What Do Auto Insurance Claims Adjusters Do? - Acceptance Insurance Blog

What Do Auto Insurance Claims Adjusters Do?

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What Do Auto Insurance Claims Adjusters Do?

If you're in a car accident and want to file a claim with a car insurance company, then you're likely going to be dealing with an auto insurance claims adjuster. Claims adjusters work for the insurance company to deal with claimants, investigate the details of the accident, check your coverage, and determine a settlement to cover your loss or damage.

Auto insurance claims adjusters can go by different titles including claims handler, claims specialist, claims analyst, or loss adjuster in other parts of the world. Claims adjusters can also be found in the medical and property insurance field. In order to know how to deal with auto insurance claims adjusters after a car accident, it's important to understand what they do.

What is an Auto Insurance Claims Adjuster?

Auto insurance claims adjusters who work for insurance companies are hired to primarily investigate claims. Think of a detective that has to fact-check every aspect of a case to determine the party at fault and prevent cases of fraud. Apart from identifying the at-fault party, an auto insurance claims adjuster will check if your policy covers your loss and damages. After you file a car accident insurance claim, an auto insurance claims adjuster may perform the following:

  • Assess car damage in person and take photographs
  • Interview witnesses or passengers involved in the accident
  • Gather police reports and hospital records
  • Contact your medical provider to determine medical expensesContact your medical provider to determine medical expenses

Who Do Auto Insurance Claims Adjusters Work For?

It's important to remember that auto insurance claim adjusters work for insurance companies. This tidbit may seem like an obvious detail but consider that auto insurance claims adjusters are trying to save their employer money while determining the settlement of your claim. Some insurance companies may refuse to pay, stall, or offer a settlement that's too low. Ultimately, your experience with an auto insurance claims adjuster will depend on your insurance company.

Because they work for the insurance company, auto insurance claims adjusters can also choose to pay an unhappy claimant after the claimant has fought against a claim denial. Insurance adjusters may consult with a manager or supervisor to pay off the claim to avoid the negative press from a disgruntled customer.

Are Auto Insurance Claim Adjusters Your Enemy?

It's natural to be distrustful of auto insurance claims adjusters. After all, they're the ones who will determine how much money to pay you for your loss and damages after the accident. Their close connection to the insurance company can make you think that there'll be a conflict of interest when settling your claim. Fortunately, auto insurance claims adjusters have no financial interest or gain from your insurance claim outcome. In fact, it benefits them more for you to have a positive experience and have all of your medical expenses, lost wages, and damages covered.

Most of the time, you'll be paired with a friendly and empathetic auto insurance claims adjuster that has been trained to deal with stressful situations and panicked customers. An auto insurance claims adjuster can help you recover from a car accident with a fair settlement, but not before they do a full and reasonable investigation to avoid any cases of fraud and double-checdk every covered cost.

How an Auto Insurance Claims Adjuster Settles Claims

It's in everyone's best interest to settle a car accident claim as effortlessly as possible. An auto insurance claims adjuster is tasked with settling claims relatively quickly to keep up with the workload that can range from 50 to 100 claims a month. You may start by filing the claim online or by phone. When calling an insurance company by phone, make sure to ask for the following information:

  • Name of your auto insurance claims adjuster
  • Claim number
  • Office contact information
  • Expected turnaround time to settle the claim

When you notify the car insurance company or your car insurance agent of your car accident, you may be redirected to an auto insurance claims adjuster. They are the person that you'll be primarily interacting with. Smaller claims can be handled over the phone, but more serious and complex cases will require face-to-face interaction with an auto insurance claims adjuster. Here's a run-down of a typical car accident claim process:

  • Interview

    Interview An auto insurance claims adjuster will start off by asking for your statement of the accident through a phone call or at an in-person interview. The information that they obtain will help them determine who was at fault for the accident and if it's covered by your policy, while also protecting the insurance company from fraud. If needed, they'll also interview witnesses, passengers, and the other driver involved.

  • Travel

    If the case requires face-to-face interaction, an auto insurance claims adjuster will go in person or send out an agent nearby to inspect the damaged car and property. An adjuster will take pictures and video of the damage. If they're close enough, they may also interview people in person.

  • Examine Records

    Auto insurance claims adjusters will obtain police reports, accident reports, and hospital records to verify related insurance costs. They may also ask you to send in your car to a licensed repair shop to get a repair estimate and vehicle appraisal. It's crucial to have this paperwork ready and organized to streamline the settlement of your claim.

  • Review Policies

    Insurance adjusters will consider expenses incurred, lost income, and pain and suffering to value your case to settle it. The adjuster will send you an initial offer. If you feel that the offer is too low, then you can enter negotiations with your insurance company alone or with the help of a personal injury attorney, although most cases don't require outside help.

  • Negotiate Settlements

    Insurance adjusters will consider expenses incurred, lost income, and pain and suffering to value your case to settle it. The adjuster will send you an initial offer. If you feel that the offer is too low, then you can enter negotiations with your insurance company alone or with the help of a personal injury attorney, although most cases don't require outside help.

Determining Settlement Value

Auto insurance claims adjusters must consider multiple factors when determining the value of a claim. From your medical expenses to your financial losses due to lost wages and missed work, your adjuster will review every document to get an accurate value of your injuries and damages. Assessing the pain and suffering value is more subjective, but many insurers use a multiplier to estimate the extent of your pain and suffering. Multipliers are used to determine how much a jury would potentially award you if the case went to trial.

For example, if you only visited the doctor once for your injuries, the auto insurance claims adjuster would multiply the amount of your damages by a factor of 1.5 or 2. If you've racked up thousands of dollars of physical therapy and hospital stay costs over an extended period of time, an adjuster may determine that you have suffered extensively and multiply the value of your special damages by 3 or more. Auto insurance claims adjuster may consider the following variable when determining your case:

  • Is an injury related to the car accident or worsened by the accident?
  • How soon did you seek medical attention after the accident?
  • Was your treatment necessary and covered?
  • Age
  • Previous medical history
  • Car accident details

How to Deal with Auto Insurance Claims Adjusters

When dealing with an auto insurance claims adjuster, you should be honest about the specific details of your car accident. If they feel like you are lying or holding something back, then they may inquire further into your case and delay your settlement. You must contact your insurance company as soon as possible after the car accident. You'll need the following information ready for your interview with your auto insurance claims adjuster:

  • Policy number
  • Date and time of the accident
  • Location of accident
  • A written statement describing the accident
  • Name and insurance information of the other party
  • Number of the police report and other relevant information

During your interview with your auto insurance claims adjuster, you must ensure you're accurately portraying your current state. Even saying you're doing fine can be seen as a sign that you're recovered and can affect your settlement value. An adjuster may also ask to record the conversation. You may choose to opt-out of recording your conversation in lieu of an informal account of your accident.

Problems with Auto Insurance Claims Adjusters

In rare instances, you may have a problem with the way your auto insurance claims adjuster is handling your claim. They may offer an unreasonably low offer or completely deny coverage in some cases. If you have major issues during the settlement of your case, here are a few ways you can solve your issues.

  • Speak with an Insurance Adjuster's Supervisor

    If you're having trouble dealing with your auto insurance claims adjuster, then you can ask to speak with their direct supervisor. Explain your situation in a calm and collected manner and ask the supervisor to take a look at your case and act as a mediator between a claims adjuster and you. An insurance adjuster's supervisor may back up the adjuster, but you'll usually get your claim resolved if your policy covers your loss and damages.

  • Write to the State Department of Insurance

    If reaching your claims adjuster has become increasingly difficult and settlement offers are slow to come, you may want to contact or write to the State Department of Insurance. Include all necessary documentation and an outline of your complaint in writing to ensure you have a strong case.

  • Hire an Attorney

    Talking with an experienced car accident attorney can guide you in the right direction when handling your claim. An attorney can tell you if your settlement offer is too low or just the right amount. They can also negotiate on your behalf and help you get a fair settlement for complex cases.

Dealing with auto insurance claims adjusters to close your claim can be stressful and confusing. Fortunately, Acceptance Insurance has expert auto insurance claims adjusters on staff. Contact an auto insurance claims adjuster from Acceptance Insurance to go over your insurance options, get a free insurance quote, or get your car accident losses and damages covered. We're here to help you so that you can be up and running in no time.

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