What Does a Claims Adjuster Do?

What does a claims adjuster do?

We buy insurance to help protect us against unexpected accidents, losses or events from fire and theft to injuries, illness and car accidents. When you make a claim with your insurance company, the company will assign a claims adjuster to your case to determine if your policy covers your claimed loss, and how much you will be paid (if at all) for your claim.

When it comes to car accidents, claims adjusters have to investigate the accident facts, assess the losses or damages, and negotiate a settlement on a claim. It’s important to note that claims adjusters work in best interest of the insurance company. So, if you’re injured in a car accident, you can hire a personal injury attorney to do the same work as a claims adjuster, but on your behalf.

In fact, a personal injury lawyer will do more for you than a claims adjuster because, per California law, a claims adjuster cannot give you legal advice of any kind. Hiring an attorney to represent and advise you is one of the best choices you can make after you’re injured in a car accident.

Are all Claims Adjusters the Same?

There are three main kinds of claim adjusters: staff, independent, and public. Staff adjusters are employed full-time by the insurance company, and are generally assigned small personal claims. Independent adjusters still work in the insurance company’s best interests, but they work with larger or more complicated claims.

Public adjusters are employed by the policyholder in the event of a massive loss like a destructive house fire, or serious storm damage. A public adjuster does the same work as the other kinds, but in your best interests.

Getting the Full Story

As an employee of the insurance company, the first thing a claims adjuster does in the event of a car accident is to get the insured’s side of the story. The adjuster does this through the insured’s written accident report and interviews. An experienced adjuster knows that one person’s experience is not the full sequence of events. So, most adjusters will then request and go over all official accidents records like police reports and state department of motor vehicle driver reports.

Responding to Claims

After gathering the full story and all the facts, and adjuster then responds to the claims filed against the insured. The initial response is generally a simple letter that identifies the adjuster, provides the applicable policy limits, and asks the you or your lawyer to provide all documents relating to the your damages, from medical records and bills to proof of earnings or proof of property damage.

In a personal injury claim, the adjuster will spend a lot of time gaining access to all medical bills and records relating to your claim in the hopes of finding something to lower your claim’s worth. Most adjusters will send the injured party a medical authorization that will allow them to request the injured party’s medical records themselves. Do not sign this authorization form unless your Los Angeles personal injury lawyer tells you to, as you do not want the adjuster digging around in your medical records without your knowledge.

Similarly, the adjuster may ask you for a recorded statement describing the accident and your injuries or losses. Do not give a recorded statement unless your lawyer instructs you to do so.

Determining The Case Value

Once the adjuster has gathered the information from both sides, he will put a value on the claim and try to settle it. The adjuster will usually ask you how much you want to settle, but you should never give a number first. Work with your lawyer, and ask the adjuster how much he will offer to settle. Your lawyer will then negotiate on your behalf. Do not try and negotiate with a claims adjuster by yourself.

Trust Ellis Law

Case adjusters aren’t bad or evil; they just have different interests than you do. That’s why it’s vital that you hire a Los Angeles car accident lawyer to work on behalf of your best interests. Ellis Law Corporation can help.

You might experience a flood of calls from the insurance company and claims adjuster in the days following your accident. While it may seem like these people want to help you, its our experience that the negligent driver’s insurance company wants to settle matters as quickly and for as little as possible. Rely on the advocacy of a skilled car accident attorney from Ellis Law to fight for your best interest and the best possible compensation.