How Do Insurance Adjusters Approach An Injury Claim?

After the person that had been injured in an accident has filed a personal injury claim with the responsible party’s insurance company, the insurer assigns that same claim to one of the company’s adjusters. All insurance adjusters have the same goals.

What is the adjuster’s 2 goals?

Each adjuster wants to keep the size of the payout that must go to the claimant as low as possible. At the same time, it is the adjuster’s intention to eliminate the possibility that the insurance company could become the target of a lawsuit.

What factors come under consideration by the adjuster?

The nature and extent of the claimant’s pain and suffering: An adjuster’s initial offer would normally be higher, if the claimant had suffered a catastrophic injury. The size of the claimant’s medical expenses: The total that would result from a summation of all of the claimant’s medical bills.

The amount of money lost by the claimant, while recovering from the accident: If the claimant had been employed, then the weeks without a paycheck would have accounted for any lost earnings.

What had been the negative effects of the injury? Had it caused the claimant to miss some wonderful opportunity, such as the chance to attend a conference, or to take part in a special educational program?

What could be the influential forces on the adjuster’s thinking?

The adjuster’s desire to avoid a lawsuit would increase, if it became clear that the claimant had chosen to file the papers that would allow him or her to pursue of a lawsuit.

The adjuster would study the evidence, in order to determine how clearly and completely it linked the policyholder’s actions to development of the injury that had been reported by the claimant. The contents of the claimant’s demand letter: That would give the amount of money that the letter’s sender/the claimant hoped to receive, in the way of compensation for the reported injuries.

How do adjusters’ actions reflect the influential nature of the forces that have been listed above?

Each of them studies the contents of whatever demand letter was sent by the claimant for that particular adjuster’s assigned case. If the claimant has not retained an injury lawyer in Medicine Hat, then the adjuster’s initial offer is well below the figure mentioned in the demand letter.

Adjusters’ actions are a bit different whenever there is a lawyer, one that has agreed to support a particular claimant’s demands. In such a situation, the adjuster might reduce the figure demanded by some percentage that had been stated by the head insurer. Eventually, some percent of the written demand does become the amount of money that the adjuster proposes/offers. That initial offer represents the start of negotiations.