What is the Role of an Adjuster in Personal Injury Case


After an accident that results in an injury to you, you would likely deal with an insurance company to discuss your compensation. And insurance company are represented by a claim adjuster. But what is his or her role? An insurance claim adjuster usual role is to investigate the liability of their insured to the accident. They will get a police report, photos, statements, and other evidence.


What happens after liability has been proved?


After investigating and the fault has been determined. The adjuster will then determine how much the case is worth or what they may be required to pay for the victim. The adjuster would ask for the injuries and the treatment. They will collect copies of medical records, bills, and medicine receipts. They may also ask questions such as medical history. 



However, insurance adjusters do not work for the insured nor the victim but the insurance company. Thus, their goal is to keep the expenses of the insurance company and make personal injury claims as little as possible. But they still want to avoid a lawsuit. It is because an injured person or the plaintiff may go to court and file for a civil lawsuit if they think that the adjuster’s offer is unreasonable. If the settlement goes to trial, the judge or the jury will decide for the appropriate compensation. This situation is risky for an insurance company because the verdict may end up very high. Another reason is trial means expenses. Thus, the adjuster’s job is to negotiate with the lowest settlement without a lawsuit.



How Does the Insurance Adjuster Negotiate?




Usually, the adjuster calculates a maximum amount they can give to the victim. Then, they will offer 25 to 50 percent lower than that number. This way, if ever the plaintiff asks for a higher settlement, they can give it. Let us say that the case costs $50,000. They will offer $20,000. Then the victim would ask $40,000. If they would agree to this amount, then they still saved $10,000.



How an insurance adjuster calculates an offer?


  • Medical bills and expenses incurred from the accident and if there would be any in the future
  • Lost income or lost wages
  • Pain and suffering
  • Emotional and psychological impact

Other considerations:


  • Policy limit
  • The strength of the plaintiff’s case


Thus, the victim must negotiate to get the best settlement possible. Hiring a lawyer for insurance claim can show that they are not afraid to put things in court if not given a fair settlement. Nevertheless, the injured person must still be able to present necessary evidence to prove injuries and to prove the defendant’s fault. An accident claim lawyer can also help in gathering relevant documents and contact witnesses. Also consider sending a demand letter first, so that the settlement starts with the number you believe is fair.

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