How Insurance Adjusters Proceed After Insurer Has Assigned Them A Claim

Insurance adjusters have 2 objectives, after learning that another claim has been added to all the other claims that are in their file. First, each of them wants to have the insurance company making a payout that is a low as possible. Second, each of them hopes to avoid the threat of a personal injury lawsuit, with the insurance company being the target of such a lawsuit.

After collecting all the available evidence, the adjuster then studies certain facts.

• The total for the claimant’s medical expenses
• The loss of income, as reported by the claimant
• Reported pain and suffering
• Has there been any mention of other negative effects, which were caused by the injury?
• What are the policy limits on the documents that the policyholder received from the insurance company?

In addition to considering the above facts, adjusters make a speculation, in response to this question: What would a jury award this plaintiff, if this case were to go to court?

After making those considerations, along with that speculation, adjusters study the demand letter from the person that filed the claim. Adjusters must decide how to respond to that demand letter. An adjuster’s calculations should have already revealed the true value of the assigned case. A diligent adjuster would compare the demand with that true value. In addition, adjusters’ responsibilities include that of consulting with the insurer. This is the time for such a consultation.

The insurer might tell the employee (adjuster) to offer some percent of the calculated value. That could be well below the amount quoted in the demand letter. Adjusters’ experience should prepare them for the response to that initial offer.

Adjusters’ method for dealing with responses

Sometimes, a claimant might call an adjuster, and seek an explanation for an initial offer. In that situation, the contacted person in the adjuster’s office would explain what further information the insurance company needed.Later, the claimant could send a letter with the added information, along with a counter-offer. It would be the adjuster’s job to study that counter-offer, and to determine how much below that figure the adjuster’s next proposal/offer should be.

Personal injury lawyer in Ottawa knows that as the 2 parties exchange offers, the adjuster’s eyes watch for mention of an acceptable figure. If the claimant mentions such a figure, then the adjuster should express a willingness to settle. As a follow up to that action, it would be the adjuster’s duty to answer any more of the claimant’s correspondence.

Adjusters work with the insurer to send a release form to the claimant’s lawyer, and to await delivery of the signed release form. Once the insurance company has that signed form, the adjuster’s obligations have ceased, with respect to that one particular case.