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The Insurance Adjuster – “A Wolf in Sheep’s Clothing”

Clients tell me stories all the time about their experiences with insurance adjusters.  Spoiler alert….they are not good experiences.  Since I have practiced in the injury law field for 25 years, I have seen insurance adjusters go to great lengths to deny and diminish valid injury claims.  The key to dealing with an insurance adjuster is understanding what makes them tick.  Insurance adjusters are not what they seem to be.  An insurance adjuster is a wolf in sheep’s clothing.  Unfortunately, many people don’t figure this out until it is too late.  Let’s go over some basics about insurance adjusters: What is the insurance adjuster’s goal?

The insurance adjuster’s goal is to find any reason possible to deny your claim.  If they can’t find (or create) a reason to deny your claim, then they work to pay you as little as possible.  Remember all those TV commercials that you have seen portraying insurance adjusters as kindly, generous souls?   I am sure that you have seen them.  They look like modern episodes of the Andy Griffith how.  The adjuster is normally sitting on an injured person’s front porch, drinking sweet tea, shaking hands, kissing babies and handing out big checks.  You might expect to see Aunt Bee walking out at any minute with a fresh batch of chocolate chip cookies.  This is all done in an effort to get people to trust the insurance company.  Sorry folks, that’s not the way it works in the real world!    

Insurance adjusters work for insurance companies.  Insurance companies are for-profit businesses.  The goal of the insurance adjuster is to make money for the insurance company.  They make money by denying your claim or paying you as little as possible.  The less they pay you, the more they keep for the insurance company.  You are a claim number to the insurance company.  As soon as your claim is finished, your claim is closed and they will never think about you again.

The insurance adjuster wants to pay you as little as possible.  Does that make them a bad person?  No, not at all.  Insurance adjusters are just doing their job for the insurance company.  It is up to YOU to understand the role of the insurance adjuster.  If you put your fate in the hands of the insurance company, you will generally not be happy with the results. 

How does the insurance adjuster deny and devalue claims?

The insurance adjuster has many tools at his/her disposal to deny or devalue your claim.  You probably won’t even recognize many of their tactics until it’s too late.  Right after an accident, the insurance adjuster may call you up and explain how sorry they are for your misfortune.  (Some of them actually sound sincere.)  Right after they get done with the generic and uninspired apology, they move on to offering you a “drive by settlement”.  What’s that?  A drive by settlement occurs when the insurance adjuster gets you to take a quick (and small) check, right after an accident, before you speak with an attorney and before you know the value of your case.  The adjuster swoops in, gets you to sign a Release, gives you a check for a little bit of money and then they laugh all the way to the bank! 

Another favorite ploy of the insurance adjuster is to get you to give a recorded statement about the accident and your injuries.  They will explain that this is a formality and that it needs to be done before they can possibly pay on your claim.  Innocent enough, right?  Nope.  The insurance adjuster has been trained in the laws of negligence, contributory negligence, etc.  The insurance adjuster’s goal is to get you to say something…..anything…that they can use to deny your claim.  In North Carolina we have the law of contributory negligence.  If you are found to be even 1% responsible for an accident, your recovery can be denied.  While the purpose of the recorded statement might seem like it’s just checking a box, it’s not.  It’s an opportunity for the insurance adjuster to ask you slanted questions with the goal of getting you to say something that they can then use against you.

Insurance adjusters will often ask you to sign a medical authorization so that they can “collect the medical records and bills related to your injury.”  Once again, sounds innocent enough, right?  Nope!  If you have previously signed one of these medical authorizations for an insurance company, pull it out and take a quick look at it.  I can promise you that there will be no limit on what medical records they can request.  What’s that you say?  They can request records that are not related to my accident?  Yes!  When you sign one of these medical authorizations for the insurance company, they have the ability to plunder through your medical records (including medical history) just looking for a reason to deny your claim.  What’s that?  You complained of a sore back five years before the collision?  Well, THAT must be the reason that your back hurts now.  Claim denied!  Sounds crazy, but this happens all the time.

So, what’s the best way to deal with the insurance adjuster?

That’s simple.  The best way for you to deal with the insurance adjuster is to not deal with them at all.  You are going to do far better to speak with a qualified and experienced attorney at Bradley Law Group.  If you have a valid case, then WE will deal with the insurance adjuster.  We will not be giving them recorded statements.  We will not be sending them medical authorizations and we will definitely not let them pull a “drive by settlement”.  Our job is to put the insurance adjuster in check until you can fully heal.  We will open all appropriate claims and gather all necessary evidence.  Once your case is ready to move forward, we will work to get you the absolute best settlement possible.  We have experience, resources and leverage.  The insurance companies know this.  Remember, if you get a sugary-sweet call from an insurance adjuster after an accident, the best thing that you can do is to get their name and number and then hang up.  An insurance industry study once showed that injured people with attorneys recover 3.5 time what unrepresented people recover.  Is it any shock that the insurance adjuster doesn’t want you to speak with us?  Call Bradley Law Group for a free consultation.  Know your rights and avoid the wolf in sheep’s clothing!

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