Information a claims adjuster needs

Insurance claims adjusters will need some information to begin processing the claim. First of all, the adjuster will need to know the names of all the people and vehicles involved in the crash. The adjuster will also need to know what property was damaged and if anyone was injured. If so, what is the extent of the damage/injury. If there are any photos of your vehicle or if there is an estimate of damages, that would also be helpful. Adjusters will also request a police report and contact information for any witnesses to the accident. Beyond these things, adjusters will also push for details of the accident, how it happened, when, where and who was responsible. Unless you have spoken to an attorney first, you need to be very careful about what you say, especially if the adjuster works for the other driver’s company. It’s best to refuse to give such a statement on the record until after you’ve had a chance to talk to a lawyer.

How to talk to a claims adjuster

The very first rule of interacting with an insurance claims adjuster is to be very careful. Even seemingly friendly questions can be spun in a negative light if you aren’t the one in charge of writing the report. Adjusters may start by asking if you are OK with them recording the conversation. It is generally a good idea to politely say “no” and take an opportunity to speak with your Texas auto accident lawyer. Speaking informally is much less risk, but you should absolutely avoid making any recorded statements that could be used against you down the road.

Another tip for talking with insurance claims adjusters is to avoid minimizing the harm you suffered. Most people instinctively downplay the harm they suffered so that they don’t seem whiny or dramatic. Saying, “Oh, I’m fine” or “It was nothing” can be damaging to your case. It’s best to speak with an experienced attorney before saying these or other things that could eventually harm the prospects of your claim.

Providing a statement

If you receive a call from the other driver’s insurance claims adjuster you will almost always be pressured into providing a formal statement, either written or recorded. You should never agree to provide such a statement without first speaking to an experienced Texas auto accident attorney who can advise you about what to say and what not to say. If you are contacted by the other driver’s insurance company, know that you are well within your rights to refuse to answer any questions. Remember, the insurance company is not the police. Be polite and respectful, no reason to be rude, just decline to answer questions on the record. Doing so prevents you from saying something that could harm your chance of success. It’s easy to get confused or tongue-tied, especially when talking to a professional insurance claims adjuster who knows exactly what questions to ask. Better to speak with a lawyer of your own first so that you can be sure not to jeopardize your claim.

Reasons to deny coverage

When an insurance claims adjuster wants to deny a claim there are three broad categories of reasons for justifying such a denial. Insurance claims adjusters will often say they are simply “investigating” an issue, something designed to slow down the claims process and buy the insurance company time to find a reason to refuse payment.

The first common reason for denying a claim is because of coverage issues. If the claims adjuster is investigating a coverage issue then they are looking for some excuse to say that there was no insurance coverage at the time of the accident so they can deny the claim. A coverage issue can be because of nonpayment, because an authorized person was driving the vehicle, because the car involved was not listed on the policy or because the car was being used for business or some other unauthorized purpose at the time of the accident. Companies will look for any possible reason to justify denying a claim due to coverage issues.

The next category involves liability issues. This means that they are trying to blame the accident on someone other than the driver they insure. This often involves placing blame on you or the person driving your vehicle. Insurance claims adjusters may also simply blame a mystery third party for the damage, claiming that some third party was responsible for the accident and excusing them from covering the claim.

The third commonly used excuse for denying a claim involves damage issues. This may mean the insurance company is looking for evidence that injuries suffered in the current accident were actually preexisting, such as back problems that were caused by an earlier wreck. The insurance claims adjuster may also look for evidence that the damage, either to your property or to yourself, was caused in a subsequent accident. Showing that you were involved in an accident a few days later and blaming that crash for your pain would get the first insurance company off the hook and allow them to justify denying the claim.

What makes a successful claim?

Though many factors go into whether a claim is ultimately successful, there are two basic elements of any claim, without which, you cannot prevail: liability and damages. The success of your claim depends on whether you can prove to the satisfaction of a judge or jury that you suffered harm (some kind of damage) and that someone else was liable for that harm (someone else was at fault). If you can show that the damage you suffered originated from someone else’s negligence, you are well on your way to a successful claim.

Settlement basics

Though the settlement process is a long and complex one and is difficult to boil down into a paragraph, the best bit of advice is to remember that a first offer is always a starting point, not the end of the line. Insurance claims adjusters are given authority to settle your auto accident claim within a certain broad range. Once that range has been stipulated, it becomes the adjuster’s job to ensure that the settlement figure is as close to the bottom of the range as possible. As a result, when negotiations begin you can guarantee that the first offer will be at the absolute bottom of the range. After all, why would a person start a negotiation in the middle or at the top, leaving little room to go up? Given this, it is almost always a bad idea to jump at the first offer from a claims adjuster, far better to wait until the number comes up to a figure that more completely compensates you for the harm you’ve suffered.

If you’re dealing with an insurance claims adjuster and would like a second opinion to ensure your rights are being protected, contact San Antonio Automobile Accident Attorney today.