Insurance Adjuster

If you are involved in a car accident, motorcycle accident, or other type of accident caused by another person’s negligence, you will likely try to seek compensation for the damages you incur by filing an insurance claim.

The insurance adjuster assigned to your case can significantly impact your claim.

But what is an insurance adjuster? What is their role in the process? What things should you know before interacting with one? We answer these important questions below.

What Is an Insurance Adjuster?

The U.S. Bureau of Labor Statistics describes insurance adjusters as professionals who inspect property damage to determine how much the insurance company should pay for the loss. Insurance adjusters generally work for insurance companies.

This means that they are there to represent the insurance company’s interests, not yours.

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What Do Insurance Adjusters Do?

Insurance adjusters evaluate insurance claims to determine if the insurance company must pay a claim and, if so, how much it should pay.

Typical job duties of insurance adjusters include the following:

• Investigating claims
• Interviewing claimants and witnesses
• Inspecting real and/or personal property for damage
• Coordinating repairs for damaged property
• Determining the replacement value of property
• Reviewing insurance policy language to determine if the policy covers the loss claimed
• Contacting third parties regarding the claim
• Determining whether to deny, deny in part, or approve accident claims
• Requesting information pertaining to claims, such as accident reports or medical records
• Coordinating any necessary appraisals and inspections
• Preparing reports for claims examiners to review
• Settling insurance claims
• Deciding the appropriate amount to pay on claims
• Assisting others with the resolution of the claim, such as lawyers

Each insurance company has its own unique responsibilities for the adjusters they employ, but this is a general framework for this particular position.

Things To Know When Dealing With an Insurance Adjuster

Now that you have a better understanding of the role of insurance adjusters and what they do, here are some things you should know when you are dealing with one.

The Adjuster Is Not on Your Side

Insurance companies often advertise their services with heartwarming messages about how they’ll be there for you when you need them. However, insurance claims are often adversarial in nature because of your opposing interests.

The insurance adjuster works for the insurance company, which wants to minimize your claim value as much as possible to protect its profit margin. You want to be compensated the maximum amount possible for the damages you’ve suffered, like medical expenses, lost wages, property damage, and pain and suffering.

The process can be adversarial even when you’re dealing with your own insurance company, which can happen if you’re making a claim under your comprehensive or uninsured motorist coverage. But if you’re dealing with someone else’s insurance company, it may be even more combative. The claims adjuster has no incentive to help you recover as much money as possible. In fact, some insurance companies provide financial incentives or other perks for adjusters who minimize the value of claims.

So, while the adjuster might seem friendly and concerned about your health, keep this principle in mind: The adjuster is not on your side.

You Must Be Careful What You Say (And Do)

Keeping the point above in mind, you must always be careful what you say.

Insurance adjusters have been known to use various tactics to try to minimize claims, like:

• Asking the claimant how they are, getting the response “Fine,” and then using this statement to claim you were not injured because you were “fine”
• Saying they need a recorded statement to process your claim so they can use any information you give or inconsistencies in your statement to deny or minimize the value of your claim
• Asking accident victims who were under the influence of pain medication about their injuries, getting wrong information while they were in an altered state, and trying to hold you to this statement for their benefit

Some insurance adjusters have gone so far as to try to “friend” or otherwise follow claimants on social media to find any information they can to use against claimants. Therefore, you also need to be careful what you say and post on social media.

Additionally, it’s not uncommon for insurance companies to hire private investigators to follow you and try to capture you doing activities that require exertion to try to refute your claim.

The Adjuster Wants To Give You as Little Money as Possible

As stated previously, insurance adjusters work for insurance companies and are incentivized to minimize the value of claims. Insurance companies profit more when they bring in much more money in premiums than they pay out in claims.

Because of this, they may try tactics such as:

• Blaming you – Texas uses a modified comparative fault approach. You can’t recover compensation if you are found more than 50% at fault for the accident. Even if you were less at fault than this, whatever damages you can recover are reduced by your degree of fault. This makes blaming you a financially efficient way to minimize the claim value.
• Disputing medical care – Insurance adjusters love to claim that the medical treatments you received were not necessary or the costs were excessive. Insurance companies may even outsource this responsibility to a third party to conduct an audit, which may result in reports that medical expenses should have been lower.
• Recommending repair shops or doctors – Some insurance companies may have business relationships with repair shops or medical facilities that give them a discount for multiple clients. These providers may feel more loyalty to the insurance company and may want to continue this business. They may do so by not providing all of the services you need.

Having an experienced personal injury lawyer on your side can help you fight against these tactics that are designed to prevent you from receiving the compensation you need. Learn more about when you should hire a lawyer.

Don’t Rush the Process

Being involved in an accident can be a hassle. You have to go to the doctor, follow restrictions, take time off work, keep up with paperwork, etc. All the while, you’re losing money while you’re off work. These factors may encourage you to accept whatever money the insurance company offers.

Insurance adjusters know this. It’s why they sometimes delay claims or make form rejections. They expect you not to fight back. Don’t fall for this trap. Instead, focus on your health, follow your doctor’s orders, and reach maximum medical improvement. Let your lawyer handle the insurance company and keep your claim on track.

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You Probably Need an Austin Personal Injury Lawyer to Help You Negotiate With an Insurance Adjuster

Some insurance adjusters go so far as to say you don’t need a lawyer. However, when someone tells you that you don’t need representation, that’s usually a sign you do. Additionally, the more serious your injury, the greater the likelihood that you will need a lawyer who can accurately estimate the value of your claim and seek fair compensation.

FVF Law provides a free, no-obligation consultation to all potential personal injury clients. We can discuss how we can help during a free consultation. Contact us today at (512) 982-9328 to learn more.