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Attorneys For Car Accident Injuries

– 6 Facts You Need to Know About Your Insurance Claims Adjuster


We have all heard about “claims adjusters” that work for insurance companies. This article will let you know a little bit more about what they do and how what they do affects how much money you get from an Automobile Injury Accident or other Work Related Personal Injury claim.


Who is a claim adjuster?

They are people like you and me. The minimal education requirement in most circumstances is the completion of a four year college degree. Once the adjuster is hired, s/he is trained to investigate, evaluate and resolve claims.

Car accident Lawyer Los Angeles

Car accident Lawyer Los Angeles

When an adjuster gets a claim assigned to them, what do they do?

Hopefully, coverage for the loss has been confirmed. If not, the adjuster may have to conduct an investigation to determine coverage, such as determining when was the premium check sent; when was it processed by the company? Other issues that an adjuster will look into are: did the agent make representations that the insured thought were applicable to the present loss; is there something out of the ordinary that may provide coverage? The adjuster will have to take statements from the insured, possibly the agent or others connected with the company. They may need to obtain documents to clarify various issues.

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Assuming coverage is fund to exist, the next thing the adjuster will need to do is conduct an investigation of the claim.

Normally this would start with a statement of their insured or vehicle driver in the event of a car accident. Once the statement is done, the adjuster will want to obtain pictures of the vehicles involved, the accident scene and anything else relevant to the claim. The adjuster will attempt to contact any witnesses to the accident. Independent witnesses (those who do not care who wins or loses) are the best because they are truly independent. If there are no independent witnesses the adjuster will obtain statements from anyone who has knowledge of the incident. The adjuster will obtain police reports if there are any as well to attempt to rely upon statements of the investigating officer and/or the parties to the incident made in the report.

The adjuster will then attempt to make a decision about liability.

What did their insured do (or fail to do) which was a cause of the accident? Is the plaintiff at fault? Are there others at fault? Adjusters will attempt to find some way to apportion all or some part of the liability to persons other than their insured if at all possible. Insurance companies do not care about anyone other than their shareholders and their own insureds. They do not care at all about injured claimants other than to try to get a quick settlement of a claim if possible.

In the event of a personal injury action,

The adjuster will then review the medical bills and records to try to minimize the amount of the bills

Carriers use billing review companies, computer medical reviews and other experts to accomplish this. If the case is one of clear liability against their insured, the insurance carrier will offer a settlement to the claimant. The offer will not be a full value offer and will be an attempt to conclude the claim on terms reasonable to the carriers.

If the claim cannot be resolved, litigation may then begin.

If this begins, the insured is represented by a Personal Injury Attorney assigned by the insurance carriers. Experts are used by both sides. The experts may center on bills, liability, treatment or a myriad of things depending on the case. Juries are very stingy in awarding money on cases and the carriers know this. They will fight cases as far and as long as they can. Their mantra seems to be the “three d’s” (delay, deny and defend). Plaintiffs’ Car Accident Lawyers are fighting for just compensation for accident victims. However, before any case is taken to trial, both the plaintiff and the attorney need to carefully consider that jurors do not want to be part of the system anyway. If they are forced to, they need to clearly articulate why they are there (nature and extent of injury, the defendant not taking responsibility for their actions, etc). If they cannot do this, the jury will penalize them for wasting their time.


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