Written by: Susan Melony
If you file an insurance claim because you hurt yourself, you might have to deal with an insurance adjuster. Some people have never heard of this profession before. Even if you know about the title, perhaps you don’t understand an insurance adjuster’s job.
We will talk about that right now. You’ll definitely want to have your wits about you when you deal with this person.
What Precisely Is an Insurance Adjuster?
Insurance adjusters work for insurance companies. If you hurt yourself and file a claim, that probably means you hold someone else accountable. Maybe that’s an individual or a company.
The insurance adjuster investigates the claim you made. You should understand that insurance adjusters are not on your side. They work for the insurance company and not for you.
You might have seen insurance company commercials where they talk about being on your side, but that’s not generally the case. They’re for-profit entities, which means they want to pay out as few claims as possible. If they pay out fewer claims and less money, they make more profit.
Those at the top benefit most. They make higher salaries and also potentially collect other financial benefits. The insurance adjusters work to keep as much money as possible for the insurance companies, which often means trying to invalidate claims or pay you less than you should rightfully get.
Claim Settlement Offers
When the insurance adjuster goes to work on your case, they’ll look at what you say happened, and then they will try to determine whether they agree it’s a valid claim. They will probably want to interview you. They may try to trip you up. They might want you to say something during the interview that contradicts what you said happened when you first filed the claim.
They might also look at doctor’s reports to see if an injury you claim happened matches what the doctor says. They might look at police reports or other incident reports. They will look for camera footage of the incident if any exists. They might look for cell phone footage, traffic camera footage, store security camera footage, etc.
After the insurance adjuster reviews all the details they can find, they will probably offer you a settlement. That amount might not be as much as you think you should get. If you feel like the amount is not commensurate to what happened, you might have to hire an attorney and sue the insurance company. The matter can play out in court if necessary.
Additional Settlement Offers
You can usually look at an insurance policy to see how much money you should get for a particular injury. However, you may feel like the initial amount the insurance adjuster offers you is not enough because you also want to factor in emotional pain and suffering.
Those intangibles might force you into a courtroom if you feel like the insurance adjuster and the insurance company want to short-change you. However, if the insurance company sees that you’re getting litigious, they might come back with a second, higher offer. If that number works for you, you might still avoid a long, drawn-out courtroom battle.
Keep in mind that if you have to duke it out with an insurance company in court, that can take a long time, and the conclusion might not work out in your favor. You will have to pay a lawyer part of any money you receive. Because of this, you might choose to take a smaller amount than you feel you deserve, but you’ll spare yourself a long, potentially exhausting legal quagmire.
Independent Adjuster Firms
You might also have a situation where the insurance company hires what they call an independent adjuster. That adjuster works as an arbiter, but their job remains the same. They investigate your claim and make a monetary recommendation if they feel the evidence warrants it.
You would think that you can trust an independent adjuster firm more, but they’re still actively working against you in most instances. That’s why it’s not a bad idea to at least consider legal representation, even if you feel like you have a pretty simple claim.
Don’t Let Casual Conversation Fool You
You should also know that you don’t have to let an insurance adjuster interview you if you don’t want to do that. You can submit a written report detailing what you say happened to you. You don’t have to submit to a verbal examination where the adjuster might try to trip you up.
You might go into that conversation thinking the adjuster seems very nice and accommodating. That’s a ruse more time than not. Insurance adjusters often try to put on a friendly act because they want to get you talking, hoping that you will say something that throws your claim into question.
You can get a lawyer to speak on your behalf, and you can ask them about what questions you should answer if you submit to a verbal interview with the insurance adjuster. It’s likely your attorney will simply tell you to forego the interview, though.
If you talk to an insurance company on the phone, regardless of whether you’re speaking to an adjuster or someone else, you should know they record those conversations most of the time. They want to get you to say something indicating you’re accepting some responsibility for your injury.
If you speak to an insurance adjuster, either on the phone or in person, don’t estimate or guess about anything you don’t know. For instance, don’t give them an estimate of how much money it will cost to pay your medical bills. Don’t estimate how much work you’ll miss because of the injury.
If you contact the right lawyer and get them to represent you, you can deal with insurance adjusters and feel a lot more confident about it. Remember that they’re not on your side, and they’re actively working to try and deny you as much money as they can.
"Susan is an avid writer, traveler, and overall enthusiast."