After You File an Injury Claim with an Insurance Company, the Adjuster Goes to Work

After You File an Injury Claim with an Insurance Company, the Adjuster Goes to Work

Be careful that adjuster doesn’t end up working you over! Insurance companies seldom bend over backwards trying to be fair.

When you seek compensation for a negligence-based injury, it’s virtually certain you must deal with some type of insurance company. If you’re hurt in a car wreck, your claim is with the at-fault driver’s insurance company. If you file a medical malpractice claim, the doctor’s medical malpractice insurer handles the matter. If you sue for premises liability, a homeowner or commercial liability insurer is the target. All too many insurance companies refuse to fairly settle personal injury claims, knowing full well that injured victims will have to hire an attorney to collect rightful damages. Why?

For starters, in order to win your claim, you – the injured plaintiff – must prove who caused your injury. Plus, New York is a comparative negligence state. This means that even if you played a part in causing your accident, you can still recover damages. But the compensation amount is relative to the blame you share with the negligent policyholder. So, if you claim $100,000 in damages and it turns out you are 25 percent to blame for the accident, the maximum award is 75 percent of your claim ($75,000).

Then there’s every insurance company’s business model since the dawn of time: “Take in maximum dollars in premiums and pay out as little as possible in claims.”  To that end, insurance companies have hundreds of actuaries who compute risk, accountants to watch every penny, lawyers to defend them whenever the company wishes, and adjusters who say they’re on your side but whose real job is keeping claim awards dreadfully low!

However, the insurance adjusters’ ultimate goal is to avoid a lawsuit. If a case doesn’t settle, injured victims usually file a civil lawsuit. If the case goes to trial, the damage awards can be much higher than insurers hope for. And another risk they run surrounds legal fees and other costs associated with a trial on top of the money they must pay.

Adjusters try to straddle a fine line between serving you – just enough to where you won’t take the insurance company to court – and “giving away the store.” So how do you deal with them without becoming a victim?

  • Accept that the adjuster is not on your side – for reasons that should now be apparent.
  • Don’t say anything that can come back to hurt you: Adjusters record all your telephone conversations in hopes that you’ll say things to compromise your claim. A question like “When did you first see the other vehicle?” is a trap, because it assumes you did see the other vehicle when you earlier said you didn’t.
  • Don’t let them pester you with “new developments”: This usually happens when you reach some sort of impasse. They call you – often at odd times – with something they say “you must know,” when it’s really an attempt to start another negotiation. One person we know consistently got calls from an adjuster at precisely 8 a.m. every morning as he was scrambling to get ready for work.
  • Avoid settlement ambushes: Some adjusters will pressure a claimant into settling for a “lowball amount” before a clear diagnosis of the victim’s injuries is made. Many claimants fall prey to this tactic and end up woefully short of collecting fair compensation.

When it comes down to it, your best bet is to hire a seasoned Personal Injury Attorney rather than deal with insurance adjusters (and maybe their lawyers). That way, you circumvent this entire irritating process because then, they must deal with your lawyer — not you!

If you have been injured by the negligence of others and need legal assistance, please call The Kaplan Law Firm at (516) 399-2364 or fill out our online contact form.