What You Need to Know Before Talking to an Insurance Adjuster

By Jessica Bosari
After 13 years in personal and commercial insurance, Jessica Bosari now writes about personal finance, car insurance, risk management and related topics. Since 2008, she has been simplifying complex ideas through engaging articles for her readers.

What You Need to Know Before Talking to an Insurance AdjusterIf you have a car insurance claim, you should know a few things before you answer a call from the insurance company’s adjuster. It’s important to remember that the adjuster’s job is to save the company money first, and to honor your rights as a consumer second. Having spent many years adjusting car accident claims myself, I can tell you what to expect and how to handle the adjuster who is handling your claim.

Understanding Adjuster Motivations

Above all, you need to remember that the insurance company pays the adjuster’s salary. The primary purpose of an insurance adjuster is to pay only as much as the company is legally required to pay under the insurance policy—not a penny more. Adjusters are rated on their ability to pay and close as many claims as possible each month as well, so they may be overworked and overstressed when your claim comes in as the next case for review.

With all of that in mind, it’s easy to forget that the adjuster is also a person with feelings just like you. She isn’t trying to cheat you – she just wants to get your claim resolved and closed as quickly as she can. But that process is not as straightforward as it may sound. It’s also the adjuster’s job to:

  • Investigate the claim and confirm the facts
  • Determine who is at fault
  • Calculate the amount of damages
  • Identify signs of fraud
  • Prepare the case for financial recovery when the other driver is at fault
  • Follow consumer protection laws
  • Minimize the cost of claims

These duties mean that the adjuster has to interview you, possibly take a recorded statement, and get reports from the police, other drivers and witnesses before deciding who is at fault. The adjuster can still process damages, but she is likely to withhold payment until she has everything she needs from you as far as supporting evidence. That’s because your statement can be a determining factor in whether the insurance company can be repaid by the at-fault driver’s insurance policy.

Fraud is a big problem as well. Adjusters have to watch out for “red flags” while still providing swift customer service. Car insurance is the leader when it comes to fraudulent claims. In 2012, drivers made 209,724 questionable car insurance claims.

It’s a balancing act of knowing when a few red flags mean something is fishy about a claim and when the adjuster is just holding up a claim unnecessarily. Although putting a case into a fraud investigation can get the claim off the adjuster’s desk, I’ve never known an adjuster to over-scrutinize a case just to get it off her desk. There’s a certain amount of pride that comes with correctly identifying a fraudulent case, and more than a little embarrassment in referring a claim that turns out to be legitimate. So for the most part, consumers don’t have to worry about fraud. But adjusters do, and that can mean undertaking a little more investigation before paying a claim.

Dealing with Difficult Adjusters

Of course, you can’t please everyone, and some people can’t be pleased no matter what you do. I’ve worked with more than one adjuster who had an axe to grind. These individuals tend to get a power trip out of controlling the flow of money in a claim. Sometimes, they’re just control freaks who make emotional decisions instead of logically thinking about the case.

You can recognize this unfortunate breed of adjuster by the questions he asks. If you get loaded questions that make you sound like the at-fault driver, you’re probably dealing with an emotionally motivated adjuster. Some adjusters will make a statement followed by, “Right?” An example would be, “But you weren’t hurt in the accident, right?” If you hear anything like this, there’s a good chance the adjuster wants you to agree to something that may or may not be true, just to get the claim closed.

I don’t envy you the experience of trying to get your claim paid fairly by this type of adjuster. If you suspect your adjuster is not being fair, or is motivated by reasons other than settling your claim fairly, ask a supervisor to review your case. Don’t be bullied by an adjuster who spends time nitpicking an issue that has no logical bearing on your claim. His supervisor will usually set things straight and make sure your case is settled fairly.

How Much Should the Company Pay?

The initial accident investigation is one of the biggest causes of delay in paying and closing a claim. But trying to reach agreement on the amount of damage can cause big delays, too. When the car is a total loss, you and the adjuster have to agree on how much your car is worth – and that’s not easily done.

It’s important to establish a strong rapport with your adjuster early on. Follow his instructions when it comes to moving your car from a storage facility to another place that won’t charge you to hold on to the car. That could be your driveway, or the insurance company’s salvage yard. Get your accident report to the adjuster as soon as possible, and be sure he has everything he needs from you to come up with a fair offer. Having a good working relationship with the adjuster makes negotiating the claim much easier for you both. That’s because you’ll have to work together and agree on how much your car is worth before you are paid.

And please do trust that the value of your car is up for debate. The adjuster will get a report from its vendor to put a value on your car. He doesn’t shop the market himself, and because there are so many different types of cars out there, he probably doesn’t know what your car is really worth based on experience alone. It’s up to you to do your own research to be sure that the insurance company’s vendor accurately determines the value of your car. Look up cars for sale of the same year, make, model, mileage and condition as your car, as close to your home ZIP code as possible. The goal is to find three cars just like yours for sale in the area. Take an average of the asking price for these cars to come up with the value of your car.

Negotiating the Claim

Remember those adjuster motivations I told you about? This is where minimizing the cost of claims comes in. The adjuster has two numbers in his paperwork. One is the lowest value of your car and the other is the highest. Of course, he’ll start with the lowest to minimize costs. Never accept this first offer. He can always do better.

Once you have the adjuster’s initial offer, send a counter offer that includes copies of the listings for the cars you found for sale. Ask the adjuster to pay the average value you calculated. Most of the time, the adjuster will increase his offer only a little, but if you resist, he’ll soon realize that if he wants to close the claim quickly, he’ll have to move closer to his high number.

Your policy includes a provision for cases where you and the adjuster do not agree on your car’s value. Unfortunately, you have to pay another professional to place a value on your car in order to invoke the provision. Usually, the difference in opinion over the car’s value is not enough to warrant that expense. You may be better off taking the adjuster’s final offer.

If You Remember Only One Thing…

Remember that your car insurance claims adjuster is a person like you, but they have a job to do–get you paid without incurring unnecessary expense for the insurer. Work with your adjuster, but do your own homework. Most of the time, this process results in a settlement you can both live with.