After accidents that involve personal injury occurs, the aggrieved party has to receive rightful compensation. It is supposed to cover any inconveniences caused due to a car accident, including medical expenses, damage of property, and permanent medical conditions. Often, your medical insurance company is responsible for dispensing the required sums of money. Similarly, the defendant liable for causing you harm and personal injury has to liaise with his or her insurance company and ensure they make payment to you.
Since most of these liable parties are not well versed with insurance transactions, they may choose to seek the services of an insurance adjuster. He or she will represent the defendant and analyze the monetary claims you bring forth. The offices of Clay County Personal Injury Attorney have helped their clients to prepare for meetings with the insurance adjusters. We give helpful pointers and tips that ensure that you have the upper hand in negotiations. Our goal is to ensure that the sums of payment you receive are equitably sufficient to cover all the injuries caused by the car accident.
Who is an Insurance Adjuster?
An insurance adjuster is a professional who represents an insurance company in meetings to settle claims with victims of accidents and, in this case, car accidents. The job position is also known as a claim adjuster. While conducting negotiations, an insurance adjuster may appear to hold an advantageous position and have the upper hand, mainly because that is their field of expertise. However, such an observation is not entirely accurate, because, in essence, you as the claimant have in-depth and first-hand information regarding how the car accident occurred as well as any key details not mentioned in reports. Your observation is more accurate than an insurance adjuster would be because you were actually at the scene of the accident.
Additionally, most insurance adjusters have to check in with their supervisors before deciding on any settlement. This requirement means that they do not hold any power to make the final decision until specific conditions are met. The claim adjusters also have a limited field of coverage. For example, an adjuster with fewer years of work experience or has just started his or her career can only handle settlement negotiations ranging from $5000 to $15,000. The limitation means that they can only go too far, and they have to hand the matter over to another adjuster should your claims exceed those stipulated for them.
Moreover, if your claim falls within the mentioned range, you now have the advantage of knowing that the adjuster you will deal with might be just as nervous as you are before a negotiation meeting. The reason is that there is a chance that his/her work experience is not vast. Knowledge of such detail may help you to relax and settle in better.
For the more experienced insurance adjusters, they can handle settlement of claims ranging from $15,000 to $30,000. Regardless of the level of experience that an insurance adjuster has, you as the claimant should not worry. When you raise a valid claim of payment and have your facts right, you can quickly get the exact amount you wish from the insurance company.
Roles of an Insurance Adjuster
Typically, the adjuster’s primary role is to be present during the meeting to negotiate the settlement of a victim’s claims. With you as the victim, the insurance adjuster will work on behalf of the liable defendant’s insurance company. Some of the other specific roles of an insurance adjuster are:
An appraisal is a procedure that involves an expert verifying and assessing the number of damages caused by accidents. An insurance adjuster has the role of making an analysis of any possible damages arising from the car accident and giving an estimate of a real monetary figure. Since this role is highly personalized and exclusive to the adjuster, he or she may take advantage and value your damages at a lower price than is fit. However, you can seek legal backing from your lawyer, or produce equally verified documents from professional insurance agents. The documentation will support your claims and allow you to have a valid course of negotiation.
Noting Important Details Concerning the Car Accident
As you give your account of events surrounding the accident, including before and after the actual crash, the insurance adjuster is keen to note any outstanding details. He or she does this mainly to try and figure out a way to twist the course of events and possibly shift some blame on you. They do this so that certain principles like comparative negligence can affect the course of action. Once they find a loophole regarding your account of events, they will try to reduce the figure of claims you indicated in your demand letter. However, you should not worry about such witty methods because they often have no standing. After all, you can have your personal injury lawyer to help in the negotiation process and raise concern when the adjuster tries to take advantage of you.
He/she Participates in the Final Determination of Claim Approval
Insurance adjusters may not have the final say concerning what monetary figure the insurance company will finally agree to give you. However, since they work on the ground and have the most interactive and live negotiations with you, the claimant, they have to participate in the final decision. They offer helpful information concerning the general claim and give any additional information they may have noted from observation.
An insurance adjuster has to act in a responsible and just way. However, they often make inaccurate and false reports that leave you at a disadvantaged position. Other adjusters may maliciously downplay your claims when reporting them to their supervisors. Despite their attempts in engaging in corrupt processes of settlement, your injury attorney will make constant probes and follow-ups with the defendant’s insurance company, to ensure that everything goes on smoothly. They can also try to force you to take a lower settlement amount than you deserve, to take on new matters. The adjusters do this because they mostly work on commissions. Therefore, the more settlements they make, the more they earn. Some are known to hasten the process and give the claimant a raw deal.
Matters for Negotiation
Once your attorney has scheduled a negotiation meeting with an insurance adjuster, you should be well aware of the matters to be discussed. Your knowledge is essential because it enables you to stay focused on the primary issues for determination. Additionally, once you establish the issues for negotiation, you avoid any distracting matters raised by the insurance adjuster aimed at deterring you from the claims worth large sums of money. The essential issues for negotiation are discussed below.
- The Nature of Injuries Sustained
After surviving a car accident, you are likely to sustain serious injuries that may dramatically alter your life. Some of them are self-explanatory, and simple observation will answer most questions. For example, if you suffered a fracture that required plaster treatment, your arm or leg may conspicuously be fitted with a brace to hold it in position. Crutches are also a visible indicator of leg injuries. With the tell-tale signs of personal injury, you are not obliged to give an insurance adjuster and additional medical information concerning your treatment. Some of the information provided may complicate negotiations and give an insurance adjuster reason to exclude sums covered by your medical insurance.
Although this may be a logical conclusion, it is unjust on your part because you deserve payment for all expenses used towards your treatment process.
- Parties At Fault
As a car accident victim, you may have had no role to play regarding the cause of the accident. Typically, victims on the receiving end are usually competent drivers who had observed all traffic regulations. Therefore, they are mostly on the receiving end. Despite this known fact, most insurance adjusters always seek to shift some blame on the claimant. They know that if they can find fault, the amount to discharge to your account is significantly less. Therefore, you should be alert and stand your ground when an adjuster attempts to impose any false accusations on you.
An insurance adjuster might further refuse any claim that his client, the defendant is responsible for all the applications you bring forth. Such behavior should be called out, as it is often deceptive, not to mention wastes your time because of the delayed agreement. Luckily, if a case intensifies and adjusters refuse to agree on required settlements, your injury lawyer may seek legal backing from the court, and instigate a legal suit against the insurance company altogether.
- What the Insurance Covers
Medical procedures after a car accident always focus on emergency treatment to ensure that you are stable and back in good health. Most, if not all, of the medical procedures prescribed by your doctor, are crucial for proper recovery. Therefore, an insurance company should not exclude specific medical procedures from its scope of coverage. For example, most adjusters will tell the claimant that the insurance company does not cover orthodontic treatment. Therefore, if you suffered any bodily harm affecting your teeth and require realignment, you could have a hard time with such an adjuster.
The critical question to answer is who was the primary cause of such a dental injury. If the answer points back to the defendant covered by the insurance company you are dealing with, then you have a valid claim. The truth is that you deserve rightful compensation regardless of whether the treatment required is covered by the insurance or not. Your right holds a basis because it is not your fault that you were involved in the car accident. But for the defendant’s liable actions, you would not have sustained any injury in the first place.
Therefore, during negotiations, the insurance adjuster must be willing to consider possible accommodation of particular medical treatment that is not usually covered by the insurance. They have the option of dispensing the money you require to undergo these procedures or pay for them directly in a customized insurance scheme. You do not have an obligation to sign any agreements with the company for future client relationships in this case.
- The Extent of Medical Treatment
Most insurance companies employ acclaimed medical doctors to help them verify the validity and extent of the medical treatment you require. If you have a persistent claim that the insurance adjuster disagrees with, he or she may request that their medical doctor examines you and files a report. The medical report indicates whether or not your claim of treatment required is exaggerated in any way. However, it is essential to remember that you are entitled to a second opinion from a different doctor, who is equally qualified to examine you.
When dealing with an insurance adjuster in verifying such a claim adjuster, you always have the upper hand, because personal injury is unique to an individual. The adjuster cannot use general methods of determining the mode of treatment to subject to you without engaging specific analysis. Another critical factor to note is that treatment may change and advance with time. Therefore, a single settlement may not be enough to cover all possible expenses that you expect to undertake in seeking medical treatment.
Specific to a car accident victim, if you suffer bone fractures, you require multiple physiotherapy sessions to follow up after taking a cast or plaster out. However, this course of treatment may not be identified or established during the negotiation process to determine what kind of settlement amount you will receive. Therefore, an adjuster has to keep a window of change open in case of any dynamics that alter the expected course of treatment. As the claimant, in this case, you have to ensure that you raise this critical point during the negotiation, to prevent a future occurrence of finger-pointing and to label you as an opportunist. It does not matter much whether this happens or not, however, because you can always prove your validity by providing certified medical reports requesting follow-up procedures. As a result, you do not have to worry about having to include the information, especially at a first-time negotiation.
What To Do During Your First Negotiation Meeting With an Insurance Adjuster
After meeting for the first insurance settlement claim, the course of action is better simplified after that. Additionally, an insurance adjuster uses this first negotiation session as an evaluation of what kind of client he or she will work with to complete the set goal. Therefore, you should try and be on top of your game so that the insurance adjuster does not undervalue you. It is from this meeting that he or she also gets to understand if you are looking for a quick fix, or if you are willing to be patient until the end of the settlement process. Here are some helpful pointers to observe.
- Have a Good Understanding of Your Claim
Fully understanding what to raise in the first negotiation meeting is paramount as it sets the pace for future meetings. As a victim, you can engage with your injury attorney to ensure that you pick out all arising matters and compile them in the demand letter. The personal injury team should ensure that your claims are proportional to injuries sustained, as well as justified to avoid further disagreements.
Knowing what to ask for also saves you a lot of time and helps you to remain firm, as you will not easily waiver and agree to the insurance adjuster’s proposed amount without keen assessment. Further, understanding the nature of your claim guides the mode of negotiation to use to obtain the required settlement. For straightforward and one-time arrangements, you can define the exact amount to demand. Conversely, if agreements are to be made within a specific time frame, you can also correctly ask for specific terms of payment that the insurance needs to comply with.
- Remain Cordial and Composed
This guideline seems quite straightforward and easy to follow. However, it is very easy to lose your temper and raise a fit against the insurance adjuster. It is not unjustified to lose your patience when dealing with the claim adjuster because they are trained to drive you to the wall and give in to their lower proposals. They may result in unconventional means to test your limits and even raise unrealistic and inaccurate records. The records may indicate incorrect details that link you as a contributor to the cause of the car accident.
If you easily give in to the probes of the insurance adjuster, you may immediately appear to be guilty or unsure of your exact facts. What’s more, the insurance adjuster may intentionally annoy you and use your overreaction as evidence to discredit you in the superiors’ eyes. Conversely, getting emotional over the accident may cause you to share more than you should. Once the adjuster gets hold of vital personal information, he or she may use it to your disadvantage.
Additionally, letting your emotions get the best of you can easily blind you of the ultimate goal and make you quickly give up. When you feel like you are facing unfair treatment from an adjuster, the rational thing would be to report the issue to your personal injury attorney. He or she may be in a better position to raise the matter of concern to the appropriate authorities. Alternatively, if the insurance adjuster’s supervisors are available to address issues, you should make them aware.
- Take Down the Insurance Adjuster’s Contact Information
After the first negotiation meeting, you can be sure that you will hold follow up sessions to continue with any pending discussions. As a diligent claimant, ensure that you take down the vital contact information that helps you trace the insurance adjuster. Be keen to write down the adjusters:
- Full name
- Phone number
- Name of the insurance adjuster’s company
Some insurance adjusters may work for a quick fix and try to trick you into agreeing on the first sum they offer. If you would like to change your mind, you would need to contact them again. If the insurance adjuster was witty enough to get away without you noting their contact information, they may quickly process the payment and label the settlement closed. If you are on the receiving end of such a transaction, you will be severely short-changed.
- Avoid Giving Descriptions of The Types of Injuries Sustained
As a victim of a car accident, you may sustain several injuries. Giving descriptions of your injuries without proper medical reports could be detrimental to your negotiations. The disadvantage arises from the nature of your injury, which may advance and become more complicated or severe. Sometimes, you may also receive a misdiagnosis and not know the root cause of a certain medical condition.
Therefore, when your doctor finds something additional regarding your injury way later, you may be unable to raise any further claim to the insurance company. Such a situation can be quite frustrating to you because it is unlikely that the claim will be accepted. Even if it is validly raised, the timeline for payment may have lapsed. When dealing with that problem, your personal injury attorney may also be unable to offer much help because he or she has the duty to ensure that all claims are consolidated in the demand letter.
Handling Future Negotiations with Insurance Adjusters
As the negotiation process ensues, you and the defendant’s claim adjuster will have more encounters. The final goal will be to settle for a payment that both parties are comfortable with. Achieving this is not easy, and you have to observe several practices to ensure you get what you want from the adjuster.
Have All Your Supporting Documents
Being organized is essential when heading in for a negotiation meeting. The only way to justify your claims is by showing all your supporting documents, including receipts and pharmaceutical prescriptions. Additionally, all relevant medical reports and appointment statements are important when defending a claim of compensation for continuous medical treatment. Another essential document to always have in your file is the original demand letter you wrote to the insurance company.
Check-in on Settlement Progress Regularly
If you are not vigilant enough to be persistent and follow up on your settlement, an insurance adjuster may sit on your case or keep putting it off. No claimant wants delayed payment, as most of them are already facing severe financial constraints. However, while making follow up calls, be cordial, not overbearing. After all, claim adjusters are human beings too, who may be working hard to meet deadlines. Despite the general notion, excess work on the adjuster’s desk is not an excuse for any slow processing of claim settlements on their part.
Stay Patient During the Settlement Process
When an insurance adjuster notices that you are in a hurry to settle the matter of accident compensation, he or she will use it to lure you into settling for mediocre sums. Always remain patient but not submissive, to show the claim adjuster that you are serious about receiving payment, even if it takes a little longer. The bottom line should be that you expect the due process of administration and law to guide the determinations made. Patience also shows that you are composed and that you know what you are doing. Consequently, the claim adjuster will take you seriously and handle your matter with skill and diligence.
Find a Personal Injury Attorney Near Me
Taking on claim settlement negotiations for car accidents that affected you may be stressful and draining. The Clay County Personal Injury Attorney lawyers have the skill and professionalism required when dealing with an insurance adjuster. Moreover, we specialize in Personal Injury law and have additional information and knowledge that the insurance company adjusters may not know of. We guarantee our clients quality services in getting accident claims settled. Contact us today at 904-494-8242.