How Do Adjusters Work On A Submitted Claim?

Injury Lawyer Personal Injury Faq's

The insurance adjuster’s duty to get working becomes obvious as soon as someone has filed a 3rd party claim. The person that supervises all the adjusters then assigns that most recent claim/case to one specific adjuster.

Adjusters focus on keeping the size of the insurance company’s pay-out as low as possible.

The adjuster assigned a certain case, has to estimate what it could be worth. That task involves studying whatever documents had been submitted by the claimant. A listing of such documents would include things like medical records, bills for repairs to the damaged vehicle, copies of the employer’s statements, with respect to the employee’s /claimant’s salary, and any bills from a psychologist, a psychiatrist or a therapist.

Some of the adjuster’s time must be spent reviewing the terms of the policy that was sold to the company’s policyholder, the party then opposed to the claimant. What did that policy say with respect to the limits on the amount of money that would be doled out to any deserving claimant?

The apparent strength of an assigned case could influence the nature of the adjuster’s next move.

Did the victim send a demand letter? If so, what did it say? Did it contain a convincing argument, or a rather weak one?

Adjusters also study claimants’ medical records. Is there any evidence that the victim failed to mitigate the effects of the reported injury? The team that would be charged with defending the victim/claimant could use that sort of evidence.

Adjusters’ final steps

All adjusters have a supervisor. Each of them consults with the recognized supervisor, while attempting to determine the value of an assigned claim. The supervisors suggest how to use a case’s estimated value, when trying to arrive at the best initial bid. Presentation of that same bid would mark the start of negotiations.

Sometimes, an adjuster does not offer a bid, right after receiving the demand letter and there are obvious weaknesses in that same letter. In that case the letter’s author could get a chance to make some corrections, in hopes of strengthening the reported claim.

Eventually, the first part of the adjuster’s work comes to an end. At that point, the claimant hears from the same adjuster, because that employee of the insurance company has chosen to make an initial offer. The presentation of that offer represents the start of negotiations.

Injury Lawyer in Oakville knows that during the ensuing negotiations, both sides come forward with new offers and new counteroffers. Ideally, the same 2 sides eventually reach an agreement, and so choose to settle their dispute. At that point, the adjuster’s intensive work has almost come to an end. Still, adjusters’ tasks do not end until all the paperwork has been completed.

700 thoughts to “How Do Adjusters Work On A Submitted Claim?”

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