If you were in a car accident and encountered an insurance adjuster whose perspective made you wonder whether you were living on the same planet, you are not alone. Adjusters often make accident victims question whether they were responsible for their own injuries or whether they are imagining the pain they know they have. Some adjusters are more reasonable than others, but their loyalty is to the insurance company that employs them, not to the injury victim who makes a claim for compensation.
The law imposes a duty upon insurance companies to act in good faith when resolving a claim filed by policyholders they insure. If you are making an injury claim against the insurer of another driver, that duty does not exist. The insurer has no legal obligation to settle your claim fairly or to settle it at all. Sometimes insurance adjusters make injury victims feel like it was their fault that they were injured by a careless driver. Some insurance adjusters want injury victims to believe that their injuries are not as serious as they appear to be.
This article will help you understand why the difficult insurance adjuster you encountered is making you question your own sanity.
Insurance adjusters are trained to do two things. First, they want to settle injury claims quickly, before you realize the full extent of your injuries. They do that because settlements are final and forever. Once you sign a release, you cannot take back your agreement to resolve your claim. Even if it turns out that your injury is more serious than you expected it to be, you have no right to ask the insurance company for additional compensation.
The full extent of an injury is often unknown during the weeks or months following an accident. Many injuries resolve in a predictable amount of time but many others do not. Back injuries and some soft tissue injuries can cause lingering pain that lasts for years. At some point, a physician can tell you that your injury has likely healed or that you have reached a healing plateau. Until a doctor tells you that your healing is complete or that it is likely to be long-lasting or permanent, you are not in a position to decide how much compensation you should receive. Pain and suffering that endures for years or for a lifetime merits more substantial compensation than pain that goes away in a few weeks or months.
Insurance adjusters want you to settle on the assumption that your pain will resolve quickly, before you realize that you may be entitled to compensation for a more serious injury than you thought you had. Second, adjusters want to pay as little as possible to settle the claim. Insurance companies make money by investing the premiums that their policyholders pay. The less of that investment income they give to injury victims, the more profit they make.
Insurance companies want their adjusters to maximize profits by minimizing payments to injury victims. To achieve that goal, some insurance adjusters will question almost everything you tell them about the accident and about your injury. There are two key issues in every personal injury claim arising from a car accident:Â liability and damages. Insurance adjusters will often fight you on both of them, no matter how clear the facts might be.
A driver who is injured in a car accident must establish the liability of the other driver in order to recover compensation. Liability means responsibility for the accident. Which driver caused the collision? If both were at fault, how does the fault of one driver compare to the other driver’s?
Liability is established by proving that the other driver was negligent and that the driver’s negligence caused the accident. That usually means proving that the other driver violated a traffic law (for example, by failing to yield) or drove carelessly (for example, by changing lanes without checking the driver’s blind spot).
Even when the other driver’s liability for the accident is clear, insurance adjusters will want to place some of the fault on the driver who is making the insurance claim. They do that because the law in many states, including California, reduces an injury victim’s right to compensation in proportion to the victim’s fault in causing the accident.
For example, if a careless driver was 80 percent at fault for failing to yield when turning into an intersection but you were 20 percent at fault for not reducing your speed and keeping a careful watch as you approached the intersection, the compensation that would make you whole will be reduced by 20 percent. No matter how blameless you were, an insurance adjuster may try to convince you that the accident was your fault.
The adjuster will at least try to persuade you that you share a large degree of the blame. Unless the driver who injured you was intoxicated and driving while wearing a blindfold, the insurance adjuster will want you to believe that the driver was being careful and that the accident was unavoidable. If you disagree, the adjuster may try to convince you that your perception of the collision is simply unreasonable.
The amount of injury expense compensation you deserve when you are injured in a car accident depends to a large extent on the nature of your injury. Beware the insurance adjuster who insists that your pain is all in your head. The adjuster may want you to get a second medical opinion from a doctor the adjuster chooses, knowing that the doctor will be faithful to the insurance company that is paying for the consultation.
You may find yourself questioning your own pain by the time the adjuster and the adjuster’s doctor finish telling you that you’re just fine. Insurance adjusters often rely on the absence of definitive proof of an injury to question the legitimacy of your claim. Unfortunately, the cause of pain is not always obvious. A broken bone will show up on an X-ray but a soft tissue injury will not.
Sophisticated tests like an MRI may or may not pinpoint the pain you feel, but those test results are usually open to interpretation. An insurance adjuster may tell you that you have no basis for seeking compensation if no solid medical evidence confirms your ongoing pain.
You are not losing your mind if you feel pain that an insurance adjuster regards as an illusion. In the end, what the insurance adjuster believes does not matter. If your doctor believes you and if your friends and family confirm that you are living with pain, a jury will likely agree that you are entitled to compensation.
The right to a jury trial is the leverage you have against insurance companies that take an unreasonable view of liability or damages. Insurers settle cases because they fear a jury will make them pay more if a case goes to trial. They only have that fear if you are represented by an experienced personal injury lawyer.
Unlike insurance adjusters, your auto accident lawyer will always be on your side. Personal injury attorneys know how to negotiate with insurance companies. If you try to do it yourself, the stress and aggravation of dealing with an insurance adjuster who questions everything you say will only compound your woes.
To maximize your chance of obtaining fair compensation while keeping your peace of mind, place your claim in the care of a lawyer who cares about you, not about insurance company profits.