When filing a personal injury (PI) claim, you need to understand how the insurance company’s adjuster will determine a settlement offer. Knowing how an adjuster works will help inform your decision before you file a written demand for compensation or consider a settlement offer or counteroffer. Read on to learn just what the adjuster does to prepare their offer and how a personal injury law firm can help.
Get the Story
The adjuster needs to understand the claimant’s story in order to prepare a defense or offer a settlement. To that end, he or she will read any and all reports made, either in police or medical reports or in the form of witness depositions.
Databases exist that compile available information on you, the plaintiff, and your history of insurance or personal injury claims. This should also include time spent researching you online to find out what may be usable against you in the proceedings.
Obtain Claim Documentation
The adjuster will request records pertinent to the claim from you or your personal injury lawyers. This can include medical records, income statements, tax returns, and proof of damages. Investigations will include looking for any evidence of prior injuries that can be used to have a claim denied or reduced. If you are self-employed and claim you lost wages, be prepared to provide business records that detail how you lost wages.
A conscientious adjuster will pore over every line of documentation that you provide, looking for inconsistencies to exploit. He or she will delay a settlement offer or counter as long as possible to make sure every factor has been examined from every angle.
Decide on Settlement
After completing all of these steps, the adjuster will make a final determination regarding the claim’s value. This calculation includes odds of plaintiff victory and amounts a jury might award. Next, the adjuster considers the damage claim, broken into quantifiable (medical bills or earnings) and qualitative damages (pain and suffering). These damages could be broken down further; for example, a chiropractic expense could be marked as a soft expense, while surgery would be a hard expense.
For qualitative damages, adjusters rely on formulas and software to assign value. These are most likely based on predetermined factors and calculations that have nothing to do with you specifically, but are applicable to your case (e.g., previous payouts for broken leg recovery periods).
Make the Settlement Offer
After arriving at a value, the adjuster must decide what to offer, usually a predetermined percentage of the calculated value. The company standards may dictate a first offer no higher than 40% of the value; no set standard exists, so this will vary.
If you are unrepresented, this initial offer will be lower. Bringing a lawyer to the table may increase the odds of getting a better offer. Who you choose matters also, so be smart when you make that decision.
Understanding how the adjuster works will help you in the event of a claim. The adjuster plays the role of investigator, studying the facts and interviewing the witnesses to better prepare themselves to defend against your claim. Adjusters are quite adept in their work, so having an equally capable lawyer is critical to your success.