What Is An Adjuster?

What Is An Insurance Adjuster?

After an accident, whether it’s a car crash, a slip and fall, or any other personal injury, you’re often left with more questions than answers. One of the first things you’ll likely encounter is a call from an insurance adjuster. But if you’ve never dealt with an adjuster before, you might be unsure of what they do, who they work for, and, most importantly, how they affect your claim. Understanding the role of an adjuster is critical to ensuring that you’re treated fairly throughout the claims process.

Insurance companies employ adjusters to investigate claims, assess damages, and ultimately decide how much compensation should be paid. While this may sound straightforward, the reality is more complex. Adjusters don’t work for you—they work for the insurance company, and their primary goal is to save their employer money. This means that while they may seem helpful, their main priority is to minimize the payout on your claim.

In this blog post, we’re going to break down exactly what an insurance adjuster is, the role they play in personal injury cases, and, most importantly, how you can protect your rights when dealing with one. Whether you're recovering from an injury or just trying to understand your options, this guide will help you navigate the process and ensure you’re not taken advantage of. By the end of this post, you’ll know how to approach interactions with adjusters, and why it might be in your best interest to have a personal injury lawyer by your side.

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Defining the Role of an Insurance Adjuster

What is an adjuster?

An insurance adjuster, also known as a claims adjuster, is a professional employed or contracted by an insurance company to evaluate the claims made by policyholders. Their primary responsibility is to assess the damage caused by an accident, gather relevant information, and determine how much the insurance company should pay out to the claimant.

When an accident happens and a claim is filed, the adjuster steps in to act as the insurance company’s representative in the claims process. Their goal is to investigate the circumstances surrounding the accident, review any available evidence (such as medical reports, property damage estimates, and police reports), and calculate the monetary value of the claim based on these findings.

While adjusters play a crucial role in processing claims, it’s essential to remember that they don’t work for you. They work for the insurance company, and their job is to resolve the claim in a way that minimizes the financial impact on their employer. This often means offering the lowest possible settlement, even if it doesn’t fully cover your losses.

Understanding the adjuster’s role helps set the stage for knowing how to approach your claim. They control much of the decision-making process regarding the settlement amount, making it vital for claimants to be cautious, informed, and prepared when dealing with them.

Types of Insurance Adjusters

Not all insurance adjusters are the same, and it’s important to understand the differences between them. Depending on your case, you might encounter different types of adjusters, each with their own specific role and loyalties. Here are the three main types of adjusters you’re likely to come across in a personal injury claim:

Staff Adjuster

A staff adjuster is employed directly by the insurance company. When you file a claim, it’s likely that a staff adjuster will be the first person to contact you. Their job is to handle claims made by the insurance company’s own policyholders. These adjusters work closely with the company they represent and are trained to protect the insurer’s financial interests.

Key Points:

• Works exclusively for the insurance company.
• Has a long-term relationship with the insurer and is incentivized to settle claims at the lowest possible cost.
• Often handles multiple claims at once, which can sometimes lead to rushed evaluations.

Independent Adjuster

An independent adjuster is not employed by the insurance company but is instead contracted to handle claims on the insurer’s behalf. Despite the word “independent,” these adjusters still represent the insurance company’s interests. They are typically hired when an insurance company has a high volume of claims or needs specialized expertise in certain cases.

Key Points:

• Contracted by the insurance company but not a full-time employee.
• Often handles claims for multiple insurers, depending on their contract.
• Their primary goal, like staff adjusters, is to minimize the payout for the insurance company.

Public Adjuster

A public adjuster is the only type of adjuster that works for the claimant—that’s you. Unlike staff or independent adjusters, public adjusters are hired by individuals who feel that their insurance company is not offering a fair settlement. They can help you negotiate with the insurance company and fight for a larger payout. However, they typically take a percentage of your final settlement as their fee. Additionally, they cannot litigate a case like an attorney can, and they often take on a narrow set of cases that only involve home insurance.

Key Points:

• Works on behalf of the claimant, not the insurance company.
• Helps negotiate and maximize the settlement amount.
• Charges a fee based on a percentage of the final settlement, which can reduce the net amount you receive.

Understanding the differences between these types of adjusters can help you navigate your claim more effectively. Knowing who you’re dealing with allows you to better gauge their motivations and how they might influence the outcome of your claim.

What Does an Adjuster Do?

An insurance adjuster has a variety of responsibilities when handling a personal injury claim. Their primary job is to investigate the claim, assess the damages, and determine how much compensation the insurance company should offer. While the process may seem straightforward, there are several critical steps involved in an adjuster’s role. Understanding these steps can help you anticipate how your claim will be handled and where you might encounter potential challenges.

Investigating the Claim

Once a claim is filed, the adjuster’s first task is to gather all relevant information related to the incident. This can involve:

• Interviewing the claimant: The adjuster will speak with you to get your version of the events. Be cautious in these conversations, as they are looking for information that could potentially reduce the insurance company’s liability.
• Reviewing reports: They’ll examine any police reports, accident reports, and statements from witnesses to establish the facts.
• Collecting evidence: In cases involving property damage, they might inspect the scene of the accident or the damaged property (like a vehicle) to verify the extent of the damage.

Reviewing Medical Records

In personal injury claims, one of the most critical factors is the extent of your injuries. The adjuster will ask for access to your medical records to evaluate your condition. They will assess:

• The severity of your injuries: More serious injuries typically lead to larger claims, so the adjuster will want to understand exactly what your injuries are and how they impact your life.
• The treatment you’ve received: The adjuster will review your medical treatments, therapies, and rehabilitation efforts to determine the cost of care and how it fits into the overall compensation calculation.
• Your future medical needs: In some cases, the adjuster will also consider whether you will need ongoing or future medical treatment, which could increase the amount of compensation.

Assessing Property Damage

If property was damaged in the accident (such as your car in a vehicle collision), the adjuster will need to evaluate the cost of repairs or replacement. This usually involves:

• Reviewing repair estimates: The adjuster will obtain quotes or estimates from repair shops to assess the fair market cost of repairs.
• Determining depreciation: In some cases, the adjuster may factor in depreciation, which could lower the payout, especially if the damaged property is older or has lost value over time.

Determining Liability

Another important role of the adjuster is to determine who was at fault for the accident. This can greatly influence how much compensation you receive, as the adjuster may try to assign partial or full blame to you in order to reduce the payout.

• Comparative negligence: In many states, compensation may be reduced based on the percentage of fault assigned to each party. The adjuster will examine all evidence to decide how much responsibility you bear for the accident.
• Assigning fault: The adjuster may consult police reports, eyewitness accounts, or accident reconstruction experts to determine fault.

Negotiating a Settlement

Once the adjuster has reviewed all the evidence, they will determine how much the insurance company should offer you. This is where the negotiation process begins.

• Initial offer: Often, the first settlement offer will be lower than what your claim is worth. Adjusters will start with a conservative figure to protect the insurance company’s bottom line.
• Negotiations: If you believe the offer is too low, you or your attorney can negotiate for a higher amount. The adjuster will be prepared to discuss the reasons for their offer and might be willing to increase it, but they will still be focused on minimizing the company’s payout.

Finalizing the Claim

Once you agree to a settlement, the adjuster will handle the final paperwork and arrange for the payment. However, it’s important to remember that once you accept a settlement and sign the release forms, you typically waive your right to pursue any further compensation related to the accident.

The role of an insurance adjuster is multifaceted, and while they are critical to the claims process, their goal is to settle claims efficiently and at the lowest cost. Understanding what an adjuster does can help you navigate the claims process more effectively, especially if you need to negotiate or challenge their findings.

How to Interact with an Adjuster: Do’s and Don’ts

Dealing with an insurance adjuster can feel intimidating, especially if you’re unsure how to navigate the conversation. While adjusters are often polite and professional, it’s important to remember that their goal is to minimize the payout on your claim. Being prepared and knowing how to interact with them can help you avoid costly mistakes. Here are some key do’s and don’ts to keep in mind when communicating with an adjuster.

Do’s:

By following these do’s and don’ts, you can protect your interests when dealing with an adjuster and avoid common pitfalls that could reduce your claim’s value. Remember, the adjuster is not on your side, so it’s important to stay vigilant, be cautious, and always seek legal advice before making any major decisions.

Why You Should Consider Hiring a Personal Injury Lawyer

When you're dealing with the aftermath of an accident, it might be tempting to handle the insurance claim on your own. After all, the process may seem straightforward at first—an adjuster will evaluate your claim, and the insurance company will offer a settlement. However, what many people don’t realize is that this process is often much more complex and can be filled with pitfalls that might leave you with far less compensation than you deserve. This is where the guidance and expertise of a personal injury lawyer come in.

1. Understanding the Complexity of Personal Injury Claims

While adjusters may seem cooperative and the claims process might appear simple, personal injury claims often involve many layers of complexity. From proving liability to accurately calculating the full scope of your damages, there are many factors that affect how much compensation you should receive.

• Assessing Long-Term Medical Costs: After an accident, it can be difficult to predict the full extent of your medical needs, especially if you’re dealing with severe injuries. A personal injury lawyer can help ensure that all current and future medical expenses are considered in your claim.
• Calculating Non-Economic Damages: Personal injury claims aren’t just about medical bills. You may also be entitled to compensation for pain and suffering, emotional distress, and loss of enjoyment of life. These are often overlooked or undervalued by insurance adjusters, but an experienced attorney will make sure they’re factored into your claim.
• Proving Liability: Establishing who is at fault in an accident isn’t always straightforward. Even if you believe the other party was clearly responsible, proving liability in a legal sense can require detailed evidence and expert testimony. A lawyer knows how to gather and present this information effectively.

2. Leveling the Playing Field with Insurance Companies

Insurance companies are for-profit businesses, and their primary goal is to protect their bottom line by paying as little as possible on claims. The adjusters they employ are experienced negotiators trained to minimize settlements. Without a lawyer, you’re at a significant disadvantage.

• Experienced Negotiators: Personal injury lawyers have years of experience dealing with insurance companies and understand the tactics adjusters use to reduce claims. They know how to push back against lowball offers and negotiate for a fair settlement that reflects the true value of your case.
• Building a Strong Case: A lawyer will collect evidence, interview witnesses, and, if necessary, bring in experts to strengthen your claim. This preparation sends a strong message to the insurance company that you’re serious about getting the compensation you deserve, which can lead to higher settlement offers.
• Taking the Pressure Off You: The claims process can be overwhelming, especially when you’re recovering from injuries. Hiring a lawyer allows you to focus on your recovery while they handle the paperwork, negotiations, and legal hurdles involved in your claim.

3. Maximizing Your Compensation

One of the biggest reasons to hire a personal injury lawyer is to maximize the amount of compensation you receive. Studies have shown that claimants who hire attorneys typically receive larger settlements than those who don’t.

• Knowing What Your Claim Is Worth: Without legal expertise, it can be difficult to know what your claim is actually worth. A lawyer will accurately assess the value of your case, taking into account all damages, including future medical expenses, lost wages, and non-economic losses like pain and suffering.
• Rejecting Unfair Offers: Insurance adjusters often make low initial offers in the hope that you’ll accept less than what you’re entitled to. A lawyer can review these offers, advise you on whether they’re fair, and negotiate for a higher settlement if necessary.

4. Protecting Your Rights

When you handle a claim on your own, you may unknowingly waive certain rights or agree to terms that limit your ability to seek further compensation. A lawyer will protect your legal rights throughout the process.

• Avoiding Costly Mistakes: Without legal guidance, it’s easy to make mistakes that could hurt your claim. For example, providing too much information to an adjuster or accepting an early settlement offer might prevent you from receiving full compensation.
• Litigating If Necessary: Most personal injury claims settle out of court, but if negotiations break down, you need to be prepared to go to trial. A personal injury lawyer can file a lawsuit and represent you in court if needed, ensuring that you have the best possible chance of success.

So a quick review, hiring a personal injury lawyer isn’t just about having someone negotiate on your behalf—it’s about ensuring that your rights are protected and that you receive the full compensation you deserve. With a lawyer’s experience and expertise, you’ll have a strong advocate in your corner to help you navigate the claims process, push back against unfair offers, and achieve the best possible outcome for your case.

Common Myths About Insurance Adjusters

When dealing with insurance adjusters after an accident, it’s common for people to have misconceptions about who they are and what their role entails. These myths can lead to misunderstandings and potentially harmful decisions that could negatively affect the outcome of your personal injury claim. In this section, we’ll debunk some of the most common myths about insurance adjusters and shed light on what you need to know to protect yourself.

Myth 1: Adjusters Are Neutral Parties

One of the biggest misconceptions is that adjusters are neutral, unbiased third parties who are there to help both sides reach a fair settlement. While adjusters may seem cooperative and courteous, their ultimate loyalty is to the insurance company that employs them. Their primary goal is to minimize the payout the insurance company has to make on claims, not to ensure that you receive the maximum compensation.

Reality:
Adjusters work for the insurance company, and their job is to protect the company’s financial interests. They are trained to look for ways to reduce the value of your claim, whether that means questioning the severity of your injuries, downplaying the extent of the damage, or finding ways to shift some of the blame for the accident onto you. Keep this in mind during every interaction, and don’t assume they’re looking out for your best interests.

Remember insurance adjusters work for the insurance company. This isn't a minimum wage job, just look at the adjuster salary ranges on ZipRecruitor.

Myth 2: The First Offer Is the Best You’ll Get

Many people assume that the first settlement offer made by the insurance adjuster is the best or only offer they’ll receive. This leads some claimants to accept low offers out of fear that they won’t get anything better. Adjusters may even frame the offer as a “take it or leave it” deal to pressure you into accepting it quickly.

Reality:
The first offer is almost always lower than what your claim is truly worth. Adjusters expect some negotiation and often start with a conservative offer in the hope that you’ll settle for less. This is why it’s important not to rush into accepting the initial offer, especially without fully understanding the extent of your injuries or future expenses. Negotiating with the help of a personal injury attorney can often lead to a much higher settlement.

Myth 3: You Don’t Need a Lawyer to Negotiate with an Adjuster

Some people believe they can handle the claims process on their own and that hiring a lawyer will only complicate matters or reduce their settlement due to legal fees. While it’s possible to negotiate with an adjuster on your own, doing so without legal expertise often leaves you vulnerable to lowball offers and tactics that could limit your compensation.

Reality:
Insurance adjusters are trained professionals with extensive experience in negotiating claims. Unless you have a strong understanding of personal injury law and the claims process, you’ll likely be at a disadvantage. A personal injury lawyer can level the playing field, ensuring that your claim is accurately assessed and that you aren’t shortchanged by the adjuster’s tactics. Studies show that people who hire attorneys typically receive higher settlements, even after accounting for legal fees.

Myth 4: The Adjuster Will Always Be Fair

It’s easy to believe that because insurance companies are regulated businesses, adjusters are required to act fairly and ethically. While there are laws in place to prevent bad faith practices, adjusters are still motivated to resolve claims quickly and cheaply. Relying solely on the adjuster’s evaluation of your claim can be risky.

Reality:
Insurance adjusters are not always fair in their assessments. They may downplay your injuries, question the necessity of certain medical treatments, or dispute liability in order to reduce the payout. This is why it’s essential to gather strong evidence, seek appropriate medical treatment, and consult with a lawyer who can advocate for your rights and ensure that your claim is handled fairly.

Myth 5: You Have to Accept the Adjuster’s Final Decision

Many people believe that once the adjuster has made their final decision or issued a settlement offer, they have no choice but to accept it. They may feel intimidated by the process or think they don’t have the power to push back.

Reality:
You are not obligated to accept the adjuster’s final decision or settlement offer. If you believe the offer is too low or the adjuster is not handling your claim fairly, you have the right to negotiate, provide additional evidence, or even file a lawsuit if necessary. Having a personal injury lawyer in your corner ensures that you have the support and resources to challenge unfair decisions and pursue the compensation you deserve.

By debunking these common myths, it becomes clear that dealing with an insurance adjuster is not as straightforward as it may seem. While they play a critical role in the claims process, understanding their motivations and tactics is key to protecting your rights and securing fair compensation. Armed with this knowledge, you’ll be better prepared to handle interactions with adjusters and avoid the pitfalls that could negatively impact your claim.

Final Thoughts: Protecting Your Rights and Maximizing Compensation

Navigating a personal injury claim after an accident can feel overwhelming, especially when dealing with insurance adjusters who have their company’s best interests at heart. Understanding the adjuster’s role, motivations, and tactics is crucial for ensuring that you receive fair compensation for your injuries and damages. While adjusters are essential to the claims process, it’s important to remember that their primary loyalty lies with the insurance company—not with you.

By taking a cautious and informed approach, you can protect your rights and avoid common pitfalls when interacting with an adjuster. This means being mindful of what you say, avoiding quick settlements, and ensuring that your claim reflects the full extent of your losses—both current and future. Additionally, knowing the difference between various types of adjusters (staff, independent, and public) helps you better understand their motivations and how to respond effectively.

At the end of the day, the best way to ensure you’re treated fairly is by consulting with an experienced personal injury lawyer. A lawyer will advocate for your best interests, help you gather evidence, and negotiate aggressively to maximize your compensation. They understand the tactics insurance companies use and can protect you from accepting less than you deserve.

The stakes are too high to leave your financial recovery in the hands of an adjuster who is working to minimize the payout. Don’t face this process alone—let a professional help you navigate the complexities of your claim and secure the compensation you’re entitled to.

If you have been injured in an accident and need help dealing with an insurance adjuster, don’t hesitate to reach out to our experienced personal injury team. We’re here to answer your questions, provide guidance, and fight for the compensation you deserve. Contact us today for a free consultation.