Injury Law Blog

How to Deal With an Insurance Claims Adjuster

Every driver will likely need to file an insurance claim at some point for a car accident. Thousands of car accidents happen every day in the United States. Drivers must adhere to their states’ laws when it comes to buying appropriate insurance coverage, determining liability for their accidents, and following the procedure of securing compensation following a car accident.

When a driver files an insurance claim, the insurance company will want to investigate the claim to ensure it meets the terms and conditions of the policy in question and verify its legitimacy. For this purpose, insurance companies send claims adjusters to investigate claims.

Insurance Claims Adjuster

What Will an Insurance Claims Adjuster Do?

Insurance companies essentially sell promises to provide coverage for specific events in exchange for policyholders paying monthly premiums in full and on time. An insurance claims adjuster investigates a claim for coverage to determine several things.

  • The claims adjuster will want to ensure the claim is legitimate and not an attempt at insurance fraud.
  • The claims adjuster will investigate the claimant to determine the accuracy and honesty of his or her claim.
  • The claims adjuster will likely speak with other parties involved with a claim to verify key details.
  • The claims adjuster will look for any reason to “adjust” a claim by reducing a settlement amount or denying the claim. For example, if a claimant failed to report a coverable event on time in accordance with the terms of his or her policy, the claims adjuster would likely refer to this tardiness as justification to deny the claim.

All insurance claims adjusters have a professional and legal obligation to investigate and handle insurance claims in good faith. However, they are not looking out for the best interests of claimants. Ultimately, an insurance claims adjuster’s job is to limit his or her employer’s financial responsibility to a claimant.

Talking to an Insurance Claims Adjuster

If you need to file an insurance claim, it is usually a good idea to hire the best car accident attorney in your area who can help you draft a demand letter and even speak with the insurer on your behalf. An insurance claims adjuster is far less likely to push back against a claim if the claimant has legal representation. Additionally, hiring an attorney encourages the insurance company and the claims adjuster to handle the claim quickly to avoid potentially expensive litigation.

When an insurance claims adjuster arrives to investigate your claim and interview you about your claim, be sure to keep a few important tips in mind.

Do Not Offer Excessive Information

Answer the claims adjuster’s questions honestly and concisely.

Be Wary of Awkward Pauses

Some insurance claims adjusters will not respond immediately after you answer a question. In many cases, they are trying to create an uncomfortable silence to encourage you to keep talking.

Watch Your Phrasing

Even seemingly innocent phrases and responses taken out of context could reflect poorly on your claim. For example, if you made a claim for severe, painful injuries, the claims adjuster may ask, seemingly harmlessly “how are you?” at the beginning of your interview. Responding with “I’m fine” would technically counter your claim of painful injuries, and the insurance claims adjuster is sure to record every one of your responses during his or her investigation.

Do Not Sign Anything

Never accept an insurance claims adjuster’s settlement offer without speaking with a personal injury attorney about the claim first. Some insurance claims adjusters knowingly offer lowball settlements in attempts to convince claimants getting a smaller amount immediately is better than waiting for the full amount available from a claim.

Do Not Agree to Signed or Recorded Statements

If the claims adjuster asks to record your interview or asks you to sign a written statement, politely decline and inform the claims adjuster you will need to speak with your attorney before you sign anything or agree to a recorded interview.

Ultimately, the insurance claims adjuster, however difficult he or she may be toward you while handling your case, has a responsibility to handle it in good faith. If you encounter difficulties with an insurance claims adjuster, consider hiring an attorney who can negotiate on your behalf.