In a personal injury claim, an insurance adjuster plays a pivotal role in evaluating and negotiating settlements on behalf of the insurance company. Here’s a comprehensive overview of what an insurance adjuster does and how they impact a personal injury claim:
- Role of an Insurance Adjuster:
- Evaluation: The insurance adjuster assesses the facts and circumstances of the personal injury claim to determine the liability (fault) of their insured (the policyholder).
- Investigation: They investigate the incident by reviewing medical records, police reports, witness statements, and other relevant documents.
- Assessment of Damages: The adjuster evaluates the extent of damages claimed by the injured party, including medical expenses, lost wages, pain and suffering, and other losses.
- Negotiation: They negotiate with the injured party (or their attorney) to reach a settlement that resolves the claim without going to trial.
- Settlement Authority: Insurance adjusters often have settlement authority granted by their company, allowing them to negotiate and finalize settlements up to a certain amount without further approval.
- Types of Insurance Adjusters:
- Company Adjusters: Employed directly by the insurance company, these adjusters handle claims on behalf of the insurer.
- Independent Adjusters: Work as contractors hired by insurance companies to handle specific claims, especially during times of high volume or specialized expertise needs.
- Public Adjusters: Represent the interests of the policyholder in negotiating with the insurance company, typically in property damage claims rather than personal injury.
- Settlement Process:
- Negotiation: Adjusters and claimants (or their attorneys) negotiate back and forth until a mutually acceptable settlement amount is reached.
- Release of Claims: Once a settlement is agreed upon, the injured party typically signs a release form, waiving their right to further legal action related to the incident in exchange for the agreed-upon compensation.
- Legal Considerations:
- Liability Determination: Adjusters assess the liability of their insured and may deny a claim if they believe their insured is not at fault or if coverage does not apply.
In summary, insurance adjusters are key figures in the personal injury claims process, tasked with evaluating claims, negotiating settlements, and representing the interests of the insurance company. Their decisions and actions can significantly impact the outcome of a personal injury claim, making it crucial for injured parties to approach interactions with adjusters cautiously and consider seeking legal advice to ensure their rights and interests are protected throughout the claims process.