At some point in your driving history, you may be involved in a collision. When it happens, you will undoubtedly speak to an insurance claims adjuster about your property damage and/or injuries. Before you discuss details of the accident and injuries with the adjustor, we feel it will benefit you to understand how an insurance adjustor can potentially affect your personal injury claim and settlement amount:

Who Are Insurance Claims Adjustors

Not to be confused with insurance agents who sell insurance policies, insurance claims adjusters are the primary point of contact and the “voice” for the insurance company when an insurance claim is made by either the policyholder or the injured party.

An adjuster is employed and trained by the insurance company. Their loyalty and obligation are to execute their employer’s policies and procedures. This includes keeping settlement amounts low, so profits stay high.

Not All Claims Adjustors Do The Same Job

It is not uncommon to have more than one insurance claim adjuster handling your claim. One adjustor may manage property damage while another manages bodily injury.

When talking with the insurance company, pay special attention. Your property claim adjuster may ask you questions regarding your injuries, and any statement you make will be recorded and used by the claims adjustor during your settlement negotiations for your injury claim.

They Use Sophisticated Software To Calculate Your Injury’s Worth

Large insurance companies, such as Allstate, rely on software programs to provide adjustors with a tool to calculate what a particular injury is worth to them.[1]

The software stores data such as:

  • historical settlement/verdict payout amounts by the company
  • injury and treatment information
  • geographical location
  • lost wages
  • claimant’s injury claim history
  • plaintiff’s attorney settlement/verdict case history
  • average cost of medical treatment in your area

The software then calculates the amount the injury is worth based on this data and medical codes imputed by the claims adjustor. The adjuster will offer a settlement amount based on a combination of the policy limits, at-fault percentages if applicable, and the calculated worth.

The software cannot calculate non-economic damages like loss of enjoyment of life, pain suffering, etc. It will be up to you or the attorney representing you to help you negotiate these damages in your settlement. It is not easy to seek compensation for non-economic damages. Seeking the aid of an experienced personal injury lawyer to help you is strongly suggested.

Claims Adjustors Negotiate Settlements

Remember, the insurance claims adjustor is the employee of a multi-million dollar for-profit insurance company. They represent the insurance company and strive to maximize the amount saved on a personal injury claim to minimize profit loss. They will do this by:

  • rejecting all or a percentage of liability for the accident
  • denying payment of medical treatments/procedures/surgeries they deem unnecessary or pre-existing injuries
  • requesting claimants provide medical records or police reports to avoid purchasing them
  • offer low settlement amounts well under policy limits
  • use the amount of property damage repairs against you in your injury claim
  • influence claimants to remain unrepresented by an experienced personal injury lawyer

Fear of the unknown, misplaced trust in the insurance company, and not knowing what you are entitled to contribute to a person accepting low settlement amounts. This is why claims adjusters prefer to negotiate settlements with you and not an attorney. An experienced St.Louis personal injury law attorney can help you get the compensation you deserve.

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[1] Merlin Jr., Esq, William F. “Overcoming Allstate’s Trade Secrets and Work-Product Objections” https://bit.ly/3kXPKGo, www.propertyinsurancecoveragelaw.com, 1994

[i] The information provided in this article does not, and is not intended to, constitute legal advice; instead, all information, content, and materials available are for general informational purposes only. The information provided should not be construed to be formal legal advice nor the formation of a lawyer-client relationship. The choice of a lawyer is an important decision and should not be based solely upon an advertisement.

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