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How To Get Your Case Settled Fairly: The Adjuster
At a recent conference on auto accident law, I listened to a presentation by an insurance company claims adjuster. The topic was “How to Get your Case Settled Fairly”.
The adjuster pointed out that insurance adjusters carry heavy file loads and they are under pressure to settle claims quickly and cost effectively for the insurance company. She recommended that it is in the interest of the injured client for their lawyer to develop a rapport with the adjuster, and to assist the adjuster with her job. Her job requires her to gather information to document a “reserve” or estimated amount that the insurer thinks will have to be paid to settle the claim. Rapport with the adjuster is established by facilitating the initial investigation by helping, rather than obstructing, the information gathering process.
I agree with all this. Good relations with the adjuster makes good sense. If the adjuster is not provided with medical and other information, then in many cases the reserve will be set too low, and it may be very difficult later to get the reserve adjusted upward so that the claim can be settled for what it’s worth.
BUT then the presenter made the following revealing comment about the insurance adjuster’s agenda:
· Adjusters will almost always request a statement from the plaintiff and while this process will assist the adjuster in completing the investigation and setting reserves, it also serves to discredit plaintiffs or limit liability.
This is why I recommend that auto accident clients talk to a lawyer BEFORE MAKING A TERRIBLE MISTAKE IN THEIR CLAIM. The adjuster may be friendly, but she is not your friend. Her agenda is not identical to your agenda. In fact, the accident victim and the adjuster are in an inherently adversarial relationship. An experienced accident and injury lawyer can help the adjuster with her legitimate need to set a reserve, while protecting the client from the adversarial part of the adjuster’s job – “to discredit plaintiffs or limit liability”!
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Auto Accidents and Car Wrecks
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- Do I have to use my own health insurance for my auto accident injuries? I've been injury in a motor vehicle accident and my doctor has referred me for therapy. I have private health coverage through work and I have Accident Benefits Coverage on my auto policy. My auto insurer is telling me I have to use my own private health coverage to pay for therapy costs prior to accessing my Accident Benefits Coverage. Why?
- I was injured in a car accident and my insurance company is telling me I have to use my personal insurance (e.g. Desjardins, Blue Cross, Manulife) to pay for my massage therapy, physiotherapy and prescription drugs before I can use either the accident benefit coverage (Section B) on my automobile policy, or the insurance of the guy who hit me. Is this right?


