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Dealing with Insurance Adjusters:

How They Work And Settle Accident Claims

dealing with insurance adjusters


The best way of dealing with insurance adjusters is to understand what they do and how they evaluate your accident claim.

An insurance adjuster is the primary person who you will evaluate and essentially determine how much your settlement claim is worth.

In this article we’ll discuss:

What exactly does your insurance adjuster do?

How does your insurance adjuster settle claims?

Knowing these 2 things will significantly increase your ability to negotiate your claims and receive more money for your injury settlements.

What Does Your Car Accident Claim Insurance Adjuster Do?

The adjuster has 3 primary tasks:

  1. Evaluate your accident claim.
  2. Determine if you should be paid.
  3. if the answer is yes, calculate your settlement.

When an accident claim is started, either through your own insurance or a third party reaching out -- a file is opened and assigned to an adjuster.

The adjuster will then typically undertake some or all of the following steps:

  • Investigate and gather the details of your accident.
  • Determine whether the insurance policy covers the loss claimed
  • Get statements (sometimes recorded) from involved parties and request official records
  • Obtain signed medical authorization forms to allow the insurance company to collect medical records
  • Decide the appropriate amount the insurance company should pay you.
  • Ensure that claims are legitimate.
  • Contact claimants’ doctors or employers for more info if the claim appears questionable.
  • Consult with legal counsel on claims when necessary.
  • Negotiate settlements with claimants or insureds
  • Authorize payments

As you can see the adjuster has a vital role in determining how your accident claim is treated and the amount of money you receive.

The next big question to answer is….

How Does the Insurance Adjuster Settle Your Accident Claim?

Here is a basic claim settlement process : [1]

Step 1: Initial Contact

The insurance adjuster contacts you. Usually this is a phone call -- but can be a letter or email a few days after an accident. The adjuster will give you a claim number as well as their contact information if you need to reach them.

The adjuster will schedule where you need to take you vehicle for repairs and discuss if you have to pay any deductibles. You’re free to use your own repair shop but there are usually certain advantages for using their recommended service.

For example, GEICO offers express repairs where the repairs are guaranteed for life and the work is done much faster than if you went to another service.

The insurance adjuster will also ask you describe the accident and ask about any injuries.

It’s important that you be cautious of things you say at this point. Most adjusters record these conversations for their own records and later reviews.

What you say now regarding fault and injuries WILL go on record and could potentially come back to hurt you. ( We’ve written a whole separate article on this exact topic : 6 Costly Mistakes to Avoid When Starting Accident Claims)

In short, it’s best NOT to admit any fault and discuss your injuries at this point.

Step 2 Evaluation Stage:

After the insurance adjuster speaks with you they will begin to gather information about your accident and any personal injuries.

They’ll be looking for specifics about the accident such as:

  • Location
  • Time
  • Conditions
  • Who was involved
  • Vehicle specifics
  • Police report info
  • Other passengers
  • What you think caused it
  • Potential mitigating factors
  • Injury information
  • Repair receipts (if your vehicle has already been worked on)
  • Where medical treatment is being sought
  • Medical bills
  • Pay stubs if time from work is being lost

They want all this information so they can properly assess your claim. Along with the car accident report and other statements this is generally how they’ll decide how to handle the claim.

Once they’ve gotten a handle on the facts, potential costs, and whether or not the claim should be paid , they will then typically move toward settling the claim.

If there are injuries involved an adjuster should wait until these are resolved before trying to settle and close the claim. How else are all your medical bills going to be covered?

An adjuster acting in good faith will be aware of this and set “diaries” into the future to check the status of medical treatment -- moving to settle/close at the appropriate time.

Step 3: Getting A Settlement Offer

After the evaluation stage, you will receive a settlement offer from the insurance adjuster. The settlement amount you receive will depend on many factors.

Some of these factors are your medical bills, length of recovery, impact on daily life etc. (Check out personal injury calculator on how your pain and suffering amounts are determined)

You should know that this settlement offer IS negotiable. If you’re not happy with the amount ; just reject is. You alway have the option to negotiate a higher settlement. You simply write a demand letter and ask for a higher claim offer.

You can also get a free consultation to increase your chances of getting a higher claim settlement

Summary

Dealing with an insurance adjuster after a car accident can be stressful.

Knowing what an adjuster does and how they settle claims can make your experience smoother and it can increase the amount of your claim.

It's also important to remember that claim adjusters represent the companies they work for. They are not advocates for you by any stretch of the imagination.

Although you have a greater chance of being treated favorably by your own insurance company (compared to the other parties insurance) -- bottom line is they are looking out for the interest of their company.

Most claim adjusters generally have no special legal or medical training, and although no one would say their job is easy, it's relatively simple.

Once you have the basics knowledge of how they work, you significantly increase your odds of getting fair compensation. Best of luck.



Sources:

[1]United States Department of Labor


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