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Dealing With Insurance Adjusters
July 29, 2015

Dealing With Insurance Adjusters

Persons injured in car wrecks or other traffic accidents often must deal with insurance adjusters when making a claim to pay for their injury costs. When doing so, you must recognize that the adjuster works for a profit-driven insurance company, not for you.

For their employer’s benefit, insurance adjusters exercise powers against claimants, such as denying, delaying or underpaying a claim. Injured persons are advised to engage an experienced injury attorney or car accident lawyer to handle their side of the claim.

Adjusters Control Checkbooks

One power of an insurance adjuster during settlement negotiations is control of the checkbook by which claimants are paid. Experienced adjusters will attempt to take advantage of this.

A means of doing so is patience. An experienced adjuster deals with the process daily, while you may be making a claim for the first and only time. The adjuster may try to delay or stall the process in order to determine if you will seriously pursue your claim.

From the adjuster’s viewpoint, why rush? The insurance company wants to keep its money, and adjusters are willing to wait months or years to resolve a claim in order to pay out less.

For the claimant who has bills to pay, the clock is running. For the adjuster and the fat-cat insurance companies, time is not an overriding factor.

Adjusters Seek Leverage

In other ways, adjusters seek leverage over claimants. After all, their employer is more apt to reward them for delaying or underpaying claims than for promptly paying full value.

One approach is to offer a quick settlement of a claim at a “low-ball” amount. This way, the claimant may accept less money than he or she deserves simply in order to get some level of payment quickly.

Adjusters also may offer to pay a part of a claim but not other parts. Again, this tactic is used for leverage or bargaining power in the negotiating process.

When claims aren’t settled by fast low-ball tactics but instead are drawn out, that can serve the adjuster, too. Claimants likely may face increasing pressure to resolve a claim in order to pay bills, while the adjuster can afford to wait and haggle.

Even so, adjusters are judged in part by how quickly they can settle claims and get them off the books. So they sometimes want to move faster than they may indicate to you.

Who Are Insurance Adjusters?

Insurance adjusters are known as claims representatives, claims specialists or independent claims analysts.

But all these fancy names boil down to the same thing: They are the people who try to negotiate a claim settlement which benefits their employer — the insurance company – more than the claimant.

Though paid by insurers, some adjusters are not employed by insurance companies but instead are independent contractors. These adjusters may be engaged by insurance companies which lack a claims office in a certain area. This will not help your case, since such adjusters have a lower “ceiling” to make a financial offer than the home office, which has the most authority to make the highest offer.

Indeed, independent adjusters operate the same as in-house adjusters with that one exception: They have less authority in settling a claim, which means your settlement amount might have to be approved at the insurer’s home office.

Adjusters may not be required to have special training or expertise beyond a general knowledge of the claims business. Beyond big cases, insurance adjusters may have no special medical or legal training and are unlikely to grasp nuances of your claim as well as you do.

But some adjusters are attorneys who may be more apt to play “hard ball” with claimants. Injured persons then may gain a better chance of being paid what they deserve if they engage their own injury lawyer to negotiate on their behalf.

An experienced injury lawyer is likely to know the range your claim is worth and can assert that knowledge in negotiations. An injury attorney also relieves you of the stress of dealing with the insurance adjuster.

An Injury Lawsuit Is Your Option

Whatever their name or origin, adjusters do not have all the power in negotiations. Your claim may have a clear legal basis with clear liability.

You also have the option of engaging your own attorney to handle negotiations with an adjuster. This can show the adjuster that you mean business and are willing to file an injury lawsuit if negotiations are unsuccessful. The adjuster has no motivation to want a lawsuit, which poses the risk of a high jury verdict and could cost the insurance company even more in legal fees.

To avoid a lawsuit in a stalled negotiation, adjusters may try to get the lowest settlement possible by offering 25% to 50% less than the maximum amount they are willing or are authorized to pay. This gives them “wiggle room” to adjust the payment without reaching the maximum during negotiations.

An experienced injury lawyer can counter such strategies and try to get you the maximum amount you are owed.

How Payments Are Computed

In terms of how payments are computed, adjusters will review the same things juries would consider in reaching an amount for paying damages. These include actual costs such as medical bills and projected medical bills; actual costs in terms of lost income or salary; and damages for pain, suffering and emotional distress, which are harder to calculate.

Other factors in computing payments include the strength of the plaintiff’s case, as well as insurance policy limits. An adjuster never will offer more than the maximum amount provided by a liability policy.

Whose Insurance Gets the Claim?

As for whose insurance company gets the claim, the adjuster works for the insurance company of the person responsible for your injury. Texas drivers are required by law to purchase auto liability insurance, and when they hurt others, claims are made against that policy.

The only time you’d be likely to seek payments from your own insurer for another driver’s mistakes is after a hit-and-run collision in which the driver isn’t known, or if the driver lacked auto liability insurance. But even then, you’d have to have purchased uninsured motorist coverage to be able to make a claim from your own insurance company.

Establishing Your Payment

Establishing the amount of your payment involves the many factors listed here, including evidence in your case. An injury lawyer can help you to amass and assert such evidence to emphasize the other driver’s negligence and your own injuries.

Contact Jim Adler & Associates for a free review of your case. To receive a fair settlement, you may want to engage a knowledgeable injury lawyer to handle your negotiations with an insurance adjuster.

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