What is an Insurance Adjuster?

Insurance Adjuster

Despite what their advertisements might lead you to believe, insurance companies are for-profit businesses whose sole purpose is to make as large a profit as possible. They make money by selling premiums, not by paying claims.

An insurance adjuster is a representative of an insurance company. Their sole purpose is to reduce the value of your claim or reject it entirely.

Insurance adjusters know personal injury law, they are professional negotiators, and they are your adversaries as soon as you file a claim against their employer. It’s best to let your personal injury lawyer negotiate for you to recover the maximum amount for your claim.

Continue reading to learn some tactics insurance adjusters use to undervalue and deny insurance claims and how you can spot them. 

What Strategies Do Insurance Adjusters Use to Fight Claims? 

What Strategies Do Insurance Adjusters Use to Fight Claims? 

An insurance adjuster carries an invisible bag of tricks into any settlement negotiation. These tricks can get you to lower the value of your claim or give up on it entirely. They can also weaken your case if you make it to court. The following is a sample of some of the strategies that you will be dealing with if you choose to represent yourself.

Blaming You for the Accident

The insurance adjuster will likely try to establish that you were the negligent party or at least share liability. Under Texas modified comparative negligence (“proportionate responsibility”) principles, a court will reduce your compensation in proportion to your percentage of fault for the accident. However, if your fault exceeds 50%, you will receive nothing. The insurance company will undoubtedly try to use this against you.

The Fishing Expedition

If the insurance company can get you to sign documents without reading them first (NOT a good idea, by the way), they can have you allow access to your complete medical records. Once they have these, they can “go fishing” looking for a previous injury, such as a back injury, that they can claim as the real cause of some or all of your current pain. This argument, if successful, may defeat your claim. 

Scouring Your Social Media Accounts

If the insurance company gains access to your social media accounts, they can search for anything to use against you. For example, they’ll look for a comment about the accident, a recent photo of you enjoying yourself at a party, etc. Your best bet is to say off social media until your compensation is in your pocket.

Requesting a Recorded Statement

Under this strategy, the insurance adjuster convinces you to give a recorded statement outside the presence of your lawyer and asks you trick questions. Even if you don’t fall for any of the tricks, the adjuster can splice the recording to take your words out of context. 

Trapping You With Your Own Words

Questions like “How much would you say that your response to the slick roads contributed to the accident?” are designed to induce you to make a damaging “admission.” They might try to get you to contradict yourself so that they can discredit you.

Sending You an Unsolicited Settlement Check

Watch out for this one. You might need the money, and it might be tempting to cash the check. Once you cash it, however, you have accepted the check as your full settlement. As you might guess, the amounts of these checks are usually unacceptably small.

Stalking You

Insurance adjusters may watch you from public areas: parked cars, sidewalks, etc. Don’t let them catch you mowing your lawn or otherwise engaging in physical activity. The larger your claim is, the more the insurance company will try to gather evidence to undervalue or deny it.

The Lullaby Strategy

The Texas personal injury statute of limitations for filing a lawsuit is only two years after the accident (with occasional exceptions). The insurance adjuster might try to lull you into complacency with a series of short delays, hoping that you will forget about it. If you miss the deadline that applies to your case, you’ll forfeit your right to file a lawsuit. 

“You Don’t Need to Hire a Lawyer…”

Actually, they are the ones who don’t need you to hire a lawyer. This one is the most dangerous trick of all if you fall for it. It is more dangerous than the other tricks because your lawyer can warn you of any other insurance adjuster tactics (only a small portion of which have been described here). Your attorney can also protect you from these strategies and fight back.

An Experienced Personal Injury Attorney Can Make All the Difference When Dealing With an Insurance Adjuster

You should seek help from a personal injury lawyer if you’re filing an insurance claim. Even if you aren’t sure whether you have a viable claim, you can take advantage of a free initial consultation to find out. Remember – most personal injury lawyers won’t charge you legal fees unless they win your case. Even then, you don’t pay until the defendant or insurance company releases the funds.