Auto Adjuster Rules Against Insured: What Are Your Options?

When an insurance adjuster rules against the insured, it can be a challenging situation for the claimant. Insurance adjusters are employed by insurance companies to settle claims quickly and cost-effectively, which often results in claimants receiving lower settlements than they deserve. It is important to remember that insurance adjusters are not objective parties and primarily serve the interests of the insurance company. They may employ various tactics, such as delaying tactics, avoiding communication, or twisting words to delegitimize claims and reduce payouts. In such cases, claimants have the option to invoke the Appraisal Clause in their insurance policy, which allows for an independent assessment of the claim by both parties, leading to a mutually agreed-upon settlement or arbitration.

The insured can invoke the Appraisal Clause

If an auto adjuster rules against you, the insured, there are steps you can take to protect yourself and your interests. One important option available to you is to invoke the Appraisal Clause.

The Appraisal Clause is included in many property insurance policies, including standard Texas homeowners policies, and it allows either the carrier or the policyholder to demand an appraisal if there is a disagreement on the actual cash value, amount of loss, or cost of repair. This process can help resolve disputes without the need for costly and time-consuming litigation.

Here's how the Appraisal Clause works:

• Each party selects an impartial appraiser within 20 days of receiving a written request from the other party.
• The two appraisers then work together to choose an umpire. If they cannot agree on an umpire within 15 days, either party can request that a judge make the selection.
• The appraisers will independently assess the amount of loss. If they agree, their decision is final.
• If the appraisers disagree, they will submit their differences to the umpire, and a decision agreed upon by any two of the three parties will set the amount of loss and is binding.
• Each party is responsible for paying their own appraiser and half of the umpire's cost.

It is important to note that appraisal is only appropriate when the amount of loss is the sole issue in dispute. Appraisers do not have the authority to determine questions of causation, coverage, or liability. Additionally, there must be a genuine attempt to reach an agreement between the two parties before invoking the Appraisal Clause.

The Appraisal Clause can be a powerful tool for the insured to ensure a fair assessment of their claim. However, it is crucial to seek the help of an expert who understands the process to increase the chances of a successful outcome.

The insured can hire a public adjuster

If an auto adjuster rules against the insured, the insured can hire a public adjuster. A public adjuster is an independent trained insurance professional that helps individuals with the insurance claim process. They are licensed and trained insurance professionals who advocate exclusively for policyholders. Unlike an insurance company adjuster, a public adjuster's financial interests are directly tied to the interests of the policyholder to receive full and fair compensation on insurance claims.

Public adjusters can be hired for auto insurance claims. They can assess the damages, negotiate with the insurance company, and work to maximize the settlement for the policyholder. The cost of a public adjuster varies based on the nature of the claim, where the insured lives, and the adjuster they choose. Most public adjusters charge a percentage of the total claim payout, typically ranging from 5% to 20% of the insurance settlement.

When deciding whether to hire a public adjuster, consider the following:

• The size of the claim: Public adjusters typically charge a percentage of the final settlement, so factor in the price for large claims with potentially high payouts.
• Stress of working with insurance companies: Some people find dealing with insurance companies stressful and prefer to have a public adjuster handle the entire claim process and communicate with the insurance company on their behalf.
• Past claims experience: If the insured has had a poor claims experience in the past, a public adjuster can help ensure their claim is handled fairly and efficiently.
• Time constraints: If the insured is too busy to correspond with the insurance company, a public adjuster can save them time by handling the claim process.
• Claim settlement amount: If the insured feels the claim settlement offered by the insurance company is too low, a public adjuster can help negotiate a higher payout.

When hiring a public adjuster, it is important to:

• Check their license: Verify that the public adjuster is licensed to practice in your state.
• Ask about their experience: Inquire about their claim adjusting skills, credentials, and experience. Ask for references from local clients who were satisfied with their work.
• Discuss fees: Understand the fee structure and negotiate if needed. Public adjuster fees typically range from 5% to 15% of the claim payout but are negotiable and capped in some states.
• Communicate expectations: Be clear about what services you expect from the public adjuster and whether you want to stay involved in the claim process.
• Review the contract carefully: Before signing the contract, make sure you understand the terms and fees to avoid any surprises.

The insured can contact their insurance company

If an auto adjuster rules against you, the insured, the first thing you should do is contact your insurance company. This is the easiest and most immediate way to resolve any concerns you may have. It is important to remember that insurance adjusters are employed by insurance companies and are therefore not on your side. They are trained professionals whose sole job is to pay for vehicles to be repaired as cheaply as possible.

When you contact your insurance company, be sure to provide sufficient evidence to support your case. This can include documents, photographs, and any other relevant information. You may also want to request valuation and arbitration services to help resolve the disagreement. It is also a good idea to be familiar with your rights under the Fair Claims Settlement Practices Regulations, which outline the responsibilities of insurance companies when handling claims. These rights include:

• Advising you of all benefits, coverage, time limits, and other provisions of your insurance policy
• Acknowledging your claim, starting an investigation, providing forms and instructions, and offering assistance within 15 days of receiving your claim
• Accepting or denying your claim within 40 days of receiving proof of your claim
• Offering a fair settlement that includes taxes, license, and transfer fees
• Advising you whether or not they will pursue subrogation, or the recovery of damages from a third party

If you are unable to resolve the issue with your insurance company, you may need to hire a lawyer with expertise in this area. A lawyer can help you understand your rights and navigate the claims process. They can also represent you in court if necessary. Remember that you have the right to be treated fairly and honestly by your insurance company, and you should not hesitate to assert your rights if you feel you have been treated unfairly.

The insured can hire a lawyer

If an auto adjuster rules against you, it may be worth hiring a lawyer. This is especially true if you have a large or complex case, or if there is a huge difference in the amount you want and the claim amount the adjuster has quoted.

A lawyer can handle your claim from start to finish, and build a more comprehensive case. They can also help to expedite the claims process, as insurance companies rarely want to enter a lengthy and expensive litigation process.

If you decide to hire a lawyer, it is recommended that you hire a specialist. Friends, family, and colleagues can be a good place to start when seeking a referral. You can also start a search at the American Bar Association's list of state bar associations.

The insured can avoid giving a recorded statement

After a car accident, it is important to report the incident to your insurance company if you want to file a claim for injuries and damage to your vehicle. However, it is crucial to be cautious about what you say to the insurance adjuster. The adjuster works for the insurance company, and their goal is to settle your claim quickly and cheaply. They are trained to ask specific questions to elicit responses that can be used to reduce your compensation.

Recorded Statements Can Be Used Against You

The insurance company will ask for a recorded statement to gather information about the accident, determine fault, and decide on the compensation amount. While this may seem harmless, it is not advisable to agree to a recorded statement. The insurance company is not on your side, and the adjuster's job is to protect the company's profits by minimising your payout. They will ask questions designed to make you sound less sure about how the accident happened and look for any inconsistencies between your statement and other accounts. They may also ask about your medical history or whether you were taking any medication, and your responses can be used to downplay the severity of your injuries.

Recorded Statements Lack Precision

Recorded statements are less precise than written statements. It is easy to fumble a word or phrase or make a mistake when stating a crucial fact. Additionally, you may use overly casual phrases that could be taken out of context. A written statement allows you to be more precise and ensure every word and fact is correct.

You Are Not Legally Obligated to Provide a Recorded Statement

You are not legally required to agree to a recorded statement. In California, for example, there is no law mandating that you give a recorded statement to an insurance company. Remember, once you give a recorded statement, it becomes part of your claim, and you cannot change what you said.

A Lawyer Can Help You Navigate the Claims Process

Consulting with an experienced attorney before providing any statements is crucial. An attorney can help you accurately tell your side of the story, prepare a written statement, and ensure you only provide relevant information. They can also speak to the insurance company on your behalf, levelling the playing field and protecting your legal rights.

In conclusion, if you've been in a car accident, it's important to remember that you have the right to decline a recorded statement and seek legal advice first. By doing so, you can avoid potential pitfalls that could reduce your compensation and protect your interests.

Frequently asked questions