Working with Insurance Adjusters

A large portion of my practice requires working with insurance adjusters. I deal largely with workers’ compensation and personal injury adjusters. Those that are involved in a work injury or car accident will likely deal with the adjuster assigned to their file. This may sound like a daunting task especially just coming off a traumatic incident. This article will provide some tips that will be helpful when working with adjusters.

First off, whenever an injury occurs, a claim number and an adjuster will be assigned to your case. You will likely be notified via a letter that will come in the mail or a phone call from an adjuster. If it’s a work injury, your employer’s workers’ compensation insurer will be the one contacting you. If you are involved in a motor vehicle accident, you will likely receive calls from your own car insurance as well as the other driver’s car insurance. It’s important to not avoid these phone calls and/or letters as it will only delay any compensation you may receive. I have seen plenty of claims denied and or significantly delayed because the injured refuses to talk to the adjuster.

Next, the adjuster is likely going to want to take your statement regarding the accident. This is typically a time when those that have been injured start to get nervous. I’m here to tell you, if you are nervous contact an attorney, but do not ignore them. For the most part, giving the adjuster a statement of how the injury occurred is not a time to be overly nervous-the adjuster just wants to get an understanding of what occurred. Generally, the adjuster is not trying to trick the injured. Just tell the truth and provide as much detail as possible, including symptoms and medical treatment. However, once again, if you feel uncomfortable, contact an attorney. If an attorney gets involved, the adjuster will no longer be able to contact the injured directly and must go through their attorney for all communication. This often reduces the stress and anxiety from the injured.

As the claim progresses, adjusters will periodically call and look for updates. If you have an attorney-they will call your attorney and look for update. As such, it is important to give your attorney updates as it pertains to medical treatment and work status. As your attorney, we will constantly be providing updated medical records to the adjuster so that they can adequately analyze the file. I’ve realized in my experience that providing less updates (medical/work) only hurts the case.

Typically, the file reaches a point to negotiate a settlement when the injured is done receiving medical treatment. It is also wise to wait a few months following the expiration of medical treatment just in case there isn’t any recurrence of symptoms. It’s at this time, the injured and their attorney put together their summary of the file and what they perceive to be the value, providing a demand to the adjuster or the adjuster’s attorney. If the parties can reach an agreement, the file is resolved. If they can’t, the parties typically bring the matter to court and put the decision in the hands of a judge or jury.

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