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5 Things You Need to Know About Insurance Adjusters

Five things you need to know about car insurance adjusters:

Contrary to popular thought, dealing with an insurance adjuster is not like dealing with a customer service representative. When you forgo filing a lawsuit and opt to handle your matter administratively, you have essentially opted into playing the insurance adjuster's game on the adjuster's turf. This article will discuss the five major things you need to know about insurance adjusters and why you need an experienced car accident lawyer on your team.


Questions Answered on This Page:

  • What do I need to know about insurance claims adjusters?
  • Do I have to file an insurance claim after an accident?
  • What tactics to insurance adjusters use to reduce the amount of my claim?

Fact 1: You don't have to file an insurance claim.

Texas law does not require you to file an insurance claim or deal with an insurance adjuster. If you are involved in a car accident, you can immediately file a lawsuit. Texas law, in other words, does not impose a "time out" on how soon you can file after your accident.

Even if you already filed your claim with the insurance adjuster, you still need legal representation to guide you into the most beneficial settlement. Adjusters gets bonuses for saving the insurance carrier money, i.e. not paying you the full value for your case.

While it is sometimes beneficial to avoid filing a lawsuit, and instead go through the insurance claims process, it's important to remember that the insurance claims process is not a system designated by law. Rather, it is the creation of the insurance industry. Think of it this way, imagine you are in a car accident and the person that hit you said, "Let's not get any lawyers or courts involved. Instead, let's settle this with an arm wrestling contest." If you enter into such an agreement with that person (provided that all the necessary steps were taken to create a contract) this would be a perfectly acceptable way of resolving a claim, in the eyes of the law. In other words, even though this sounds like a terrible idea, if the two parties involved choose to resolve their dispute in this fashion, even though it's done outside the legal system, it's still technically legal to do so.

An insurance claim is analogous to the arm wrestling contest. If you and the insurance carrier agree to resolve your dispute using some alternative system (i.e. an insurance claim) you're free to do so. But, just the same way that you're ability to win the arm wrestling contest depends on how good you are at arm wrestling, winning an insurance claim will depend upon your familiarity with the rules of that particular game. Our perspective on insurance claims can best be summarized by a quote from the movie War Games, "The only winning move is not to play."

In all seriousness, insurance carriers dictate the way that an insurance claim works. Law makers and the courts determine the way that the court system works. Which do you think sounds like it would be the most impartial?

Fact 2: An insurance adjuster's decision is final.

Once you play their game by filing a claim with the insurance adjuster, they may decide your arguments are not compelling enough and your ability to recover compensation is severely hampered. There is no appeals process, and you therefore will not be able to get them to voluntarily reverse their position once they deny a claim or pay you more than they've offered.

Over the years, some prospective clients have told us that they thought they would attempt to resolve their insurance claim themselves and if it didn't work out, then they would get an attorney to file suit. This doesn't work for several reasons:

  1. The company now has your statement, records, and medical history. Your lawyer can no longer protect you from misinformation getting out.
  2. Each day, evidence that is vital to your case disappears. The insurance company doesn't want to know the truth, but only information that will help their case. Meanwhile, witnesses move on, documents go missing, and people's memories fade.
  3. The closer we get to the statute of limitations, the scarier it becomes. We've seen insurance companies drag their feet so long that by the time potential clients come to us, it's too late.

Fact 3: A recorded statement is not a requirement.

The insurance company cannot legally compel you to give a recorded statement. In case you're not familiar with the term, a recorded statement is an audio recording of you answering questions asked by the insurance adjuster, typically recorded over the phone.

Think about that for a second. Insurance companies record every phone call that comes into their call centers, so why would they need to do an official recorded statement? The answer is that it is all an elaborate ruse. By the time you provide a recorded statement, the insurance adjuster has already had you explain what happened in your accident (which they recorded as well) several times. As such, the recorded statement is little more than an attempt to put pressure on you (under the guise of the recording being "official") to repeat your account, hoping that you will explain some aspect differently and impeach yourself in the process.

Also, much of what an insurance adjuster would ask you in a recorded statement wouldn't be permitted in court with drawing on objection from your attorney. The bottom line is that you should only do a recorded statement with an attorney present, or you should just not do it all.

Fact 4: Partial payments are a tactic to pay you less overall.

No court in the history of Texas has ever asked a defendant to pay you for your medical bills today, pay for your pain and suffering a month from now, and pay your exemplary damages a year from now. All court cases are resolved in one lump-sum payment where each of the items previously listed are a line item adding to the total judgment amount. When an insurance adjuster suggests a piecemeal settlement, it is more than likely a deceptive tactic.

In essence, they are trying to pay you enough money for your injuries so that the remaining balance of your claim is too little for you to pursue. For instance, if your claim is worth $30,000 and the insurance adjuster tells you that they will pay you $5,000 now and pay you the remaining amount at a later date, all they have done is lowered the effective amount of your claim by 5,000 dollars making it the remaining amount less so worth pursuing by way of going to court. You didn't get $5,000 of free money, you just lowered the overall value of your case.

Fact 5: Even your own insurance company can turn on you.

Your insurance company will probably provide great service to you until the time comes that you have to file an injury claim against your own policy (as when you file an uninsured motorist claim or an underinsured motorist claim). Under those circumstances, your insurance company is liable for your injuries, but they are still only as liable as the defendant would have been if he had adequate insurance coverage.

What this means in practical terms is that your own insurance carrier has a vested interest in defending the other driver. They are given an unfair advantage since you may have shared information with them regarding your claim (a claim that you thought would be against the other driver) that you would not have volunteered to the other side.

Give Grossman Law Offices a call.

If you've been injured in a car accident, hiring an attorney to represent you will eliminate the uncertainty of filing an insurance claim and dealing with an adjuster alone. Call Grossman Law Offices today for a free, confidential consultation with an experienced car accident lawyer at (855) 326-0000.


Read any of the articles below to learn more about car insurance:

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