When a person is involved in an accident, the damages they suffer both financially and physically can be devastating. The law allows a victim of an accident to seek compensation for the costs incurred from the party responsible or their insurance company. The insurance companies have individuals called insurance adjusters who are competent in negotiating the claims with the victim and settling on a figure that they feel fair to both the victim and the insurance companies. Unfortunately, insurance adjusters do not work for the good of the victim but of the insurance company.
Because of this, they will try to give the least amount in damages and can result in intimidation as a way to coerce the victim to accept their offer. This makes it even more necessary for an accident victim to hire a lawyer that has experience in seeking claims from insurance companies. At the LA Personal Injury Law Firm, we have extensive experience handling insurance adjusters and know the tricks they use. We have dealt with them successfully in the past and will deal with them for you to ensure you get your rightful compensation.
Responsibilities and Roles of Insurance Adjusters
After the injuries you sustain following an accident, you will automatically file a claim for the damages from the responsible party. Hiring a lawyer is always advisable because of the legal aspect and the stresses of dealing with adjusters yourself. Once your lawyer files a claim with the insurance provider of the at-fault party, they will discuss with the insurance adjuster representing the insurance company.
Some companies may not get into the negotiations with their in-house insurance adjusters but may hire a firm of independent adjusters. Some insurance companies may not have offices in the area where the victim is and may get independent adjusters to deal with your case. These adjusters will also be working for the insurance company and will act just like the in-house adjusters of the insurance provider. After the negotiations, the figure arrived at is presented to the claims supervisor of the insurance company who may approve or reject it.
If your claim is against certain entities like the cities or state government, you are not the only one as they receive numerous claims. Such bodies have adjustment offices just for dealing with the claims. Negotiating with adjusters representing government entities is like that of private entities. When dealing with government adjusters, it may be best for your lawyer to try and settle with the adjuster instead of going to court. When the case goes to court, there may be a hesitation in awarding you generously with public money. This means dealing with the government may get you lower damages than with private adjusters.
An adjuster will typically investigate your claims or the case you present. Presenting a claim does not automatically guarantee compensation. An insurance company is a profit-making organization that will protect their company from bogus claims, which can lead to its collapse.
For this reason, the insurance adjuster will not favor you and will launch an investigation into your claim. He or she will seek to find out what happened or the circumstances of the accident. This will help them know if their client was the one at fault, you or their client shared blame with you. Insurance companies have received bogus claims, and when not careful, they will compensate for undeserving cases. An adjuster, therefore, aims at reducing the damages paid to you and reducing the expenses of the insurance provider.
As much as the insurance adjuster aims at reducing the damages paid to you, they also want to avoid a lawsuit seeking damages from you. Their aim usually is to have an out of court settlement for your claim. If you and your lawyer are not satisfied with the offer, you can decide to file a case in court seeking damages. When this gets done, the jury is mandated to establish the party responsible for the accident.
A court case is generally a risk for the insurer because the jury often awards the victim higher compensation than they may have been seeking for. The company may also suffer other costs due to the trial that may include legal fees.
Sometimes, upon receiving your claim, the adjuster may not need to discuss with you and may offer to settle by giving you a phone call. This is often with smaller claims, and if you accept the settlement amount proposed, the adjuster will send you paperwork to complete the process. It is essential to know that insurance adjusters have a limit to the claims they can take. These restrictions depend on their experience in handling various claims.
Some companies will allow insurance adjusters to settle claims ranging from $5,000 to $10,000. Those more experienced will get allowed to handle applications ranging between $10,000 and $20,000. Most adjusters will not let you know of their authority to settle a claim. However, if you decide on an amount over their approval limit, they will need to ask for approval of the claim from a more senior person.
When an Attorney Acts as an Adjuster for the Insurance Company
Sometimes, an insurance company without a local office may use a local lawyer or an in-house lawyer to act as their claims adjuster. This should not cause you to panic because they work like regular adjusters. However, it is always good to have your lawyer represent you. Government or public entities will also use their lawyers at the local offices to negotiate your claim before it ends up in court.
If you go to negotiate directly, you may feel intimidated, and the adjusters can take advantage of the situation and offer you less than what you deserve. Your lawyer will, however, not be intimidated by the situation but knows what to do in every step to ensure you are well compensated.
Deciding on the Damages to Award
An adjuster before agreeing on the settlement, he or she will take into consideration all the facts a judge would consider if the case were to go to court. For example, the bills you incurred getting treatment for your injuries, the cost of repairing your car, or the income you lost as you were recuperating. In evaluating your medical bills, the adjuster will look at how much you have already used in treatment. They will also consider if treatment is still ongoing for the injuries and if you require further treatment and the costs for the same.
Your earning capacity and the wages you have lost will also be taken into consideration because it is an awardable claim. The pain you have undergone as a result of the injuries and the suffering gets taken into account. The adjuster considers every aspect that got affected by accident before settling on a claim.
Some claims are easy to agree on, while others will be challenging. Damages that have monetary value or are quantifiable are easier to decide on, such as lost wages or medical expenses. Other costs, such as those of pain and suffering or wrongful death, can be hard to agree on.
Handling an Insurance Adjuster
Understanding how adjusters decide claims is crucial in helping you understand how to manage them. Insurance adjusters usually have two goals. The first goal is to ensure the insurance provider does not spend vast sums of money to settle claims. The other purpose is to reduce the amount of time taken settling a claim. Some of the tips that are helpful when dealing with an insurance adjuster are:
Know the Facts of the Claim
Adjusters handle many claims each month, ranging between fifty and a hundred applications. One of the aims of an adjuster, as earlier stated, is to settle a claim within the shortest amount of time possible. Insurance adjusters are also rated, and their ratings are subject to the claims they can resolve without the involvement of supervisors or the lawyers of the insurance provider.
Knowing all that is important about your claim is crucial in ensuring speedy settlement. When an adjuster knows you understand the claim you are seeking and know its worth, they will not stall your damages.
When you and your lawyer are well prepared with all the supporting documents for your claim, you may be surprised the adjuster doesn’t know as much as you do about the case. Some adjusters, especially those that deal with smaller cases, are not trained in legal or medical matters. Others may not have the time to analyze and comprehend your claim. When your lawyer has taken the time to understand the claim thoroughly, they will have an advantage over the adjusters.
Although the insurance adjuster is well knowledgeable of the insurance business and how to go about claims, the facts can be something you know more than them. Because of your presence at the accident scene, you have more facts concerning the accident than the adjuster has. You understand more than them the damages you sustained and how serious they were as well as your suffering as a result.
Always have as much evidence as you can collect before seeking a claim. With enough evidence that supports your claim, it becomes easier to discuss the settlement with the adjuster. For instance, have detailed medical reports from the doctors that treated you, including evidence from procedures carried out. These may include X-rays or CT scan images, among others. Following an accident, it is always encouraged to take pictures of the scene and the surrounding. These will also go a long way in convincing the adjuster to settle your claim. Photos of your injuries are also crucial, as well as those for the damages to your car.
The adjuster has a lot of cases that need settling within a short period. With guidance from your lawyer, you will ensure that you have all the supporting documents that will make your settlement go faster and smoother. Take time to get familiar with the process or let your lawyer explain it in detail. Do not lose focus and stay calm to maintain an upper hand.
Prepare a Solid Case
When deciding on the settlement amount, insurance adjusters put their primary focus on how strong your case is and the insurance limits. When an insurance company is paying your damages, it will not offer a higher settlement than the limits of the policy or cover. For example, if the at-fault driver has a limit of $60,000 to settle their liabilities, the insurance provider will not go beyond this amount in settlement. When your damages exceed this amount, your lawyer will pursue the responsible driver for the difference.
When your case is solid supporting the injuries you suffered in the accident, the adjuster may offer you better compensation, but within the liability limit. This makes it even more important to have a lawyer on your side.
A strong case will mean that in case you should proceed to court; you are likely to get better damages. When your case is weak, it will also be weak in court, and the damages you get will not be much. For this reason, having all your facts and as much evidence as you can gather is crucial for your compensation.
Never Disclose the Lowest Amount You Will Accept
Always keep in mind that the insurance adjuster works for the insurance provider while your lawyer works for you. Whether the insurance company is your own or you are seeking a third-party claim, an adjuster is on the side of the company. The insurance adjuster will analyze your claim and make a counteroffer that is favorable to the insurance provider.
Before contacting the company, discuss with your lawyer the value of your case and the lowest figure you can accept. However, do not disclose this to the insurance adjuster. Instead, focus on the facts that strengthen your case instead. The adjuster, while avoiding giving you favorable compensation, will look at items or factors in your case that may be challenging to explain or prove. Your lawyer, however, will know how to engage the adjuster and focus on the facts. If the adjuster’s reasons are valid, it may be advisable to adjust your claim.
Getting awarded damages will not happen very fast. The insurance adjuster will engage you with back and forth before negotiating a settlement is agreed on. Irrespective of how long the process may take and their persistence, be patient, and ensure not to compromise below what you are ready to take. You may be required to engage in various negotiations with the adjuster, making it better to let them talk with your lawyer. For instance, a standard car accident claim may take a single meeting and up to four telephone conversations.
The process can get you emotionally involved and stress you. The adjuster may try to intimidate you, but you must stay calm and patient. This can, however, get overwhelming, making it a good idea to let your lawyer handle the claims for you.
Discussions with an adjuster can get you agitated and frustrated. However, you need a satisfactory outcome requiring you to remain respectful. The adjuster is only representing the interests of the company, and you should not take what they say personally. Be fair and respectful to the adjuster, and he will return the same to you.
Avoid going to a negotiation meeting with the mentality that the adjusters are dishonest. The most important thing that will help your claim is having the facts and evidence of the claims as earlier discussed. Keep in mind that insurance adjusters act with the authority of the insurance company and the liability cover of the insured driver. In case the amount given is not fair, raise the issue respectfully. If you are still not satisfied, you can ask your lawyer to file a lawsuit to get your damages.
Never Sign Documents or Papers After the Accident
Following an accident where you sustain injuries, get in touch with a lawyer immediately after seeking medical care where necessary. You will also be required to inform your insurance provider of the accident. When you have sustained injuries, do not accept to sign papers or documents from the insurance provider, whether your insurers or that of the at-fault driver.
Additionally, do not make recorded or written statements. When the insurance company of the at-fault driver gets in touch with you, politely decline their offer but tell them that you will ask your attorney to call them. This is crucial to avoid sharing information that gets used to offer you a minimum settlement for your claim.
If you have any questions concerning compensation for damages, ask your lawyer but not the adjuster.
Tactics Used By Insurance Adjusters That You Need To Know
Insurance adjusters, although not dishonest, will try and protect the insurance company from bogus claims. When you launch your application, the adjuster or the company must investigate to establish if your claims are valid. In doing this, the insurance adjuster will use the following tactics:
Talking To Your Doctor
When you present your medical claims, you will attach the attending doctor’s report and their contact. Insurance adjusters sometimes call the doctor and ask pointed questions or close-ended ones. These kinds of questions do not allow the doctor to explain the condition of your injuries or how complex they are. This approach makes the victim seem less injured, which works to the advantage of the insurance company.
Hiring An Independent Doctor
This is often when the medical expenses claim is substantial, or the treatment required is over an extended period. The insurance company will get an independent medical examiner to evaluate your injuries. You must remember these medical examiners work for the insurance company and can give a report that favors the company and not the victim. For this reason, lawyers will advise their clients against the medical exams unless in their presence.
When the insurance company is suspicious of the injuries the victim is claiming, they will hire an investigator to follow the victim and take videos of them. When a victim in their claim says they are unable to walk without assistance, play football with their children or develop a limp, the compensation is high. For this reason, the company hopes their investigator will record the victim doing the things they claimed unable to do. If this gets found out, the insurance company will claim you attempted to defraud them. This will negatively affect your claim.
Adjusters carry out these interviews very early during the process. They get trained in asking leading questions that are supposed to give them information. They use the information shared to challenge your claim or story and avoid paying you the amount you ask. This is one of the reasons your lawyer will advise you against speaking with an adjuster directly or without your lawyer present.
Using Social Media
This is a growing trend among adjusters in finding information about a victim. Most people post things they are doing, their photos, and anything they want on their social media accounts. Unfortunately, most people share more than they need to in their social media accounts. If you have been claiming not to be able to walk without crutches and you post a photo indicating you were jogging the previous day, this is evidence that your claim is bogus. The adjuster will use this to deny your claim.
Calling You Immediately Following The Accident
Adjusters can call you just after the accident. They know that you are in shock and are confused. They are also aware that at this time, you may say something that will negatively affect your claim. When this happens, avoid them and ask them to talk to your lawyer.
An insurance adjuster may offer you a quick settlement discouraging you from the lengthy process of getting your claim approved. This may seem attractive at the beginning but highly advised against. A quick agreement is always a way to deny you your rightful compensation.
Disputing Your Claim
This is common when presenting the cost of medical treatment and of repairing your car. Do not allow this to frustrate you when you know your claim is credible. Ask them to carry on investigations to substantiate your expenses instead of being intimidated to adjust them.
Find a Personal Injury Lawyer Near Me
Road accidents are some of the worst things that can happen to a person. Following up on a claim can be frustrating while you still need to focus on healing and to get your life back on track. Instead of going through the frustrations of dealing with an insurance adjuster, let your lawyer handle them. Your lawyer knows all the legal requirements and the tricks used by insurance companies in denying claims, and will not be deterred by them. At The LA Personal Injury Law Firm, we have experience in handling insurance adjusters and ensuring you get rightfully compensated. Call us today at 310-935-0089, and let us discuss your claim with you.