Protect your right to compensation by learning to spot these top insurance adjuster tricks
If you’re in an accident in which you incur personal injury or property damage, you will usually be dealing with an insurance company. That might be another party’s insurer, your employer’s workers’ compensation insurance company, or your own insurer.
Either way, you’ll probably be visited by an insurance adjuster whose only concern is the best interest of the insurance company that employs them.
What is an insurance adjuster, and what do they do?
An insurance adjuster works either as an employee or contractor for an insurance company. Their principal job is to investigate claims against the insurance company for losses for which the insurance company is allegedly liable.
Their investigation will elicit the facts of the loss incident and assess the monetary amount of damages. In doing so, they will interview you and witnesses to the event, take written statements, review accident records, including police reports, examine property damage, and take photos of the accident scene and property damage.
Their principal, if not their only, purpose is to protect the interests of the insurance company that is paying them. That interest is to minimize their claims payouts and maximize their profits. The adjuster’s performance is measured to a large degree by how well they manage to deny or limit claims.
In the performance of their duties, an adjuster will typically employ tricks to manage your claim most favorably for their employer, the insurance company. Also, since their performance is evaluated by how well they manage the case, they have a self-interest that inspires them to, yes, cheat.
General tort and workers’ comp laws
To help you fully understand an insurance adjuster’s objectives, let’s start by reviewing some basic aspects of the laws dealing with liabilities and damages from accidents that are usually covered by insurance. An honest adjuster will operate within the parameters of those laws. A dishonest adjuster will not.
Personal injury claims
Personal injury and property damage claims are governed by the rules of state tort law. Liability for a tort (other than a workers’ comp claim) requires that a party negligently or intentionally commit an act or omission that was the proximate cause of the harm.
A tort claim can be complicated by a plaintiff’s comparative negligence. Most states, including South Carolina, recognize some form of comparative negligence, in which a plaintiff’s award might be reduced proportionately according to their percentage of fault.
Workers’ comp claims
Some injuries occur at workplaces and are subject to state workers’ compensation laws. Workers’ compensation is a no-fault insurance system, so proving an employer’s liability is not required of an employee. However, most employers satisfy their workers’ comp obligation with insurance.
Hence, a worker injured on the job must deal with their employer’s insurance provider. Insurance adjusters will invariably be involved in a workers’ comp claim. While liability will not be an issue, other issues will be addressed by an adjuster, such as worker eligibility and whether their injury was incurred during a proper performance of their duties.
Choosing the Best Workers’ Compensation Attorney
To get maximum compensation, it’s essential that you choose the right workers’ comp attorney. Learn what to look for and what questions to ask to ensure you get the best attorney for your case.
What tactics do insurance adjusters use to reduce or deny claims?
The following are a few of the tricks insurance adjusters typically employ to minimize or deny your claim.
Insurance adjusters will bait you into saying something that could be construed as an admission of your fault or comparative negligence.
The adjuster will not admit that their insured’s actions caused the accident. Rather they will ask you several questions to which your answers, together, might constitute an admission of your own fault.
In the case of worker’s comp claims, they will try to get you to admit to facts that cast doubt on your eligibility as an employee or to circumstances not covered by workers’ compensation.
An adjuster cannot see your medical records without your written consent. Do not sign anything, much less a consent to view your medical records, without consulting your attorney. Adjusters commonly try to use the information in your records that is unrelated to the accident or injury in question against you and blame you or another party.
Also, you may be asked to submit to a so-called independent physical examination. First of all, when an insurance company demands a physical examination, there is no such thing as an independent one. The examiner is chosen and paid by the insurance company. If they ask to attend such an exam, don’t consent. You have a right to privacy protection.
Recorded or signed statements
Invariably, an adjuster will ask you for a written statement. Do not give any statement that you must sign. Let them take notes during your interview, but don’t initial them, sign them, or in any way acknowledge the accuracy of those notes.
Also, do not give your consent to be recorded by audio or video means. It’s bad enough that they can bait you with questions or innocuous conversations to get you to unconsciously admit to compromising information. It’s worse if they have it on tape.
A most sinister tactic of an unscrupulous adjuster is to tamper with recorded testimony. With minor editing, your recorded words can be twisted to mean something you didn’t say.
Delay, delay, delay
When you suffer an injury or property loss from an accident like a car crash, you often endure financial stress while you’re waiting to be compensated. For example, if your vehicle is disabled, you will endure inconvenience or financial hardship while you’re waiting for it to be repaired.
An adjuster might purposely delay a settlement of your claim so that your frustration and stress induces you to agree to an early unfavorable settlement.
A related tactic is to give you the old “run around.” You might be faced with a revolving door of adjusters handling your claim. The new adjusters will feign ignorance about the case so that you must continually start anew. Your frustration will be exploited to get you to accept an unfavorable settlement.
Sadly, there is not much you can do about someone sitting in a public roadway to watch your house as long as it doesn’t become harassment. Insurance adjusters can videotape the front of your house or your trips to the grocery store while you have a broken leg or other impairment. Again, those video recordings can be misinterpreted or even manipulated.
Their surveillance can also extend to your communications on social media, such as Facebook, Instagram, and Twitter. An adjuster can monitor your social media postings for innocent communications that can be twisted to compromise your claim.
Discouraging attorney consultation
Adjusters will say that you don’t need a lawyer. They’ll try to persuade you that they’re your friend and have your best interests in mind. They’ll also warn you that a lawyer will cost you money or take an inordinate share of any settlement you get from the insurance company.
Their warnings are a red flag that your interests are not foremost in their mind. It suggests they’re afraid of something.
Liability in workers’ comp cases
Liability is not an issue for workers’ compensation claims. However, the questions of your eligibility as an employee and whether your injury occurred on the job are indeed relevant.
Employers don’t like to pay out workers’ comp claims because they can increase their premiums. Insurance companies don’t like to pay out claims because they reduce their profits. A claimant can expect to see many of the same workers’ comp adjuster tricks that are employed for personal injury cases.
Misrepresenting laws concerning damages
The laws of personal injury and workers’ comp claims are fairly well defined. Unfortunately, most people don’t know or understand these laws. Adjusters will try to mislead you about the parameters of the damages to which you are entitled.
Also, they will lie to you about the precedents for settlements of claims similar to yours. They’ll tell you they’ve settled similar claims for much less than the amount to which you’re actually entitled.
Contact Chappell, Smith & Arden, P.A. to help with your workers’ comp claim
An insurance adjuster is not on your side, no matter how they try to persuade you otherwise. They’re paid by the insurance company against which you have made a claim for compensation. Their employer’s evaluation of their performance is based largely on how well they keep a lid on the company’s claims payouts.
Your best interests are served by engaging an experienced personal injury or workers’ comp attorney. They will be knowledgeable in the law but, equally importantly, experienced in dealing with insurance adjusters. Your attorney will not be influenced by adjusters’ common tricks and will also know the insurance company’s settlement policies and payout histories.
If you’ve been injured in an accident in South Carolina, contact the experienced personal injury and workers’ comp attorneys at Chappell, Smith & Arden, P.A. We’ve dedicated our practice to helping injured clients across the state of South Carolina get the justice and compensation they deserve. We can investigate your case and negotiate with the insurance company to ensure you get maximum compensation.
Contact us today for your free consultation.