After a car accident, slip and fall, truck collision, or other injury-causing incident, most people expect to deal directly with an insurance company. What many accident victims do not realize is that one of the most important people involved in their claim is the insurance adjuster.
Insurance adjusters play a significant role in determining how personal injury claims are investigated, evaluated, and resolved. While adjusters may appear friendly and helpful, their primary responsibility is to protect the interests of the insurance company. Understanding how adjusters operate can help injured individuals avoid costly mistakes and make informed decisions about their claims.
What Is an Insurance Adjuster?
An insurance adjuster is a professional employed by an insurance company or hired as an independent contractor to investigate claims and determine how much money the insurer should pay. After an accident is reported, the insurance company assigns an adjuster to review the facts and assess the company's potential financial exposure.
The adjuster's responsibilities often include:
Reviewing accident reports
Examining medical records
Interviewing witnesses
Inspecting property damage
Evaluating liability
Determining claim value
Negotiating settlements
Types of Insurance Adjusters
There are several different types of adjusters that may become involved in a personal injury claim.
Staff Adjusters- They are employees of an insurance company and handle claims directly within the company's claims department.
Independent Adjusters- These types of adjusters are contractors hired by insurance companies to investigate claims..
Catastrophic Claims Adjusters- When severe injuries or significant financial exposure are involved, insurance companies may assign specialized adjusters who focus on high-value claims and conduct particularly thorough investigations.
What Happens After an Insurance Claim Is Filed?
Once an accident claim is reported, the adjuster begins gathering information. The process generally includes a multi-step process such as the following:
Initial Contact
The adjuster will usually contact the injured person shortly after receiving notice of the claim. During this conversation, they may ask questions regarding how the accident occurred, insurance coverage, and the severity of injuries. Many people assume these conversations are informal. However, anything said to an adjuster can potentially be used during the claim evaluation process.
Investigation
The adjuster will then investigate the circumstances of the accident. Depending on the type of case, the adjuster may obtain:
Police reports
Traffic collision reports
Photographs
Video footage
Witness statements
Medical records
Vehicle repair estimates
In California cities such as Sacramento, Stockton, Los Angeles, Modesto, Oakland, and Redding, adjusters often rely heavily on official accident reports and documented evidence when evaluating claims.
Liability Assessment
One of the adjuster's primary goals is determining who was at fault. Under California’s comparative negligence system, injured parties may still recover compensation even if they are partially responsible for an accident. However, their recovery can be reduced by their percentage of fault. As a result, adjusters frequently examine whether they can assign some portion of blame to the injured person in order to reduce the insurer's financial liability.
Why Insurance Adjusters Request Recorded Statements
One of the most common requests accident victims receive is a request for a recorded statement. The adjuster may explain that the statement is necessary to process the claim. However, providing a recorded statement without legal guidance can create significant risks.
Adjusters often ask detailed questions designed to:
Identify inconsistencies
Clarify liability issues
Minimize injury claims
Challenge future medical treatment
Reduce settlement value
For example, a seemingly harmless statement such as "I'm feeling a little better today" may later be used to argue that injuries were not serious. In many cases, injured individuals are not legally required to provide a recorded statement to the other driver's insurance company.
How Insurance Adjusters Calculate Settlement Offers
Insurance adjusters use various methods to estimate the value of a claim. For instance some of the most common factors that are considered include medical expenses, lost income, and property damage due to their places as the largest components of a personal injury claim. Additionally, non-economic damages like pain and suffering are subjective and often among the most heavily disputed portions of a claim.
Common Tactics Insurance Adjusters Use
Not all adjusters engage in aggressive negotiation tactics. However, insurance companies are businesses focused on controlling costs and maximizing profits. Some strategies that may be used include:
Quick Settlement Offers- While receiving compensation quickly may seem appealing, early offers often occur before the full extent of injuries is known and accepting a settlement generally requires signing a release that prevents any future recovery, even if medical complications later arise.
Disputing Medical Treatment- Insurance companies may argue that treatment was unnecessary, excessive, or that the injuries were unrelated to the accident.
Shifting Fault- Adjusters may attempt to argue that the injured party was partially responsible for the incident.
Delaying the Claims Process- Some claims experience repeated requests for documentation, additional investigations, or prolonged negotiations and these delays can create financial pressure on injured individuals facing mounting medical bills and lost income.
Can Insurance Adjusters Deny Claims?
Insurance adjusters themselves may not always have final authority to deny a claim, but they frequently make recommendations that influence the insurer's decision. Claims may be denied for reasons such as disputed liability, lack of evidence, policy exclusions, coverage limitations, and alleged misrepresentations. When a claim is denied, further investigation and legal review may reveal options for challenging the insurer's decision.
Contact Frank Penney Injury Lawyers Before Speaking With an Insurance Adjuster
If you were injured in an accident that wasn’t your fault, speaking with an experienced personal injury attorney before providing detailed statements to an insurance company can help protect your rights.
At Frank Penney Injury Lawyers, our attorneys have negotiated with insurance adjusters for over three decades and understand how far they are willing to go to pay out as little as possible. By hiring our attorneys for your case, you can rest easy knowing your case is being handled with the utmost care and respect that it deserves.
Call us at 888-888-0566 or by filling out our online contact form today to schedule your free case consultation.