What You Need to Know About Dealing with an Insurance Adjuster on a Personal Injury Claim

Written by greg on December 12, 2018

Tips for handling a personal injury case

  1. Know the adjuster is not on your side!

The larger your personal injury claim the more likely it is that the adjuster contacting you will be nice and friendly. The smaller your claim appears to be to them, the more likely they may be rude and abrupt. If an insurance company perceives that they have a significant loss exposure, the adjuster is most likely going to establish rapport with you and will seem helpful and fair- until money is discussed!

One reason on significant damage claims that the adjuster may be friendly and even appear helpful is that they may attempt to discourage you from hiring a car wreck attorney. Some adjusters have said such things as “we accept responsibility “, or “you don’t really need to hire an attorney, or they’ll just take part of your money”. There is a REASON the insurance company discourages you from getting representation and its not to benefit you!

*Tip -Hire the best attorney you can early.

Insurance Company Tactic: Leaving the impression that the adjuster will fairly address your damages. Generally, the innocent victim mistakenly believes that when the insurance adjuster says things like “we accept responsibility”, that that means that the offer for damages will be fair.

Frequently, it is only after the adjuster actually discusses compensation that the personal injury victim understands that they need an attorney. Unfortunately, that usually happens many months after the accident and many things that should have been to document the claim, have not been done because the victim expected fairness by the insurer.

Bonus tip: Accepting responsibility does not mean a fair or reasonable settlement offer!

  1. What you say can hurt you!

Insurance adjusters will want to take recorded statements from a personal injury victim soon after a car crash. Some may even suggest they cannot process a claim UNLESS you give a statement. This is not true in Texas for injury claims made to the other party’s insurer!

*Tip -We recommend that you give no recorded statement to an adverse adjuster.

However, if you give a recorded statement to an adverse adjuster be very careful what you say.

 

Insurance adjusters have been trained in how to take statements from personal injury victims. Do not let them put words in your mouth. A question such as “when did you first see the other vehicle” is a loaded question because it assumes that you saw the other victim vehicle prior to impact.

Another area of conversation that comes up and recorded statements is the extent of injuries. Sometimes, a victim may not know the extent of their injuries until a day or two or even later. Other times one area hurts so badly that other medical problems are not identified. Avoid giving statements while taking medicine.

Bonus tip: If you give a recorded statement to the adverse adjuster, follow these guidelines 1. Never volunteer information. 2. Be truthful and concise 3. If you don’t know don’t guess. 4. Qualify your answers when appropriate.

  1. Watch out for insurance company tactics to reduce the value of a claim

Adjusters often will seek to imply the claim is little value or is valued less than it might be. The adjuster may try to imply they have problems with the medical or that they feel you are partly to blame. Subtle statements about a claim can reduce the expectations of the victim. Don’t fall for it.

*Tip -Talk with an experienced attorney about the value of your case not the adjuster!

Understand that the adjuster will seek to pay little in settlement of the claim. if an adjuster can settle a case for pennies on the dollar they will be praised by their supervisors.

If you are getting negative vibes form the adjuster, it may be a signal you may need to retain an attorney. Numerous studies have shown folks represented by reputable attorneys net more money than trying to represent themselves.

Insurance Company Tactic: Seeking to apportion responsibility when the accident was caused by their insured. Using this tactic, many adjusters seek to discount the damages that their insured has caused by claiming that the innocent victim was partly responsible. This is usually done even though the accident report shows the crash was caused by the negligent driver they insured.

Insurance Company Tactic: Discounting medical bills and expenses – adjusters use this tactic to reduce the amount they need to pay for medical bills and expenses. While Texas law reduces the amount collectible by the victim to amounts that are “paid or incurred”, many adjusters seek to discount the actually paid or incurred bills by citing such things as excessive, unnecessary or disallowed. Occasionally the insurance company will send out the bills for an “audit” where a friendly company they pay discounts every bill they sent to them.

These are only a few of the common tricks of the trade used by some insurance adjusters to reduce the value of the claim they must pay. Unfortunately, personal injury victims are usually at a disadvantage because they are not used to the claims procedure and processes and don’t understand the adverse positions of the parties.

Personal injury victims are encouraged to seek consultations with an experienced and reputable personal injury attorney before they attempt to deal with an adjuster regarding a personal injury claim

  1. Avoid settlement traps!

A few the most common settlement traps are:

  • Quick settlements
  • Estimated future medical settlements
  • Pressured settlements
  • Pre-diagnosis settlements
  • Disregarding medical liens.

Some adjusters attempt to pressure a personal injury victim into settling early often before a clear diagnosis has been made on the injuries. Many a victim has fallen prey to this tactic and the consequences can be severe as the risk of a serious injury shifts from the insurance carrier to the victim.

It is a bad idea to settle before you know the extent of your injuries. Insurance companies do not pay medical bills while they are ongoing and attempts to entice you into a quick settlement, so you can pay your medical bills is almost always a bad way to go.

Quick settlement offers with estimated future medical. Using this tactic an adjuster will seek to close the file early and estimate medical expenses that may be incurred. Unfortunately, the insurance company also requires a full release of liability and if the damages turn out to be more serious or the medical bills were excessive, the innocent victim is left holding the bag with no real recourse.

With big impacts such as with an 18-wheeler accident, make sure that you have been released by your doctor and are comfortable personally that you have healed before you consider discussing a settlement.

*Tip -Always consider potential medical paybacks if health insurance paid some amount or a hospital filed a lien. 

  1. Delays can hurt your case!

Delay in seeking medical treatment can be very damaging to a personal injury claim. The longer you wait for medical treatment and large gaps in the treatment will make the potential for settling your case out of court much harder. And long delays between treatment can also make it very much more difficult to recover money from a jury.

*Tip- Follow your doctor’s orders and do not delay in getting treatment.

If you cannot afford needed treatment, speak with your doctor about options or talk with a personal injury lawyer about funding options for ongoing medical bills.

Delays in finding witnesses or necessary crash information can also hamper a case/

  1. Take advantage of free consultations

Most reputable personal injury attorneys offer free consultations to personal injury victims. Whether you hire an attorney or are considering handling a car accident claim yourself, taking advantage of a free consultation is a good idea and there is not a downside to taking advantage of it.

*Tip- Speak with several attorneys to find one you are comfortable with.

Bonus tip: Talk with a lawyer in the county of the crash and not out of state attorneys.

  1. The more serious your injury the more likely you need a lawyer

Personal injury claims include more than just negotiating a number with the insurance company. The more serious your injuries and the larger your medical bills, the more likely it is that you will need a personal injury attorney to assist you. If you have health insurance, your health insurance company probably will have their hand out and want to be paid back for the medical bills they paid.

If your hospital bill hasn’t been paid there probably is a hospital lien that will take the first money out of any settlement. Retaining an experienced and successful personal injury attorney for a more serious injury is a better choice.  Insurance adjusters attempt to discourage you from getting an attorney for a reason- to save money. Studies have shown those represented by competent counsel net more money.

*Tip- The larger the case, the more your choice of attorney matters, always research attorneys before you hire one.

  1.  Do not volunteer information to the adjuster but tell your attorney everything

Causal talk with any adjuster should be avoided. This includes talk about you, your injuries, your background, prior claims or injuries and how the accident happened.

The most innocent of comments can open up issues and come back to bite you if you are not careful.

If you hire a lawyer to handle your case, tell them everything and let the attorney do the talking for you. Do not make the mistake of thinking keeping something from your lawyer will help you, it will not and will hurt or kill your claim if your lawyer is unaware of the facts.

Many folks do not tell their attorneys information they think may hurt their case. They don’t know the defense most likely already knows the facts. This is particularity true with prior injuries or accidents.

*Tip- Tell your attorney everything because it is the only way they can effectively help you.

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