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How an Adjuster Evaluates Bodily Injury Claims
February 23, 2017

How an Adjuster Evaluates Bodily Injury Claims

by Jim Adler
Most insurance companies tend to deny, delay and underpay their injured customers in order to keep more money for themselves, including from those involved in a severe car accident. Photo by vadimguzhva (iStock by Getty Images)

Ever wonder how an insurance adjuster evaluates your bodily injury claim? You should know how that’s done, since it can greatly impact the payments you receive for your injury — as can your choice of a personal injury lawyer to help get the job done.

Knowledgeable and experienced injury lawyers at Jim Adler & Associates deal with insurance adjusters daily and can represent you. That includes assessing and challenging an insurance adjuster’s evaluation of your claim.

Insurance Companies Don’t Want to Pay You

Insurance companies tout themselves in ads as caring and friendly, but in truth, they exist to make money, not to pay all clients fully and readily whenever they make a claim. Indeed, insurance companies tend to deny, delay and underpay their customers in order to keep more money for themselves. Once you understand that, you realize that, in an insurance claim for an injury, you and your insurer are in an adversarial relationship.

Thus, an adjuster may try to downplay or minimize your injuries, or even construe them as being unrelated to a car crash or other accident. But while adjusters want to reduce payments as much as possible, they also want to avoid what could be an even more costly lawsuit. That’s why most injury claims are settled out of court, with no need for a trial.

Keep in mind that the adjuster doesn’t work for you, but rather is paid by the insurance company, for which minimizing your claim is in its best interests. Accordingly, the adjuster may determine how much the insurer should be willing to pay (the maximum settlement) and then offer as little as half of that, to provide negotiating room.

In evaluating your auto accident injury claim, an adjuster must determine several things, including liability. Who was at fault in the crash? It was either you, or another driver, or a shared fault. When the other driver was at fault, your own insurer adjuster will insist that the other driver’s insurance pay on the claim.

If the other driver lacks auto liability insurance, you still can make a claim against your own insurance company, provided you have uninsured motorist coverage. If you don’t, your insurance won’t pay.

Adjusters Evaluate Economic, Non-Economic Losses

An adjuster also must evaluate your damages, in terms of actual economic losses (medical costs, lost wages) and non-economic losses (pain, suffering and emotional distress).

To calculate the latter, an adjuster applies a formula particular to that company. This may mean paying a ratio of the economic costs to cover non-economic losses of pain and suffering.

In evaluating your injury claim, an insurance adjuster also will consider the limits of the insurance policy against which the claim is made, and the strength of your case as a plaintiff in a possible injury lawsuit. If you have a strong case against the bad driver, you are more likely to receive a fair settlement.

Get a Car Accident Lawyer

To achieve success with an insurance adjuster, we advise to engage with an experienced injury attorney. Such attorneys understand how adjusters process your claim and can counter with arguments or strategies to boost the settlement in your favor.

Contact us today for a free legal review of your case.

About Jim Adler

Jim Adler, also known as The Texas Hammer®, is an American trial attorney and owner of Jim Adler & Associates. He has been practicing law in Texas in the area of personal injury for 54 years.

Jim Adler graduated from the University of Texas School of Law where he received his Juris Doctor degree (J.D.) in 1967.

Jim Adler is a member of the State Bar of Texas, American Bar Association (ABA) and American Trial Lawyers Association. He is licensed to practice in the United States Court of Appeals for the Fifth Circuit and U.S. District Courts of Texas. Read More

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