Personal Injury

How Insurance Adjusters Work When Evaluating Your Accident Claim

By January 15, 2016April 26th, 2022No Comments

The role of an insurance provider is twofold; to sell you on an insurance plan or police that provides the required coverage and to make sure as little is lost through future accidents. The role of an insurance adjuster is to determine how much the insurance company will settle for in the future.
The first number that they offer to settle a claim is oftentimes what I refer to as a “low-ball” guestimate or ballpark. Sometimes, it is thrown out to see what the parties are made of what the insured’s reaction would be at this first attempt to settle their claim.
While many people leave it up to their insurance company to handle any and all payments associated with an accident, others are rightfully turning to the advice of local attorneys such as ourselves to fight for them. For this reason, it is incredibly important that you have your claim looked over carefully by your attorney.

So, how does the process work?
The first thing that is usually itemized are medical bills and records that relate to the accident which may have been paid out. The adjusters will carefully go through what medical evidence exists and attempt to find holes, gaps and any inconsistencies that they can use to justify rejecting your claim, reducing it or requesting additional documentation and information thus stalling your eventual payment. This deliberate delay and stall in your compensation can discourage many legitimate claimants.
More often than not, the adjusters will search for alternative explanations for what may have caused the physical injuries so as to justify non-payment of your claim. For example, suppose that your legs were seriously injured during your car accident– a crafty insurance adjuster might make a convincing argument that the injury to your legs was caused by the cumulative years of your love of running, and not by the traumatic impact of the accident that you just sustained!
In these cases, the insurance company will do its best not to pay the claim, saving themselves money through the process.

If your claim is somehow higher than the average claim, this may also raise a “red Flag” or the ire of a claims adjuster. It is similar to the IRS if an insurance carrier and its agents identify a number or figure that is “out of the ordinary” or slightly higher than the standard average median they will “red flag” your entire claim for further investigation.
They are quick to label any “high” amount claim as fraudulent and then begin the hardball and investigatory process which further slows down your compensation payout. It is therefore advisable to hire experienced counsel to cut right through this self-serving nonsense.
Regardless of the reasons why an insurance company may be fighting you for a payout, you will need assistance.

With countless years of experience helping David fight Goliath, we here at Fiumara Law, PC strongly believe in your right for professional and legal counsel.
Don’t allow the big insurance carriers and their skilled and well-trained adjusters push you around and deny you the full compensation that you deserve and are legally entitled to receive for your injuries! YOU have been paying into the ‘system’ for a long time and it’s now your turn to benefit from having paid your high insurance premiums for all these years!
My adage and what I commonly say is: The insurance companies are quick to take your money and hand you an umbrella, but they are even quicker to snatch it back when it rains! When it “pours” their tactics get even worse.
Instead of getting taken advantage of go with a team that will put your best interests ahead of shareholder profits. We will help fight for you throughout the entire process keeping in mind YOUR needs. WE believe in evening the playing field for your benefit.

Contact our personal injury attorneys today at 707-571-8600 OR 760-832-6118 for a free and confidential consultation.
We serve the great people of Sonoma County, Marin County and the entire North Bay and have been doing so since 1992!

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