimise your injuries: Insurance adjusters may reach out to you soon after an accident and ask about your medical condition. Saying things like "I'm fine" can downplay your injuries and lead to a lower settlement offer.
• They are not on your side: Insurance adjusters may seem friendly and sympathetic, but their goal is to get you to lower your guard and share information that can hurt your claim. Don't let them trick you into thinking they are your friends.

Read medical release forms carefully

When dealing with insurance adjusters, it is crucial to carefully review medical release forms before signing them. Here are some essential points to consider:

Understand Your Rights and the Purpose of the Form

Know that you are not legally required to give a recorded statement or sign a medical release form. These forms are designed to authorize the disclosure of your medical information, and you have the right to withhold any information you deem sensitive or unnecessary. Understand the purpose of each section and what specific medical information is being requested.

Be Selective with the Information You Provide

Provide accurate and concise answers, focusing on what is directly relevant to your claim. Avoid giving unnecessary details about your personal life, financial situation, or medical history that is not specifically requested. Remember, the more information you disclose, the more the adjuster will have to work with when assessing your claim.

Specify the Scope and Duration of the Release

Clearly indicate the scope of the medical release, specifying which types of medical records can be accessed and shared. You may also want to specify a time frame for the release, such as a start and end date, or state that it is ongoing until revoked. This ensures that your information is only accessed and shared for the specific purpose and duration required.

Authorize Only Necessary Parties

Be cautious about whom you authorize to access your medical information. Typically, you will provide this authorization to a specific individual, healthcare facility, or legal representative. Carefully review the form to ensure that only the necessary parties are granted access and that your information is not shared more broadly than needed.

Seek Legal Advice if Needed

If you are unsure about any aspect of the medical release form or how it may impact your claim, consider seeking legal advice. A skilled attorney can review the form, protect your rights, and guide you in providing the appropriate level of information. They can also help you prepare an alternate release form that limits the insurance company's access to only the information directly relevant to your current claim.

Keep appropriate lines of communication

Keeping appropriate lines of communication is crucial when dealing with insurance adjusters. Here are some detailed instructions to help you effectively communicate and interact with insurance adjusters:

Be Prepared for First Contact

Insurance adjusters will likely request your recorded statement and ask for access to your medical records. You are not legally required to provide a statement or sign a medical release form immediately. Take your time and carefully review any documents before signing. If you're not ready, politely ask for more time. Never give a recorded statement when you're tired, upset, in pain, or under the influence of medication.

Provide Limited Personal Information

When speaking to an insurance adjuster, you only need to provide basic personal information, such as your full name, address, phone number, and employment details. You are not obligated to disclose personal information about your daily life, work schedule, income, or medical history. Be cautious about what you share, as adjusters are trained to use this information to their advantage.

Decline Recorded Statements

You are not legally required to provide a recorded statement, and it is against the law for an adjuster to record you without your consent. Politely decline such requests, as recorded statements can be used against you. Written correspondence provides a more precise and thorough record of the discussion.

Document and Confirm Conversations

Maintain a record of all interactions with the insurance adjuster. Document conversations in a notebook or diary, including dates, times, and a summary of what was discussed. After each conversation, send a brief follow-up email or letter to confirm the details of your discussion and any agreements made. Ask the adjuster to provide a letter confirming your conversations and the claim details.

Keep Adjuster Informed of Progress

Inform the adjuster about your ongoing treatment and provide updates on your progress. However, refrain from discussing any settlement offers until you have fully recovered or completed your medical treatment. It is important to have a clear understanding of the extent of your injuries and the impact on your life before considering any settlement.

Organise Your Documents

You will likely receive numerous letters and notices from the insurance company. Create a dedicated file to organise all documents related to the claim, including medical bills, out-of-pocket expenses, and lost wage statements. Staying organised will help you stay on top of the claim process and make it easier to reference relevant information when needed.

By following these instructions, you can effectively maintain appropriate lines of communication with insurance adjusters, protect your interests, and increase your chances of a fair and satisfactory settlement.

Organise your documents

Organising your documents is a crucial step in preparing for a meeting with an insurance adjuster. Here are some detailed instructions to help you get started:

• Create a folder: Start by creating a physical or digital folder to store all your relevant documents. This will ensure that you have quick and easy access to everything you need during the claims process.
• Gather all relevant documents: Collect and compile all the necessary documents related to your insurance claim. This includes policies, reports, receipts, photographs, and any other evidence that supports your claim. Make sure you have multiple copies of each document, so you can easily share them with the adjuster.
• Itemised inventory: Prepare an itemised list of your belongings, especially those that have been damaged or lost. Include as much detail as possible, such as purchase dates, prices, and descriptions. This will help the adjuster accurately assess the value of your claim.
• Organise by category: Arrange your documents into categories to make it easier to locate specific information. For example, you can have separate sections for policies, receipts, reports, and photographs. That way, you can quickly find and reference the necessary documents during discussions with the adjuster.
• Label and date: Clearly label each document with a brief description of its contents and the date it was created or acquired. This will help you quickly identify what each document is about and ensure that you are providing the most up-to-date information to the adjuster.
• Cross-reference: If possible, cross-reference your documents to create a comprehensive picture of your claim. For instance, if you have photographs of damaged items, include receipts or appraisals to show their value. This will help the adjuster understand the extent of your losses and support your claim for compensation.
• Keep notes: Throughout the process, take detailed notes on your interactions with the insurance adjuster. Note the dates, times, and content of any conversations or meetings. This will help you keep a record of what has been discussed and decided, allowing for better organisation and follow-up.

Remember, being organised and providing comprehensive documentation will not only make the claims process smoother but will also help you receive a fair and accurate assessment from the insurance adjuster.

Frequently asked questions