Dealing With Insurance Companies In A Personal Injury Claim

After an accident, an insurance adjuster from the defendant’s insurance company will likely call or visit within a day or two–sometimes within hours. Insurance adjusters are the individuals responsible for reviewing and paying out claims for the insurance company. Sometimes they are called claims representatives, claims specialists or claims analysts.

Throughout the call or visit keep in mind that your interests are not the same as the adjuster’s. The insurance representative has a duty to look for evidence to exonerate the insured defendant. Whether you are the defendant or plaintiff in a possible insurance claim, saying the minimum will help prevent you from giving an incriminating statement that will be used against you later.

Remember: This is an adversarial system where each side is trying to find facts to help its own version of events. However, litigation is expensive and time consuming even for simple claims, and, as a result, insurance companies would rather settle cases than go to trial.

Speaking with insurance adjusters
In the aftermath of an accident, victims are often emotional and helpless. You may be a little woozy and dazed from medication or under stress because of concern about injured loved ones. Experienced insurance adjusters know this and may try to get information from you at your most vulnerable moments.

The best thing to do is to give only basic information: your name, address and telephone number, your occupation and your employer. You are not required to reveal any additional personal information.

Insurance adjusters can be pushy and aggressive. You should be just as firm in your responses.

• Politely let the adjuster know from the start that you do not plan to say much. At a loss for words? Try: “I haven’t finished investigating the accident. I’m still seeking treatment and haven’t fully recovered. It’s not appropriate to discuss the accident until I have accurate and complete information.”
• Keep careful notes of any conversations with the adjuster, including the date of the discussion, the matters discussed and the topics of conversation.
• In certain situations, you should write a brief letter to the person you spoke to confirming what you talked about. If, for example, an adjuster has been slow in making an offer but had said one would be made within a couple weeks, write that you expect to hear back by a specific date. Send the letter by certified mail, return receipt requested; by fax (with an electronic confirmation); or by some other means where you can prove the letter was delivered. Keep a copy of this type of letter as well as evidence that it was delivered.

The adjuster will likely say you need to be checked out by the insurance company doctor before any possible compensation to you can be considered. You are not required to have this examination, which aims to document that there is nothing wrong with you. Medical problems are often very difficult to diagnose, particularly soft-tissue injuries (e.g., whiplash, back sprain). Once a diagnosis from any doctor is in your record, you should assume that the insurance company will use it against you when it comes time to settle or at trial.

What to do about witnesses
If the insurance adjuster asks about any witnesses, say you’ll contact the insurance company with their names and contact information. However, it might be possible to get some information from the adjuster about witnesses you were not aware of.

The same holds true for third-party involvement. Don’t give out more information than you need to.

The “quick” settlement offer
An insurance adjuster who contacts you following an accident may try to offer you a “quick and fair” settlement. There are many reasons not to take the offer. You don’t know the full extent of your injuries or property damage immediately after the incident. You can only make such an important decision when you’ve had time to get all the information.

Read before you sign
As with any legal documents, you need to be sure you understand what it is you’re signing. If you have any questions or hesitation, have a lawyer review the document first.

Be particularly wary of giving access to your medical records. Normally you have the right to release your medical records in your own time–they are your records, after all.