Dealing with a Claims Adjuster



What Do Claims Adjusters Do?

When you are in a car accident for which you were not at fault, you will likely have to explore negotiating your claim with the insurance company of the person who caused the accident. Insurance claim adjusters go through extensive training and deal with claims daily; therefore, it is important for you to know your rights and understand the process before you begin seeking compensation for your injuries.

In general, an adjuster’s primary duties are to investigate the accident, determine the amount of compensation for each claim, and negotiate and settle the claim, if possible. While adjusters are usually employees of the insurance company, it is not uncommon for the adjuster to be contracted out to a third party. Generally, this depends on the size of the insurance company and the circumstances surrounding your claim. Knowing the relationship between the insurance provider and the claims adjuster may be helpful in negotiating your recovery amount, as an employee may have a greater incentive to negotiate for the lowest amount possible.

Claims adjusters are transferred your claim information within moments of the claim being filed. Once the adjuster receives your information, they will begin to investigate and prepare their position and arguments for your claim. Generally, a claims adjuster will contact you the day of the accident or the same day the claim is opened. Knowing how to handle the first conversation with a claims adjuster can mean all the difference in your final recovery.

Handling the First Contact with the Adjuster

The first conversation you have with an adjuster is extremely important because it sets the tone for the entire negotiation and claims process. Although you may be emotional or angry about the situation and your injuries, you should refrain from taking out your anger on the insurance adjuster. It is important to understand that taking your frustration out on the adjuster will not help you or your injury claim. Being polite and courteous can go a long way, as claim adjusters are humans, too. Adjusters are much more likely be more willing to negotiate a claim with someone who is polite and respectful, rather than someone who is angry and rude.

In your first conversation with the adjuster, they will likely request a recorded statement and potentially ask you to sign a release for access to your medical records. There are limited circumstances in which you are required to provide a recorded statement. However, we recommend politely declining any request for direct access to your medical records, unless required by court order or discovery process. It is important to understand that whatever you say in the recorded statement can and will be used against you and your claim.

You are not required to give a recorded statement; therefore, you should politely say that your investigation of the accident is still ongoing and that you will discuss the facts further at the “appropriate time,” generally in a demand package. However, be aware that you may be required by your own insurance policy to give an Examination Under Oath (EUO) if you have filed an Uninsured or Underinsured Motorist Coverage claim. For further information on putting together a demand package, please read our article on the process.

Moreover, requesting more time will allow you to gather your thoughts and collect witness statements, especially if the claims adjuster contacts you the day of your accident. We are all capable of making mistakes when our emotions are high or if you are under the influence of pain medication; thus, waiting to give your statement at a later date will help prevent you from saying something potentially damaging to your claim.

You should also not discuss the facts of the accident until you present your demand package or until you have gathered certain evidence. Claims adjusters are good at what they do, and they will often engage in conversation that will attempt to pry certain facts out of you. You should politely refuse to discuss any of the facts, as a detailed breakdown of the facts in your case should be included in your demand package. You may, of course, discuss the most basic of facts (where, when, vehicles involved in the accident, etc.); however, when doing so, be sure that you are not giving any more information than what is necessary. We recommend revealing a simple and concise version of the accident. For example, (1) I slowed for traffic ahead of me, (2) I came to a complete stop, and (3) I was rear ended. Keep it simple!

Furthermore, there are very few exceptions to the rule regarding signing a document that authorizes a release of your medical records to an insurance company. When asked about your treatment or injuries, politely but firmly state that your treatment is ongoing and that your medical records will be sent to the insurance company once treatment is complete. You will want to refrain from discussing your injuries or treatment for several reasons: 1) you may leave something out, 2) your injuries may end up being more severe than what you initially thought, 3) you may discover other injuries later on in your treatment process, and 4) your medical records, which will be provided, will more accurately and effectively explain your medical conditions.

For all of the reasons listed above, you should not discuss any settlement offers until you are done with your medical treatment, as when your reasonable and necessary medical expenses increase, so should the insurance company’s valuation of your claim. Generally, right after an accident, you are not aware of the extent of your injuries and how much your claim is really worth. For this reason, insurance adjusters love to reach low settlement agreements early in the process (before you become aware of your case’s worth). Refrain from doing this, as it will likely cost you money in the long term.

Again, negotiating with insurance claims adjusters takes hard work and preparation. These adjusters have likely handled hundreds, if not thousands, of accident claims. Remember to remain polite, but firm, and remind the adjuster that you require time to treat your injuries and investigate your claim. This is your personal injury claim and you should be the one to set the parameters and pace.


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