Dealing with Insurance Claims Adjusters

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How to handle assessors after an accident

Insurance companies usually get a bad rap. They're the ones you call after you have been in a motor vehicle accident or a motorcycle accident.

Imagine: Your car is totaled, you're suffering from injuries and you know you're going to be out of work for at least a few weeks. While you're being transported to the hospital, you keep shouting at the EMS technician, “Take pictures of the car! Take pictures of the car! I need evidence for my insurance claim!”

Many people aren't so clear-headed after an accident.

Moreover, they face that dreaded insurance company phone call like they're contacting an ex-boyfriend. This company is between you and your money. Of course they're going to try to trick you, to swindle you somehow, to take advantage of the fact you don't know your policy backward and forward.

Truly, insurance companies aren't so bad.

Most of them just want to get your claim processed as quickly as possible because of the sheer volume they need to handle on a daily basis. While an insurance company is a for-profit entity, it doesn't exist to complicate your life. With a little preparation, your relationship with the insurance company can be smooth sailing.

Calling your insurance company

This phone call can happen once you've been treated for medical injuries and have been cleared by a doctor. It can even occur the next day. You'll want a copy of your policy in front of you, and you'll want to have reviewed it before you place the call. Make sure you know what your “Coverage” and “Exclusions” specifically are.

This is your chance to act as an attorney, if you ever felt a desire to go to law school or act like District Attorney Jack McCoy from television's eternal show, Law & Order. The point of this call is to illustrate your claim's value and outline all of your expenses. Your adjuster knows everything that's in your file – what he or she has to do now is justify whatever number the two of you come up with to make sure it's consistent with your coverage. For instance, you're not going to get a million-dollar payout with only basic liability coverage.

Remember the Golden Rule: Treat others like you want to be treated. Unless this person is really passionate about insurance, this is most likely just a job for him. He doesn't want to be yelled at. Be nice and polite, and he will be nice and polite to you. If you are well-prepared with your documentation, he'll be even nicer.

Your adjuster will study your policy and determine how much money you're entitled to. His main concern is making sure your settlement offer is consistent with your policy. As such, providing him with documentation to increase your settlement will not only help your situation, but it will also help the claim be processed faster.

Negotiating with the adjuster

This can be scary. Your adjuster might try tactics like strong-arming you, using words you don't understand or saying he needs to check with his bosses before agreeing to anything.

Here is what you need to do:

• Illustrate the circumstances of the accident. Paint a picture for the adjuster: You were driving your car, following all the rules of the road. You were wearing your seatbelt. Elaborate on what is in the police report. Describe the other driver's negligence. Talk about the road conditions and the weather. Bring up your insurance coverage and show how it very clearly applies to this sort of situation. This shows that you're an informed customer and that you understand the value of your claim.
• Outline your expenses thus far and what you expect your total demand will be for your accident claim. The adjuster might end the conversation and say, “All right, that's a very big number, bucko. I have to talk to the higher-ups.” Don't cave. This is your life we're talking about. He is trying to break your momentum and intimidate you into settling for less. Furthermore, he might not get back to you for a day or two. As long as you have the documentation to support the number you asked for, your request shouldn't be considered unreasonable.

• Your insurance company will likely return with a counteroffer. Send in any additional information that you feel will help your claim. Make sure not to be pigheaded about this – they might not rise to the number you have in mind. Think of a minimum number you are willing to take. Reduce your claim little by little until the adjuster rises enough that you are satisfied.
• Try not to react emotionally or take the adjuster's actions personally. He is just doing his job and trying to save the company money. Remember: Don't shoot the messenger.

• Once you have agreed upon a number, the adjuster will send you a release form to sign. That’s it! Make sure that your outstanding medical bills have been taken care of and that this settlement compensates you in an adequate manner, because once you’ve signed the release form, you can’t change your mind.

What if I get stuck in negotiations?

Sometimes adjusters are totally immovable. They have instructions from their superiors and gosh darn it, they aren't going to budge.

Despite this setback, you still have a few options. You can speak to the adjuster's supervisor, for instance. This can occasionally backfire, as the superior normally has the same instructions the adjuster has. However, speaking with a different person can put a new spin on the situation. Sometimes the threat of talking to someone's boss is enough to push through the mud.

You can also hire an attorney. A car accident attorney is well versed in dealing with insurance companies and handles all correspondence from then on – you actually cease all communication with the adjuster. The attorney will let you know if the claim offer is in the right ballpark and can pursue outstanding bills, negotiate a larger settlement and make sure you are well compensated. Then you can just focus on healing.

What if my claim is rejected?

This is another case in which you'd possibly want to lawyer up. First, however, you will want to gather every piece of documentation you have regarding the claim: every medical bill, repair estimates, proof of damages, prescription receipts and whatever else was relevant.

Since insurance adjusters live and die by paper evidence, you need to provide everything you can. It's entirely possible that the adjuster just didn't have the evidence he needed to approve the claim or that what he had was inaccurate. What you can try to do is write a letter illustrating how the documents support your auto claim and why your settlement should be approved. This can sometimes be enough for the adjuster to approve your claim.

If you still need help dealing with an insurance adjuster, consider checking out the Enjuris law firm directory!