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What Is the Role of an Insurance Company Adjuster in a Personal Injury Case?



The defendant's insurance company typically assigns at least one adjuster to work on each personal injury case. For each insurance company involved in a personal injury case, including the claimant's, there is an adjuster involved. The insurance company adjuster usually remains with the case from first notification of the personal injury claim through settlement, trial, appeal, or other case resolution. What exactly is the role of an insurance company adjuster in a personal injury case?

The Role of the Adjuster

Adjusters are often claims professionals employed an insurance company. They are trained to promote attractive, quick, and cheap settlements to injured claimants, preferably early in the lifespan of a personal injury case to save the insurance company money. They may appoint litigation counsel to defend the claim or at least work with appointed defense counsel to prepare a case budget, evaluate the case for settlement and ongoing risk management purposes, and collaborate on strategy throughout litigation.

Key Goals and Objectives

Adjusters may encourage a claimant to explore and accept a settlement before involving attorneys. They may use pressure tactics to entice the claimant into a speedy and cheap settlement. Adjusters may know of dwindling statute of limitations periods for claimants to file suit and may lead a claimant to delay to his or her prejudice in being able to file suit because the claimant falsely assumes that ongoing negotiations with the adjuster somehow stall deadlines. No insurance adjuster wants to go to trial with the legal fees and costs required to do so, risk of a large adverse judgment, escalating settlement figures if the case resolves, and unwanted publicity.

Adjuster Bias

Undoubtedly, the insurance adjuster for the defendant is an adverse party. As such, insurance companies and their adjusters do not often have the best interests of the personal injury claimant in mind. Adjusters may seem and appear to be sympathetic on the phone or in letters when listening to the claimant, but their aim is in saving their employer, the insurance company, money. Conversations may be recorded and used against a claimant later in litigation. The more the adjusters save the insurance company, the better. Therefore, it is usually prudent for a personal injury claimant not to negotiate or deal with the defendant's insurance adjuster without the assistance of his own independent counsel or at least the benefit of an initial consultation with counsel.

A claimant has competing needs and goals. The injured party may need several weeks or months to seek appropriate, comprehensive, and accurate medical treatment to obtain a suitable prognosis. The claimant needs a complete and accurate medical prognosis to properly evaluate any settlement offers, as well as to arrive at a proper valuation for the case for making any settlement demands.