Alyssa Lane
When you file an insurance claim, you will likely be dealing with an insurance adjuster from the insurance company who will review what happened and estimate the claims payment. Adjusters have two main goals: to minimise the amount of compensation delivered by the insurance company and to settle claims as quickly as possible. While adjusters can be difficult to deal with, there are strategies you can use to ensure you receive proper compensation for your damages and injuries. It is important to remember that anything you say can be used against you and that adjusters will try to obtain your medical records to weaken your case.
| Characteristics | Values |
|---|---|
| Role | Examine personal injury or property damage claims to determine how much an insurance company should pay the claimant for their loss |
| Who they work for | The insurance company paying the claim |
| What they do | Review what happened, estimate the claims payment, inspect the damages, look at police reports, talk to witnesses, ask for more information when reviewing a claim |
| What they might do | Use your medical records against you, discourage you from seeking legal advice, avoid your phone calls |
| What not to do | Admit fault, say "sorry", exaggerate injuries, speculate about the accident, give blanket records release |
| What to do if you're unhappy | Tell the insurance company why, ask to be put in touch with the adjuster's supervisor |
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What You'll Learn
An adjuster's primary goal is to minimise compensation
An insurance adjuster is a skilled professional appointed by insurance companies to investigate and assess insurance claims, particularly those that are complex or large in nature. They are the insurance company's representative and work to protect the company's interests.
While an adjuster's role is to act as an unbiased intermediary, ensuring a fair and accurate assessment of claims, their primary allegiance is to the insurance company. They will review what happened and estimate the claims payment. This may involve inspecting the damage, looking at police reports, talking to witnesses, and asking for more information.
It is important to note that an adjuster is not the same as a loss assessor. A loss assessor works for the policyholder and helps to maximise the claim settlement. They advocate for the policyholder's interests, whereas an adjuster works for the insurance company and aims to minimise the payout.
To ensure you receive proper compensation, it is crucial to be prepared when dealing with adjusters. Understand your rights, gather documents, and be strategic in your approach. Remember, you have the right to reject their initial offer and request a settlement you feel is fair.
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Adjusters use dirty tricks to avoid liability
An insurance adjuster works for the insurance company, not the claimant. Their primary goal is to minimise the amount of compensation delivered by the insurance company, and their secondary goal is to settle claims as quickly as possible. While adjusters are supposed to examine personal injury or property damage claims to determine how much an insurance company should pay the claimant for their loss, they will also employ dirty tricks to lower your potential settlement.
One such trick is asking for a recorded statement. This may seem innocuous, but there are many ways for insurance adjusters to sneak in questions with answers that can be taken out of context and hurt your claim. For example, a simple "I'm fine" in response to "How are you feeling today?" can make your injuries appear much less serious. It is much more difficult to avoid mistakes in verbal communication than in written communication.
Another tactic is to avoid your phone calls, hoping that the claimant will "go away" or forget about their claim. They may also try to pressure you into settling for less than you deserve by pushing for a settlement before you've had time to see a doctor or consult with an attorney. They might also ask you a series of loaded questions to get you to admit fault, even if partial, which could result in your claim being drastically reduced in value or denied outright.
Adjusters may also try to look at your medical records directly. If you give them access, they can go through your entire medical history and look for information to weaken your case, such as a pre-existing condition or prior injury.
To avoid falling prey to these tactics, it is recommended to hire a personal injury attorney who can help assess damages, collect evidence, negotiate with the insurance company, and represent you in court.
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Never threaten or harass an adjuster
When you file an insurance claim, you will most likely be dealing with an insurance adjuster. They work for the insurance company paying the claim and will review what happened and estimate the claims payment. While many insurance adjusters work hard to review all relevant details and arrive at a fair conclusion, others may use unethical tactics. They may try to offer a lowball payment quickly, threaten to take it off the table soon, or intimidate you.
However, you should never threaten or harass an insurance adjuster. You should also refrain from harassing behaviour or verbally abusive comments, as your words could be used against you in the future. Even if you are frustrated with the process or the adjuster's tactics, threatening or harassing behaviour will not help your case. Instead, it could be used as a reason to deny or reduce your claim.
It is important to remember that the adjuster works for the insurance company and their primary goal is to minimise the amount of compensation delivered. They will seek to settle claims as quickly as possible and may use various tactics to irritate claimants and increase the likelihood they will accept a reduced settlement. For example, they may avoid your phone calls or issue a lowball offer.
To protect yourself, it is recommended to consult with an experienced lawyer who can help you understand the adjuster's role and how they operate. With this knowledge, you can develop a strategic plan and ensure you receive proper compensation for your damages and injuries. Remember, you have the right to reject their initial offer and request a settlement that you feel is fair.
While it is important to be cautious when dealing with an insurance adjuster, you can take steps to safeguard yourself without resorting to threats or harassment. Understanding their tactics and your rights will help you navigate the claims process more effectively and protect your interests.
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Understand an adjuster's role and your options
An insurance adjuster, also referred to as a claims adjuster, typically represents the insurance company and works to determine whether a party claiming a loss is owed payment and, if so, how much. They are often the first person from the insurer that the insured meets after suffering a loss.
The role of the adjuster is to investigate insurance claims to determine the extent of the insurer's liability. They do this by inspecting damages, looking at police reports, talking to witnesses, and asking for more information when reviewing a claim. They may also inspect damaged property or vehicles, or verify medical records and patient information in cases of bodily injury claims. Ultimately, adjusters ensure fair resolutions, serving as intermediaries between policyholders and insurance companies.
Adjusters are typically employed by a single insurance company, but some work as independent contractors who represent claimants. They may also work as consultants, servicing multiple insurance companies, and are often called upon following large natural disasters.
When you file an insurance claim, understanding the adjuster's role and your options can help the claims process go more smoothly. You should try to be there when the adjuster inspects any damage to ensure nothing is missed. It is also important to know that you do not have to answer questions you are unsure about. If you do not know exactly what happened or cannot give a definitive answer, it is perfectly fine to say so.
If you disagree with the adjuster's estimate, you can tell the insurance company why and they may adjust the offer. You have the right to reject their offer and request a settlement you feel is fair.
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Consult an attorney before talking to an adjuster
An insurance adjuster works for the insurance company that is paying the claim. They will review what happened and estimate the claims payment. They may inspect the damage, look at police reports, talk to witnesses, or ask for more information when reviewing your claim.
When an insurance adjuster calls, they will often imply that you have no choice but to talk to them. However, while you are required to cooperate with your insurer, that does not mean you are not allowed to defer to legal counsel immediately after a crash. You can ask to call them back and inform them that you are busy but happy to speak with them shortly. Be sure to obtain all the adjuster's pertinent information, including their name, insurance company, phone number, email address, and fax number.
It is recommended to consult with a personal injury attorney before accepting any settlement offer. Seasoned injury attorneys have ample experience negotiating with insurance adjusters over the value of the claim. They can help you to avoid common pitfalls, such as saying something that could be taken as an admission of fault, or sharing too much information about your medical history.
If you decide to hire an attorney, they can take over all communication with the insurance adjuster and ensure your rights are protected. They will be able to guide you through the claims process and help you secure the compensation you deserve.
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Frequently asked questions
An insurance adjuster works for the insurance company that is paying the claim. They will review what happened and estimate the claims payment. They may also inspect the damages, look at police reports, and talk to witnesses.
You should not admit fault or apologise, as this can be taken as an indication that you feel responsible for the accident. You should also not let an insurance company look at your medical records directly, as they can argue that your medical history suggests pre-existing conditions or that your injuries are unrelated to your accident.
Insurance adjusters may try to avoid your phone calls or not respond to your settlement offer quickly, hoping that you will forget about your claim or accept a lowball offer. They may also discourage you from seeking legal advice, as they know that involving an attorney in the claim will likely result in a much higher payout.
It is recommended to wait a day or two before communicating with the insurance adjuster to reflect on how you approached the adjuster. You can then raise your issues and explain how you were made to feel. If you continue to have difficulties, you can ask to be put in touch with their supervisor.
