How An Insurance Adjuster Approaches A Submitted Personal Injury Claim

Every insurance adjuster has the same goals, when launching the investigation of a submitted claim. Adjusters plan their approach with those goals in mind.

Tasks given to adjuster

• Find out what happened, with respect to the reported accident
• Determine the worth of the claimant’s case

The adjuster’s goals

Get the claimant to accept the lowest amount possible. Avoid a lawsuit against the insurance company; that usually means arranging for resolution of the case before it has progressed to the trial stage.

Basic steps in adjusters’ initial approach

Look at the claimant’s financial losses: the medical bills, the lost income, any pain and suffering, and the negative effects of the accident-caused injury. Obtain details on the following: the limits on the defendant’s insurance policy and the strength of the claimant’s case. Typically, an insurer does not pay more than the maximum amount, as stated in the terms on the policy’s limits.

A case becomes weaker if the defense team could suggest that the plaintiff/claimant was partly to blame for the accident’s occurrence. In addition, it gets weakened if there is evidence that the plaintiff has failed to mitigate the injury’s effects. The nature of the victim’s injury also affects the case’s strength.

If an accident victim has suffered no more than a soft injury, that fact weakens further the victim’s/claimant’s case. When claimants have a weak case, their designated adjusters have no reason to make an especially generous offer, by way of compensation.

Tips for claimants that need to negotiate with an adjuster

Hire a personal injury lawyer in Halifax: That action proves especially useful, if the question of liability has become an issue. Lawyers know how to fight an insurance company that has chosen to blame the plaintiff/claimant.

Be sure that the evidence of fault appears convincing. The defendant’s level of negligence should be clear. In other words, it should be obvious that a reasonable person would have acted in a different manner.

Compose a demand letter and send it to the office of the adjuster at the defendant’s insurance company. This action provides the plaintiff with an added measure of control. Granted, the amount of control remains limited, but the letter’s sender retains as much control as possible. The act of sending a demand letter places before the adjuster’s eyes the amount of money desired by the sender/plaintiff. By guaranteeing adjusters’ awareness of that desired amount, demand letters help to indicate where the negotiations should begin.

Claimants’ appreciation for how to approach the negotiations increases, when their expectations for that same procedure have been met. At least one expectation gets met, if a demand letter controls, somewhat, the size of the initial offer that is apt to come from the defendant’s insurance company.

More to explorer

Why It Pays To Settle Out-of-Court

Some claimants refuse to accept an offer that has been made by an insurance company, during an attempt at reaching a negotiated