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How The Insurance Adjuster Approaches An Injury Claim?

Insurance adjusters do not get to choose the injury claims that they are expected to handle. The insurer assigns a specific claim to a particular adjuster. That particular adjuster might be working on other claims at the same time.

What goal is in the adjuster’s mind?

• To unearth evidence that will help to lower the payout, ideally making it as low as possible.
• To work well with the claimant, so that the dispute can be settled and a lawsuit can be avoided.

What factors do adjusters examine during the investigation of a claim?

How much money was spent on treating the claimant’s injuries? Did the claimant need physical therapy or occupational therapy?

Did the claimant lose any wages while he or she was recovering? Did the claimant have other financial losses? Maybe he or she was self-employed. How has the plaintiff document any loss of profits?

Was there any evidence of pain and suffering?

Did the accident cause other negative effects? Did the victim lose the ability to perform a task that was part of his or her job responsibilities? Did the plaintiff lose an opportunity to attend a conference, one that might have made it easier for the plaintiff to get a better-paying position within the company?

What is the policy limit? Does the value attached to this injury exceed that limit?

Adjusters study the strength of a claimant’s case.

If a claimant has a strong case, then the adjuster knows that it would be foolish to force the same claimant to pursue a lawsuit. The insurance company would not want to risk the chance of losing a court battle, and being forced to pay money to the claimant.

On the other hand, the adjuster’s examination of the various factors might show that the claimant’s case is rather weak. If that were the case, then the adjuster would feel inclined to make a low bid as the first offer. Accident Lawyer in Waterloo knows that if the adjuster’s low bid was challenged, the adjuster’s investigation should have unearthed reasons that the case being made against the defendant was weak. In light of that fact, the insurance company would want to stick with its low offer.

Adjusters’ experience shapes their approach to a personal injury claim. Their experience provides them with a sense for when a case is strong or weak. If a case seems strong in a claimant’s eyes, the adjuster’s low offer might trigger the initiation of a lawsuit. In this case, the insurance company would not have concerns about the possible outcome from such a lawsuit. It would expect to win a court case. It would have those expectations, because it would have studied the weaknesses in the opposing party’s case.

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