Bargaining is an art, and insurance adjusters are artists. They are masters at negotiating, but if you know how to scare your insurance adjuster, you can take them down a notch. This guide will arm you with everything necessary to face your insurance adjuster.
The corporate world isn’t as cooperative and friendly as you might think. The wheeling and dealing in businesses surround only one pillar – profit. This practice is more common in for-profit corporations, and insurance companies are no exception. Their behavior, conduct, and communication may seem sweet and enticing but remember, it’s just a charming mask used to lure you into accepting them as a trusting partner, only to stab you in the back in your hour of need.
You will hear all the oversweet words and assurance of ‘we will take care of you,’ ‘trusting us won’t be a mistake,’ and ‘we are trusted nationwide because clients are our family,’ but it only needs one incident for them to reveal their true self – a profit-making machine. Suffering an accident doesn’t hurt you as much as the time-consuming, profit-centered, victim-blaming procedures conducted by insurance adjusters on behalf of the companies.
Their only goal is to somehow direct the entire, or some part of, blame on you to minimize the settlement cost to the possible extent. The intent becomes crystal clear on the very first offer,, which is often nothing but a laughing stock, making a mockery of your already-terrible situation.
It’s unacceptable, unjust, and unfair, but it is what it is. You can either redundantly argue with insurance adjusters, only to get your already depleted settlement further shrank by half because of showing angry emotions and arguments, or reluctantly accept their offer and head back home.
The former is understandable; the rage and frustration are justified, but if you don’t want to be the latter, this guide is just for you. Learn how to scare your insurance adjuster to drive a hard bargain and save yourself from settling for less.
Table of Contents
- 1 What is an insurance adjuster in the insurance business?
- 2 Can you sue your insurance adjuster?
- 2.1 Ways that insurance adjusters act in bad faith
- 2.2 How to sue your insurance adjuster?
- 3 Car insurance adjuster secrets
- 3.1 “How can I help you?” – Don’t take the bet!
- 3.2 “Can I have your medical records, please?” – Not at all!
- 3.3 “Could you please tell us what exactly happened?” – Beware, it will be on the record!
- 3.4 “Good! Your hospital bill and medical expenses are so low” – No, they are not!
- 3.5 “Okay sir, here’s what we can offer you!” – Reject it in the first place
- 3.6 “Sir, your case is still in progress” – Yes, in progress but deliberately!
- 3.7 “We help people, you don’t have to bring a lawyer between us” – you know what, bring one immediately!
- 4 How to talk to insurance claims adjusters?
- 4.1 Keep your calm and be polite
- 4.2 Know your insurance adjuster
- 4.3 Keep your personal information with yourself
- 4.4 Do not bring your accident or injuries up
- 4.5 First settlement is always unfair settlement
- 4.6 Refrain from a recorded statement
- 4.7 How to deal with difficult insurance adjusters?
- 4.8 Be respectful
- 4.9 Do your research
- 4.10 A break may help
- 4.11 Request a different adjuster
- 5 Insurance adjuster harassment
- 6 Conclusion
What is an insurance adjuster in the insurance business?
An insurance adjuster, also known as a general adjuster or claim adjuster, is responsible for managing and investigating the claims submitted by the insured or claimant in order to determine the appropriate amount for a claim settlement based on the terms of the insured’s policy. An insurance adjuster reviews the facts, and required documents, inspects, communicates, and estimates the final settlement for the insured.
There are many methods, techniques, and tactics used by insurance adjusters to extract all the information to confirm the claim and also to find any loophole to capitalize on minimizing the settlement to the lowest possible and maximizing the profit for the insurance company.
The loopholes could be finding any erstwhile ailment and injury or any other medical history i.e., prescribed drugs, substance abuse or drug abuse, etc. If found any, an insurance adjuster can use that against the claimant by linking it to the accident and painting the victim itself at fault.
To this end, insurance adjusters first try to humble and condescend to the insured or claimant and use mixed communication tactics, sometimes using sugar-coated sentences, other times adopting harsh, culpable language for luring the claimant into accepting the first offer, which is often nowhere near the claim. They make the whole case against the insured party out of the medical history records, public safety records, or social media engagements. Insurance adjusters even reach out to the personal doctor of the insured to find anything against a claimant.
Not all fingers indeed are the same. There are definitely responsible and professional insurance adjusters out there. But the majority always overwhelms the minority. Now, profit-savvy practices have been a norm in insurance companies. Because of that, it is all the more important to learn how to scare your insurance adjuster to extract the best deal. So, buckle up, sit tight, and keep scrolling.
Can you sue your insurance adjuster?
An insurance adjuster at an insurance company is legally responsible for conducting a thorough and fair investigation to give an appropriate payout to the insurer or claimant. He has to do everything in his jurisdiction to entertain the entire process transparently and fairly. However, if he fails to do so and if the insured suspects any misdeed or bad faith in his conduct during the process, an insurance adjuster (and often the insurance company) can be sued in the courts of law.
We will discuss in detail the acts of commission and omission that indicate the insurance adjuster’s bad faith in the process later in this article. But let’s just for now bring our attention to the torment of the insured who, on one side, is going through a traumatic experience of an accident that could’ve taken his life, and on the other side, he is being subjected to the misconduct and biasedness of the insurance adjuster, which is only adding into the insured’s ordeal.
But in case the insured himself dies, and his family gets involved in the process, the story of suffering increases to new heights. Already grieving for the loss of a dear one, the delaying tactics and noncooperative behavior of the insurance adjuster only adds insult to the injury to the whole family.
Below are a few actions that reflect the bad faith of the insurance adjuster, and on the basis of which he or she can be sued.
Ways that insurance adjusters act in bad faith
Many insurance adjusters tend to offer meager settlements even after taking two weeks of a thorough investigation. And the appalling fact is that many insureds or claimants reluctantly accept the offer. Most are unaware that they have the right to reject the offer. However, even if they reject and request an increase, the insurance adjuster doesn’t budge. It is only after intense negotiations that the adjuster finally agrees to offer a somewhat appropriate payout.
Many insurance adjusters don’t take much interest in the investigation and tend to offer a pre-decided settlement that is often way under par. Because of lack of interest and ineptness, insurance adjusters don’t bother asking questions from claimants, inspecting the documents, and conducting a proper investigation. If you see any, sue him right away!
Playing delaying tactics
Generally, it should take 15 days for an insurance adjuster to go through medical history and other essential documents, conduct interviews, and complete all the other necessary means to get a good context behind the claim so as to formulate a conclusion to the claim and either approve or disapprove it. However, in most instances, that’s not the case.
The claimants have to wait for 15-30 days just to get an update on their claim. But even after the claim is approved as the investigations complete their course, the insured party is made to wait for more than ten days while the period to pay the claim is merely five days. This is often outrageous for the families who have lost someone dear to them.
Biasedness in document evaluation
It is quite a common thing to send police, doctors, accident reconstruction experts, and other professionals the documents submitted by the insured/claimant for verification or evaluation. The ethics suggest that these documents should be evaluated on neutral grounds. But some insurance adjusters tend to send the shared information with ‘favorite’ police officers, doctors, and other relevant professionals to get desired results so that they can forge the total payout and unjustly save some for the insurance company.
This practice is unacceptable and warrants the suing of the involved officials, including insurance adjusters.
These are some actions that are usually taken in bad faith and make the suing of insurance officials inevitable. The moment you see them committing such malpractices, you have every right to sue not only insurance adjusters, but you can also sue the entire insurance company.
However, it might not be as easy as you might think. Here’s what you will need to do to sue insurance adjusters.
How to sue your insurance adjuster?
If you want to sue your insurance adjuster, the first thing you need is strong evidence in order to substantiate a bad faith claim. The insurance adjuster is acting in bad faith but if you don’t have any evidence or if you cannot prove it in any way, you won’t be able to get a just and fair payout. Chances are you might get punished for filing a false case.
So, how to sue your insurance adjuster? Here is what you can do:
Understand your policy:
Thoroughly read your insurance policy so that you have a strong grasp of what it includes and what not. Knowledge is power, they say, and it aptly applies here.
Document conversations with the insurance adjuster:
Please document all the conversations you have with the adjuster as these are the building blocks of your policy. Don’t forget to add the date and time. That way, when the time comes, you will be better prepared to indict your insurance adjuster.
You should record all the files that are shared between you and the insurance company and keep them in a file. The documents may include photographs, medical reports, and any kind of other reports. It’s important because the company you are engaging with keeps all your information provided by you and they can use it anytime they please. Keeping the original documents with yourself gives you leverage over their potential forgery.
Be ready for a legal battle
If you have received a denial, be ready because that signals the onset of a legal battle that may ensue between you and your adjuster. You can start by asking the insurance company to review their decision and wait for a response. In case the company plays delaying tactics or doesn’t entertain reviewing the request, or worse, the review transpired to be unsuccessful, prepare to file a complaint with the Texas Department of Insurance (TDI).
After that, write to the company and give them one last chance to pay the claim. Tell them if they don’t comply, you will file a bad-faith lawsuit. And again, if you get a negative response, don’t hesitate in hiring an attorney. Everything will turn in your favor.
Car insurance adjuster secrets
We understand that accidents are very unfortunate, but they are a bitter reality of life on wheels. Undoubtedly, road accidents are inevitable due to some factors. That’s why you, your friend, or any of your relatives can come face to face with such an incident at any moment in your life so you better be prepared for what comes after that.
Here’s what will come after the accident:
- You will feel stressed after the traumatic episode of the accident
- You will suffer a few injuries, some even of serious nature
- You will have to face a car insurance adjuster
Now, you may get over the trauma of the accident and relieve yourself from the stress caused by the incident; the injuries might as well be healed with time, but what might be problematic is facing a car insurance adjuster to recover the financial loss caused by the mistake of a crazy driver.
This would be the first time you would be interacting with a car insurance adjuster so let us tell you in advance: his signboard may say HE IS THERE FOR YOU, but in reality, he is not. Many insurance companies are for-profit enterprises and he’s an employee who serves the company, not you.
So, it might be a little troublesome to face an insurance adjuster… but that is if you don’t know the car insurance adjuster secrets. Below are a few secrets of a car insurance adjuster knowing which will help you get the loss you deserve.
“How can I help you?” – Don’t take the bet!
When you reach out to the car insurance company, expect a very warm welcome. You will get to hear “How may I serve you, sir/ma’am?” and other sweeteners to start the conversation, but when it proceeds, you will see them asking for irrelevant information like your recent medical reports, the speed you were driving at when the accident happened, and if you have any issue with your eyesight. All these questions will come your way politely, but that politeness is just a bet you must not take!
“Can I have your medical records, please?” – Not at all!
It’s most likely that the car insurance adjuster will ask you to submit your medical records in order to get your claim. But it’s just another bet. The adjusters usually take the record and try to find any mental or physical issue in your medical history so that they can use it against you and claim that the accident only took place because you were suffering from this disease or that condition, no matter how irrelevant it might be with your case. Sometimes, they can even use your years-old health issue to spoil your case.
“Could you please tell us what exactly happened?” – Beware, it will be on the record!
One of the car insurance adjuster secrets is they try to open you up about the accident as much as they can and record everything you say. It’s a trap right there so you need to tread very carefully. At that moment, you might be giving a recorded statement without you knowing it. Though there’s nothing wrong with telling and opening up about your accident, your statement might create some glitches in your claim. The reasons are simple: you are overwhelmed already with the accident and might not be thinking clearly. Anything you say might be used against you in the future.
Say, for example, you tell them that you tried to steer left on the road to save someone or something, and then this car came out of the blue and hit you. Seemingly, it’s an honest statement, but it will give the adjuster a chance to confuse you by asking questions like are you sure you did the right thing? Had you not steered left, would the accident still have happened? And there are many other questions he or she may ask, answering which will weaken your claim. So, beware!
“Good! Your hospital bill and medical expenses are so low” – No, they are not!
Another tactic car insurance adjusters play is they don’t take your physical or mental state into account and see your hospital bills and other expenses, smile, and proceed with the claim. It is very unfair. Because the cost of your injuries and mental suffering is far heavier than a few hospital bills and other expenses. You have every right to stand up for yourself and claim compensation for your internal suffering as well.
“Okay sir, here’s what we can offer you!” – Reject it in the first place
The very first offer the car insurance adjuster offers you is not always an ideal one. In fact, it’s prepared after many cuts in your claim because of what information you have been providing them. Most of the time, such offers aren’t even sufficient to pay for your medical expenses. What you have to do is not to accept the offer instantly. Because you accept the offer, there’s no coming back. The adjusters are best at negotiating, as mentioned above. But you have to rev up your negotiations and garner the best deal out of the adjuster.
“Sir, your case is still in progress” – Yes, in progress but deliberately!
Sometimes, the car insurance companies deliberately prolong the application process so as to exhaust you to the boiling point and force you to accept the minimum offer. Already ravaged from injuries, medical expenses, no social life, the trauma, pain, and suffering, the patience of such a person wears thin gradually, eventually resulting in him instantly accepting any offer they make in the first place. That’s exactly what the insurance companies want. First, they exhaust you. Then, they exploit you and take advantage of your situation.
“We help people, you don’t have to bring a lawyer between us” – you know what, bring one immediately!
There’s one solution to all of the abovementioned problems – hire a lawyer to speak to the insurance company on your behalf. You can save yourself from a lot of trouble by hiring a lawyer that will deal with the insurance company and respond to them aptly no matter if they ask for medical history, recorded statements, or other serious things. You don’t have to do it all alone. Trusting a lawyer is a life-saving thing you will ever do.
The car insurance company will try to persuade you not to opt for a lawyer and tell you that it’ll cost you more heavily than all your medical expenses and hospital bills. But it’s because they want to save their profit and know that the lawyer will be quite expensive for them. Therefore, immediately hire a lawyer when you reach out to a car insurance company.
That’s all from the car insurance adjuster secrets. The crux of the matter is that when it comes to the car insurance adjuster and your injury/accident claim, it’s you versus them. Act accordingly!
How to talk to insurance claims adjusters?
When you get into an accident because of the mistake of another driver, it is most likely that you will receive a call from the car insurance company of that faulty driver. You can expect the call in 3-5 days after the incident takes place. The insurance adjuster will ask you about things surrounding your accident, but the real motive is something else.
The initial conversations between you and the insurance adjuster are mostly targeted for extracting information from you and finding weak points in it to shrink your overall claim. In this context, the call with your insurance adjuster becomes crucial for your case. So you need to know how to talk to insurance claims adjusters. Below are a few points that will help you prepare for the call in advance:
Keep your calm and be polite
Politeness is the key here. The claim adjuster may ask you irrelevant questions, and may even push you to answer these questions. But please remember that while you have every right to stay quiet and not answer irrelevant queries, you need to keep calm and ask the adjuster politely to ask questions that pertain to the case. If you give angry responses, it will weaken your case and leave you with nothing but regrets.
Know your insurance adjuster
The claim adjuster will call and ask about your personal information which is completely okay. However, he may go one step ahead and ask or tell you other things. Whatever the case is, beware. Keep a note and pen with yourself and inquire the person calling you about his name, company, and his designation at the company. Also, do not forget to ask about the purpose behind the call and how things are going to proceed. If you are smart enough to have a call recorder on your phone, you may want to record all the conversation, word by word.
Keep your personal information with yourself
It is okay if your claim adjuster asks you about your name, contact information, and other such details. But when things lead to the adjuster asking about your hobbies, daily activities, medical history, or any such information that has nothing to do with your case, you need to be prudent. This is not to strengthen your case, but on the contrary, a naked attempt to weaken it by finding fault with any of your given information. Therefore, it is advised not to share personal details with the claim adjuster.
Do not bring your accident or injuries up
When the claim adjuster calls you, expect many sweeteners or words of sympathy from them. They will sound like they are really sorry for what happened to you. But the truth is, they’re not. First, they will sympathize with you. Then, they will try to ask you irrelevant questions mentioned above. And in the end, they will somehow find a way to bring your accident into the discussion. It never happens out of goodwill. Yes, at some point, you will have to provide details about your accident with the claim adjuster, but that is not without an attorney.
It is important to know that if you discuss your accident or injuries with the claims adjuster, they might consider it as a recorded statement and hand you meager compensation that doesn’t meet your needs. After that, you won’t even be able to fight back as your initial statement would be used against you.
First settlement is always unfair settlement
After the initial interaction between you and the claim adjuster, a settlement would finally be offered to you. Frustrated and exacerbated from the accident and all the tiring process of extracting the claim, you might be enticed to accept the first settlement the insurance company offers. However, please keep in mind that the first settlement is always the least possible amount of what you actually deserve. It is a tool utilized by many companies to resolve the case in the first place while paying little from the coffers.
But you have the right to turn down the offer and claim the amount that you really deserve. A deserving amount shall pay for not only your physical injuries but also heal your emotional discomfort caused by the accident.
Refrain from a recorded statement
A recorded statement is the final version of your side of the story. While it is true that only you can tell the truest side of the story, it may not always win you the case. Especially, when you are undertaking it without an attorney.
An attorney knows the legal complications and could alter your statement so that it wins the case for you. Provided that ordinary citizens are not always well-aware of legal matters, you never know what part of your statement would be used against you. But one thing is certain, if you give a recorded statement in the absence of your attorney, your worst fears may come true. Tread prudently!
How to deal with difficult insurance adjusters?
Okay, so as if the accident wasn’t grueling enough that now you are forced to talk to a stone-hearted insurance adjuster and discuss your claim. However, it can be an extremely irritating or pleasant experience for both parties, depending upon how you both approach it. Whether you let the adjuster bully or condescend you and don’t stand up for yourself or whether you act unfairly with the adjuster – it’s all a matter of choice!
But we know it’s not easy to make an instant choice. And a few words of advice always helps. So keep scrolling, below you will find a few ways to deal with difficult insurance adjusters.
It never hurts to be respectful to someone. We know a lot goes on your mind after the accident. And we also understand if the claim adjuster is being a little unfair. But understand that the insurance companies hire them for very job they’re doing. They are hired for negotiating a mutual ground for both, the company and the claimant. And it’s their job to thoroughly investigate the matter.
So yes, there will be misplaced questions. But you have to keep your nerves cool and do your part in this negotiation, which is to give appropriate answers. If you don’t feel comfortable answering any query, just say it. If the adjuster forces you, politely ask him if he has any other questions or this conversation is done for good.
Do your research
It goes without question that your knowledge in insurance matters would be limited. You might be an expert in your specific profession, but insurance isn’t your domain. So when an adjuster calls you, he might try to get under your skin by using various tactics. These tactics may include uttering confusing technical insurance jargon, bringing up unknown laws or policies, and maybe the impossibility of processing your claim or any matter due to official limitations.
They might be right about a few things, but you never know. So the prior knowledge of technicalities would be a leverage you will have in a conversation with the adjuster. It’s better to be equipped to some extent than none at all. Do your research and the ground is almost yours.
A break may help
When things are going out of control, it’s always OKAY to take a break and get yourself some breathing space. It can be when the adjuster is not stopping his condescending attitude. Or when you feel the anger running in your veins. Simply end the call or ask the adjuster to please leave and you will reach out to the company when you feel ready.
Request a different adjuster
If you have been very plausible with the adjuster and he’s still giving you harsh treatment, you can request for the change of the adjuster and even file a complaint against the current rude adjuster to the company. Not that the company cares, but at least you would have documented reasons to request a new adjuster. Also, any coming adjuster handling your case would be prudent in repeating the same behavior as the previous one.
Insurance adjuster harassment
If you have ever faced insurance adjuster harassment, you would certify that it’s not easy to stand against such rude behavior. Or even if they’re not being rude, they just close every window of opportunity to talk about the claim or any other matter.
It’s not that all the adjuster fraternity apply the same tactics and treat you harshly. There are some who are perfect at what they do and who can feel your pain. However, they’ve been found in minor numbers.
But the reason behind this phenomenon must be discussed. Here’s what we think.
We are all humans. We feel for each other, our sorrows and joys alike. So we want to help each other. But sometimes, our professions and responsibilities get in the way. Take insurance companies, for example.
The basic reason behind the existence of these companies is to help those in desperate need i.e. in case of an accident, death, or other tragedy in which the family or the insured suffer the consequences.
While a few companies do what they say they do, many acts totally opposite of their claims.
They only become money-minting organizations and their scope deviates from helping people to making profits. And this way, they form vague policies that are seemingly targeted at helping people, but when dissected, they will turn out as merely tools to serve the company at large.
The top tiers of the company make these rules, and the medium and lower tiers are employed to carry out these draconian policies. The adjusters are no exception. They only do what they are told to do.
That is another reason to be respectful to them because they are themselves part of this vicious cycle. But by standing out against them, you actually take exception to the company and protest against their anti-people policies.
We guess, if you have reached out to this part of the article, you are ready to take any insurance company down by a notch! So far, we have discussed the tactics the insurance adjuster plays and how you can save yourself. We also dissected how you can sue your insurance adjuster and the secrets of insurance adjusters.
In concluding this guide, we will try to summarize everything in a short and precise way, without jumping into details.
You may not expect it but sooner or later, you will have to encounter an insurance adjuster. When you do, save yourself from the illusion that the insurance adjuster is there to help. He is there to serve the needs and wants of the company using your vulnerabilities. Provided this context, it becomes clear that you are left on your own and have to fight your own war.
One way to do this is to equip yourself with the knowledge of technicalities and complications pertaining specifically to your matter. That way, you will have an advantage over the insurance adjuster. You would be able to confront him if they try to lead you astray.
Another way is to hire an injury attorney. This might be a bit expensive, but it’s the easiest and most profitable way. You can tell everything you know about the incident to your attorney and then just relax in the back seat while your attorney strives to get you the best deal.
It won’t be a prolonged case with your attorney in the driving seat. Many insurance companies hate to confront them because they know lying and using delaying or other tactics with the attorney shall cost them heavier than simply giving you what they deserve.
So, yes. That’s how you scare your insurance adjuster and get your job done!