After being involved in an incident such as a traffic collision, one of the first points of contact you will have is with an insurance adjuster. This individual, who may represent your own insurance company or the insurance company of another party involved, is responsible for investigating the claim, assessing liability, and determining the value of the settlement. It is a professional interaction that requires a clear understanding of roles and responsibilities. While you are not obligated to have legal representation during initial communications, being prepared and informed can help you protect your interests during these early discussions.
The primary role of an insurance adjuster is to manage risk and financial exposure for the company they represent. They are trained to gather facts and settle claims efficiently and for the lowest amount that is legally permissible. This is not a personal judgment but a function of their professional duty. It is important to approach all communications with this understanding. They may be polite and empathetic, but their ultimate goal is to resolve the claim in a manner that is economically favorable to their employer. Your goal is to ensure you receive a fair settlement that adequately covers your damages.
- Understand Who You Are Speaking With: When you receive a call, first ascertain which company the adjuster represents. Is it your own insurer or the other party’s? The dynamics can differ. With your own company, you have a contractual duty to cooperate with the investigation. With the other party’s insurer, you have no such obligation.
- Keep the Conversation Factual and Brief: When describing the incident, stick to the basic, objective facts. You can state the date, time, location, and the vehicles involved. Avoid providing a detailed narrative or speculating about what happened. Do not admit fault or say anything that could be interpreted as an apology, such as “I’m so sorry, I didn’t see you.” Such statements can be used to assign you a degree of comparative negligence.
- Politely Decline to Give a Recorded Statement: The adjuster for the other party’s insurance will almost certainly ask for a recorded statement. You are under no legal obligation to provide one. It is within your rights to politely decline. A recorded statement can be used later to find inconsistencies in your story or to downplay your injuries. You can state, “I am not comfortable providing a recorded statement at this time. I will be happy to provide the basic facts of the accident in a written summary.”
- Do Not Disclose Your Injury Prognosis or Medical Details: It is appropriate to state that you were injured and are seeking medical attention. However, do not speculate on the extent of your injuries, your diagnosis, or your expected recovery time. It is far too early to know the full impact. Simply state that you are receiving care and that the full extent of your injuries is not yet known. Do not authorize the adjuster to access your full medical records.
- Document All Communications: Keep a log of every interaction with an insurance adjuster. Note the date, time, the adjuster’s name, the company they represent, and a brief summary of what was discussed. This creates a paper trail that can be invaluable if there are disputes later.
- Be Cautious with the First Settlement Offer: The initial settlement offer from an insurance adjuster is often a starting point for negotiation and may be lower than what the claim is potentially worth. It is designed to close the claim quickly and cheaply. Do not feel pressured to accept any offer immediately, especially before you have reached maximum medical improvement and understand the full cost of your damages, including future medical needs, lost earning capacity, and pain and suffering.
- Refer to Your Own Policy: If you have coverage such as Medical Payments or Personal Injury Protection under your own policy, you may need to provide certain information to activate these benefits. Understand the terms of your own policy and what is required of you. These are first-party benefits you have paid for, and using them does not typically prejudice your claim against another at-fault party.
- Know When to Seek Legal Counsel: If the accident involved significant property damage, clear injuries, a dispute over fault, or if the adjuster is being uncooperative, it is prudent to consult with a legal professional. An attorney can handle all communications with the insurance companies on your behalf, ensuring your rights are protected and you are not taken advantage of during a vulnerable time.
In summary, dealing with insurance adjusters is a standard part of the post-accident process. By remaining calm, factual, and reserved in your communications, you can fulfill necessary reporting obligations without compromising your potential claim. Remember that the adjuster’s role is to save their company money, and your role is to protect your own financial and physical well-being. Being informed about your rights and the tactics often employed in these discussions is your best defense. If the situation becomes complex or you feel overwhelmed, seeking professional legal advice is a recommended course of action to ensure a fair outcome.