The Silent Adjuster: Understanding An Insurance Adjuster's Inaction And Its Impact

There are many reasons why an insurance adjuster might not be responding to your calls or messages. It could be due to the high volume of claims they are dealing with, an incentive to slow down the process, or because they are not legally bound to respond within a certain timeframe. It is important to remain patient and persistent in your attempts to contact them, providing clear and concise details of your claim. If you are unable to get a response, you may need to contact a supervisor or seek legal advice from a personal injury attorney.

The insurance company is trying to reduce costs and increase profits

Insurance companies are businesses that aim to generate profits for their stakeholders. While profit-making is not inherently negative, the issue arises when the interests of the insurer are misaligned with those of the claimant. In such cases, the insurance adjuster becomes an adversary, working to minimize payouts and maximize profits for the insurance company.

One common tactic employed by insurance adjusters is to delay or deny claims. By prolonging the claims process, they aim to increase pressure on claimants, who are often facing medical bills, vehicle repairs, and financial constraints due to loss of earnings. This desperation may lead claimants to accept lower settlement offers out of desperation, resulting in higher profits for the insurance company.

Additionally, insurance adjusters may be juggling numerous claims, making it challenging to respond promptly to each one. They may also be incentivized to delay responses as they are not legally bound by fixed timelines for responding to claims. This allows them to slow down the process and reduce the number of claims paid out.

Furthermore, insurance companies have a vested interest in settling claims before the full extent of injuries or damages is known. By keeping claimants waiting, they can influence claimants to settle for lower amounts. This tactic is particularly prevalent in no-fault states, where the insurance company may be responsible for covering damages regardless.

To improve profitability, insurance companies may also employ strategies such as diversifying their risk, investing premiums in interest-generating assets, and minimizing administrative costs. They may also increase sales through networking, partnerships, and effective marketing strategies.

The adjuster is overloaded with claims

Adjusters are often overloaded with claims, which can lead to stress and burnout, and negatively impact an organisation's bottom line. This is due to a variety of factors, including an overwhelming number of claims, an abundance of administrative tasks, and a lack of access to efficient tools and technology.

One reason for adjusters being overloaded with claims is the rising severity of bodily injury claims, which leads to increased complexity. Medical inflation is expected to surge, resulting in more complex claims that take adjusters longer to manage effectively. Adjusters are also often assigned a wide variety of claim types, from low-dollar unrepresented claims to catastrophic cases, making it challenging for them to make quick and easy decisions and recommendations.

Additionally, adjusters are often overloaded with administrative tasks that could be automated or outsourced. These non-core tasks, such as keying bills, negotiating payments, and managing paperwork, take away from their time to focus on their core skills and duties, further adding to their workload.

Outdated tools and technology, or a lack of solutions to support third-party claim evaluations, can also contribute to the problem. Manual processes, such as gathering facts and preparing negotiation points, can be time-consuming and inefficient, leading to longer claim open times.

The combination of these factors can result in adjusters feeling overworked and stressed, which may impact their ability to respond promptly to claimants.

They are not legally bound to respond within a certain timeframe

It is important to understand that insurance adjusters are often handling a large number of claims and may be overwhelmed with work. They may also be facing unrealistic targets and be overworked, which can result in delayed responses. However, it is essential to recognise that insurance adjusters are not legally bound to respond within a specific timeframe. This means that their delaying tactics are not technically illegal, and they are not breaking any laws by postponing or even rejecting your claim.

The lack of legal obligation to respond promptly can be frustrating for claimants, especially when dealing with the stress of an accident or injury. It is crucial to maintain a calm and assertive approach when dealing with an unresponsive insurance adjuster. Start by documenting your attempts to contact them, including dates and times, and then reach out directly to express your concerns and request an update. If this does not yield a response, consider contacting their supervisor or the insurance company's customer service line to escalate the matter.

In some cases, you may need to involve a personal injury attorney to negotiate on your behalf or take legal action if the adjuster's behaviour is particularly unreasonable. It is worth noting that insurance companies are profit-driven, and their interests may not align with yours. As a result, claimants often receive lower settlement amounts than they may deserve. Consulting with an attorney can help ensure you receive fair compensation and navigate the complex process of filing a claim.

While insurance adjusters have no legal obligation to respond within a set timeframe, it is still essential to be persistent and proactive in your communication with them. Keeping your expectations reasonable and being clear and concise in your messages can also help improve the responsiveness of the insurance adjuster handling your claim.

Your claim may have been reassigned or fallen through the cracks

If you're facing radio silence from your insurance adjuster, it's important to remember that you're not alone. Many people have been in your shoes, wondering why their adjuster isn't responding. One possible explanation is that your claim may have been reassigned or fallen through the cracks. Here's what you can do in this situation:

Understanding the Reasons for Delays

First, it's essential to recognize that insurance adjusters often have a heavy workload and are handling multiple claims simultaneously. They may be overworked and understaffed, especially during busy periods like holidays. Additionally, they might be waiting on information from other parties involved in the claim, such as police reports or statements from the other driver. While these delays can be frustrating, understanding the context can help you approach the situation more effectively.

Taking Action

• Contact the Adjuster Directly: Start by reaching out to the adjuster and providing them with specific dates and times of your previous attempts to get in touch. Express your concern about the lack of communication and request an update on your claim.
• Call the Insurance Company's Customer Service Line: If you still don't receive a response from the adjuster, contact the insurance company's general customer service line. Explain the situation and ask to speak to a supervisor or manager. They may be able to reassign your claim or push the original adjuster to take action.
• Provide Detailed Information: When communicating with the insurance company, be clear and concise about your claim. Provide all the necessary details, such as claim numbers, dates of the incident, and any relevant documentation. This will help the insurance company understand your situation better and expedite the process.
• Consider Hiring a Lawyer: If you continue to face delays and lack of response, consider seeking legal assistance. A personal injury lawyer can take over the handling of your claim, saving you from further stress. They can also negotiate on your behalf and often obtain higher compensation amounts than you might achieve on your own.
• Stay Persistent: While it's important to be reasonable and patient, don't hesitate to be persistent in your efforts to get a response. Follow up on your communications at appropriate intervals, and don't be afraid to assertively seek the information you need regarding your claim.

Remember, it's your right to receive timely updates and fair treatment from your insurance company. If you feel that your claim has been neglected or mishandled, don't hesitate to take the necessary steps to resolve the issue and get the response you deserve.

You have not been persistent enough in your attempts to contact them

If your insurance adjuster is not responding, it could be because you have not been persistent enough in your attempts to contact them. It is important to remember that insurance adjusters are often overworked and have many claims to handle, so it is crucial to be proactive in your communication with them. Here are some tips to improve your chances of getting a response:

• Keep a record of your attempts to contact the adjuster, including dates and times. This will not only help you keep track of your efforts but also demonstrate your persistence if you need to escalate the issue.
• Be polite and friendly in your initial contacts, as there may be legitimate reasons for the lack of response. However, if you continue to get out-of-office messages or unreturned emails, it may be a sign that your claim is being mishandled or ignored.
• Follow up with the adjuster regularly, sending friendly reminders and highlighting the dates and times of your previous attempts to reach them.
• If you still don't hear back, contact the general claims department at your insurance company. They can help you get in touch with the adjuster or inform you if they are no longer with the company or handling your case.
• If your issue still hasn't been resolved, reach out to the adjuster's manager or supervisor. They may be able to reassign your claim or push the original adjuster to respond.
• As a last resort, consider contacting a lawyer or the Department of Insurance for assistance. They can help ensure that your claim is being handled appropriately and that your rights are protected.

Remember, persistence is key when dealing with insurance adjusters. Don't be afraid to be assertive and advocate for yourself. At the same time, try to remain calm and focused, as acting out of anger or frustration may harm your claim.

Frequently asked questions