How Does The Adjuster Investigate A Personal Injury Claim?

After a policyholder has been involved in an accident, he or she must report that same incident to the company that has sold him or her the relevant insurance policy. At that point, the insurer would create a new file. That new file would get handed to one of the insurance company’s adjusters.

Whenever an adjuster receives a new file, his or her plans and actions focus on completion of an investigation. Adjusters that have a new file in their hands seek to carry out a thorough examination of each claim’s facts. How does that goal affect the tasks that are part of the investigative efforts?

The adjuster’s first task: Get desired statements

The first statement sought would come from the person that the claimant has identified as the liable party. That person is also the policyholder. Next, the adjuster would check to see if any officer had submitted a police report.Finally, if the injured victim had submitted a claim, then one of the adjuster’s tasks would involve interviewing that same victim, as personal injury lawyer in Edmonton.

The next group of tasks would focus on research, in order to obtain facts that could indicate the veracity of the submitted claim.

Study the company’s database; see whether or not the present claimant has submitted any previous claims. Go online, and check for any postings that the claimant might have made on a social media network, such as Facebook. See if any posted pictures or comments fail to agree with the claimant’s allegations, or with any reported facts.

Make requests

Seek permission to go after the victim’s medical records, by seeking claimant’s signature on a form: Smart victims deny such a request, unless they could have a lawyer review the same request, before it has been signed.

Ask for a recorded statement from the claimant: Smart claimants refuse that request as well, unless the requested statement can be made in a lawyer’s presence.

Use collected information, in order to complete specific calculations and arrive at an estimate of the claim’s value

Actions that are never included in any adjusters’ investigations

Act of seeking out an injured party that has not filed any injury claims, in order to learn whether or not he/she does plan to file a personal injury claim.

Act of sharing estimated values with claimants: Adjuster could respond to questions about the size of the adjuster’s initial offer. Yet the presented offer might not reflect the size of the claim’s estimated value.

Act of searching for detailed information on the claimant’s reported injury. Instead, adjusters prefer to work on forming allegations that the same injury had been made more serious, as a result of either the claimant’s actions, or lack of appropriate action.