How Does The Insurance Adjuster Work On A Personal Injury Claim?

Once an insurance company has received a new claim, the insurer assigns that same claim to one of the company’s adjusters. At that point, the adjuster starts working on the assigned claim/case.

Adjusters must investigate each of the claims assigned to them.

The investigation involves studying all of the circumstances related to the claim-triggering incident. The adjuster’s investigation should also include a determination of the claim’s worth. Adjusters always hope that the investigated claimant will accept the lowest settlement offer.

How does adjuster determine the value for that lowest settlement offer?

The claimant gets asked for all the medical bills. That offers a clue to the medical expenses.It is the claimant’s job to offer proof of the lost income.

Claimants have the right to seek money for pain and suffering. They also have a right to seek money for any negative effects on the life of the injured party. Following the calculation of those expenses, it becomes the adjuster’s job to study the limits, as stated in the terms of the purchased policy. No insurance company would agree to cover a claim that exceeded the policy limits.

How does the strength of the claimant’s case factor into a determination of a given claim’s value?

The decision to hire a personal injury lawyer in London has the ability to strengthen claimants’ cases. Any evidence of shared fault on the part of the claimant/plaintiff would force a lowering of the claim’s estimated value. The demand letter sent to the adjuster plays a role in determining the claim’s estimated value.

–Does that letter contain any pictures of damage to the vehicle, or photographs of any reported injuries?
–Does that letter contain any statement that supports the allegations about the liability of the defendant/policyholder?
–Does that letter include a copy of the police report?

In what other ways do adjusters’ tasks work to throw light on each of the investigated claims’ values?

Some of the tasks carried out on an assigned file entail study the company’s database. That should show whether or not the present claimant has ever filed another personal injury claim. If the data were to offer evidence of past claims, then that fact could force a re-evaluation of the estimates made earlier, based on the expenses and the policy limits.

Some of the tasks would involve a study of the types of treatment used on the reported injuries. Who had ordered and administered that same treatment? Had it been a medical doctor or a chiropractor?

Companies that use a computer program, when determining the worth of claims about pain and suffering, might not expect adjusters’ time to be spent on that specific task. Those programs account for type of treatment used.