An insurance adjuster works for an insurance company, either as an employee or as an independent contractor. There are also public adjusters who you can hire to represent your interests and help you navigate the claims process. If you have a claim against your own insurance policy or a third-party claim against someone else’s liability insurance policy, you will deal with an insurance adjuster.
What Do Insurance Adjusters Do?
Insurance adjusters perform the following functions:
- Acknowledge receipt of your claim. They will probably send you a letter confirming that they received your claim.
- Review the relevant insurance policy. They will determine (i) whether the policy covers your claim and (ii) whether coverage limits apply to your claim.
- Investigate your claim. The adjuster will want to know the date, time, location, and parties. They might interview witnesses, visit the accident scene, and review the police report.
- Determine your medical condition. They will collect medical records, and they might discuss your case with medical experts.
- Evaluate the amount of your damages, including non-economic damages such as pain and suffering. Often (but not always), they will use a software program to calculate your damages. These software programs, as you might guess, tend to produce ‘lowball’ estimates of your claim’s value.
- Document your claim. The insurance adjuster will keep records of all correspondence, documents, and actions related to your claim.
- Negotiate a settlement with you or your attorney. This may or may not include alternative dispute resolution methods such as mediation or arbitration.
- Issue payment (probably to your lawyer).
- Manage litigation, if you file a lawsuit. This means working with the insurance company’s lawyers to defend the company’s interests in court.
- Close your claim and archive any documentation.
These activities are not set in stone. An insurance adjuster’s duties vary based on the policies of the insurance company.
The Insurance Adjuster is Not On Your Side
You need not treat an insurance adjuster as your enemy, but you do need to remember that your interests are absolutely adverse to each other. If the adjuster approves a claim of $10,000, for example, it must subtract $10,000 from its own bottom line. The insurance company’s loss is your gain, and the insurance company’s gain is your loss.
Negotiating With the Insurance Adjuster
Negotiating with an insurance adjuster without legal representation puts you at a very serious disadvantage since insurance adjusters negotiate insurance claims for a living. Even if you are a skilled negotiator, you probably won’t understand the nuances of the law and policy language, and the insurance adjuster will. Your best option is to get an attorney and let them negotiate for you.
Damages
For a personal injury claim, you can seek the following types of damages:
- Economic damages: Just about any loss that’s easy to count–lost wages, medical bills, the cost of child care while you are in the hospital, etc.
- Non-economic damages: Intangible losses such as pain and suffering, emotional distress, etc. This is where an insurance adjuster is most likely to underestimate your losses.
- Punitive damages: Punitive damages are an extra amount that a court occasionally adds to economic and non-economic damages to punish the defendant for outrageous behavior. Insurance adjusters are reluctant to even discuss punitive damages.
It’s best to start off by asking for more than what you think you deserve to give yourself some room to bargain.
Tricks That Some Insurance Adjusters Like to Use
Here are some strategies that insurance adjusters like to use to get you to abandon your claim or accept a lower settlement value:
- Demanding excessive documentation
- “Lowballing” (issuing ridiculously low offers)
- Deliberately misinterpreting policy language to exclude your claim
- Delaying the claims process, especially if the statute of limitations deadline is approaching
- Blaming you for your own injuries, or at least trying to assign partial blame
- Tricking you into saying something they can use against you
- Spying on your social media accounts (beware of new friend requests while your claim is pending)
There are hundreds of other ways that an insurance adjuster might use to minimize the value of your claim.
Taking Your Claim to Court
There are several reasons why you might want to file a lawsuit even though you still plan to settle your claim, including:
- To beat Missouri’s five-year statute of limitations deadline to file a lawsuit
- To gather evidence using the powerful pretrial discovery process
- To show the insurance adjuster you mean business
You can settle your claim any time before the final verdict, even while the jury is deliberating your claim.
Contact a St. Louis Personal Injury Lawyer to Resolve a Sizable Insurance Claim
A St. Louis personal injury lawyer can help you resolve your insurance claim in more ways than you might imagine. Roach Law Car Accident Lawyers is here to help you navigate this difficult time. Contact us today at (636) 519-0085 to schedule a free consultation.
