Suppose your vehicle is involved in an auto accident. Whether or not you were driving, you have an obligation under your insurance policy to promptly report the accident to your auto insurance company within the next 24 hours under many policies. If you fail to do so, the company may resist or attempt to deny any claim you later submit for damages to your vehicle and personal injuries caused by accident, raise your insurance premiums, and even cancel your policy.
After you and the owner(s) of other vehicles in the accident have notified their respective insurers and any of you submits an insurance claim, you can expect to be called by one or more adjusters. You must understand who the adjusters are, for whom they work, what they do, how they do it, and how you should deal with them.
What is an Auto Insurance Adjuster – for Whom do They Work?
An auto insurance adjuster sometimes called a “claims agent” or “claims adjuster,” is a licensed professional who determines and recommends to an auto insurance company how much, if any, it should offer to pay to settle claims for personal injuries and vehicle damage resulting from an auto accident.
An adjuster processes both “first-party claims,” claims submitted by the policyholder(s) to recover for damages to their vehicle and personal injuries, and “third party claims,” claims submitted by another driver or anyone’s passengers to recover for damages to their car and personal injuries for which, they maintain, the policyholder is legally responsible.
An adjuster may be either a “staff adjuster” employed by the insurance company, an “independent adjuster” who works as a contractor with an insurance company on its claims, or a “public adjuster” who contracts with a vehicle owner or someone else injured in an accident to help with their claims against any insurers.
What does an Auto Insurance Adjuster Do?
An auto insurance adjuster’s role is to determine whether a claim submitted under an auto insurance company’s policy is valid and, if so, evaluate how much the claim is worth.
The adjuster focuses and bases their advice to the insurer on the same primary issues an attorney considers when evaluating a legal action by or against a client, including:
- how the accident occurred and who was at fault,
- what damages resulted to the claimant’s vehicle, and what are the estimated total costs of repairs and
- what personal injuries did the claimant sustain in the accident, and what are the resulting medical costs, loss of income, and other damages the claimant incurred.
How does an Auto Insurance Adjuster do Their Job?
To assess each claim, an adjuster investigates the accident and attempts to obtain as much information and relevant evidence. Whenever possible, the adjuster personally examines and takes pictures of damaged vehicles before they are repaired. Like an attorney, an adjuster tries to interview and obtain statements from drivers, passengers, and other witnesses to the accident and gather any available evidence such as copies of police reports, photographs of vehicles taken at the scene of the accident, body shop estimates or bills, medical bills, doctors’ diagnoses and so on.
After assembling and thoroughly analyzing such information and evidence, the adjuster makes their recommendations to the insurance company. If the claim is not valid in their opinion and not covered by the policy, the adjuster recommends that the company denied it.
If the claim is covered, the adjuster recommends that the insurance company offer the claimant as low a dollar amount as they think the company can get the claimant to settle the claim. After all, the adjuster wants what’s best for the insurer’s bottom line, not for the insured or any third-party claimant.
So, How Should You Deal with an Auto Insurance Adjuster?
In two words, “very carefully.”
Insurance adjusters are not your friends, not your advocates, and not working in your best interest; in fact, you should consider that they are much closer to the opposite.
For starters, here are a few of the many things you should watch out for, do and not do:
- Take your time and be prepared – have as much information and evidence related to the accident and your losses available as you can: names, addresses, phone numbers, insurance information, and so on of other drivers and any witnesses, copies of any police accident report, pictures from the accident scene of your and the other vehicles and your injuries, body shop estimates, medical bills, etc. If you’re not ready to meet or talk with the adjuster, say so.
- Ask for the adjuster’s name and contact information and what insurance company, driver, or passenger they are working with.
- Stay calm and deliberate – do not argue, get angry with or take your frustration out on the adjuster.
- Stick to the relevant, objective facts about the accident itself – don’t share your opinion as to what caused the accident, who was at fault, how you’re feeling, how serious your injuries are (you are not a medical expert), what you were doing before the accident, where you were going, etc.
- Respond, if at all, as briefly as you can and only to the questions you’re asked – don’t volunteer any unnecessary details or any other information or evidence you may have – chances are, it’s as likely to be used against you.
- Take notes of any conversations with the adjuster – what they asked, how you answered, etc.
- Consult with an Attorney Before you Deal with Auto Insurance Adjusters
Hopefully, you understand a little more now about what auto insurance adjusters do, how significantly they can impact your chances of recovering fair compensation for your injuries and property damage after an accident, and how complicated and time-consuming the process can be.
If you’ve been in an auto accident and would like to discuss it with and consider hiring an attorney to help you with your insurance claims or in any other way, get in contact with us. The experienced attorneys at Kelly & West have dealt with insurance companies and insurance adjusters on behalf of hundreds of clients over our nearly 40 years of practice.
