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How to Deal With Insurance Adjusters

In almost any case where you are seeking monetary damages as a result of a serious injury sustained in an Orlando car accident, you will at some point have to deal with an insurance company and an insurance adjuster. Because of this, it is important to understand what motivates insurance adjusters.

Goals of the Insurance Adjuster

The insurance adjuster works for the insurance company, not for the insured or for the accident victim. An insurance adjuster therefore has an interest in making profits for the insurance company.  In some cases that can manifest as a desire to avoid paying for claims, but insurance adjusters also want to avoid lawsuits.  Going to court and especially going to trial is risky for an insurance company, as damage awards given by juries sympathetic to the plaintiff are often very high.

The job of an insurance adjuster is therefore to achieve the most beneficial settlement possible to the insurance company without there being a lawsuit filed. What an insurance adjuster initially offers to pay may not be the maximum the company is willing to pay, or what you are entitled to recover, as the adjuster usually leaves room for upwards negotiation in future settlement discussions.

Factors Considered by the Insurance Adjuster

If you are injured in an accident, before deciding what to offer you, the insurance adjuster will look at several factors, beginning with the actual expenses that have been incurred to date and that will be incurred in the future. Actual expenses are medical bills and related cost. The adjuster will also look at lost income and lost wages. These are all relatively easy to calculate, as they can just be added up.

What is more difficult, but will still be accounted for by the insurance adjuster, are damages for pain and suffering. Because of the complexities associated with calculating pain and suffering damages, insurance adjusters will usually employ a formula to help them determine the proper amount. Some insurance adjusters will use a per diem system, under which the injured party is paid a set amount for each day of suffering. Some will use a pain multiplier system, under which the insurance adjuster multiplies the cost of the actual damages for medical bills and lost income by a set number, usually between 1.5 and 5. There may be other methods used to calculate pain and suffering as well, but these two are the most popular.

After reviewing your actual losses and pain and suffering, the insurance adjusters will also look at two more factors; your policy limits and the strength of your case. An insurance adjuster will never pay more than the maximum amount of the insurance policy, known as the policy limit. So if there is $10,000 in coverage available, there is no set of circumstances under which an insurance company will pay more than that for damages. If you have a very strong case, the insurance adjuster will be more likely to offer a larger settlement to avoid a legal action. The weaker your case is, the less the adjuster is likely to offer, as the likelihood of you bringing a successful court action is much lower.

Understanding the Adjuster is the Key to Favorable Settlement

Understanding the motivations of the insurance adjuster can help you negotiate the best settlement possible. You might also consider retaining a personal injury attorney, as this signals to the insurance adjuster that you are taking your rights seriously and you are prepared to file a lawsuit. The more evidence you present the adjuster with documenting the extent of your injuries, the stronger your case is. If you know the amount you are willing to settle for, you might consider writing a demand letter, which states to the insurance adjuster what you will accept to settle the case. Sending a demand letter allows settlement negotiations to begin at the number you think is fair, instead of what the insurance adjuster decides, which can result in a more favorable settlement.

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