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Insurance companies are in the business of risk management, which means they go to great lengths to avoid paying more than they have to on a given claim. Claims adjusters are the foot soldiers of this process. They investigate the merits of claims and determine the amount that an insurer will pay. To improve their own performance ratings, some adjusters will use aggressive or even underhanded tactics to reduce their employers’ exposure. People who are faced with disputes with insurers may need to pursue litigation to overcome an adjuster’s strategies.
What does an insurance adjuster do?
A claims adjuster can be thought of as an investigator. They tend to have specific skills that qualify them to review evidence and determine the value that should be paid under the applicable insurance policy. Adjusters do a number of things on behalf of the insurer, including protecting it against fraudulent claims and acting as the insurer’s “eyes and ears” to evaluate the specific facts of the claim. An adjuster will often examine the physical evidence related to a claim, such as damage to an automobile or an individual’s physical injury. They may also conduct interviews with the parties and witnesses. Adjusters may also be directly involved in negotiating settlements with covered individuals, and will also be involved in any litigation that may ensue if the injured person disputes the insurer’s findings. Among other things, an adjuster may be the individual who pressures an injured person to accept a “quick cash” settlement after an accident.
Contesting an adjuster’s conclusions
Ultimately, an insurer has a legal obligation to treat each claim in good faith. Few adjusters will make it easy for an injured person to build a case of bad faith. When an adjuster’s conclusions don’t fit with the facts, the injured person needn’t accept inadequate coverage. Disputing a denied or under-compensated claim doesn’t necessarily require jumping straight to a lawsuit. The first step is often simply to reach out to the adjuster to discuss the rationale for the adjuster’s decision. In some cases, the adjuster may not have a complete set of information, or may have missed an important fact that could change how the insurer handles the case. In any dispute with an insurer, an injured individual who goes without legal assistance will be at a significant disadvantage. An adjuster’s job is to be an insurance expert. The role requires developing a sound basis for the insurer’s decisions. An individual who lacks the adjuster’s sophistication may do more harm than good while making arguments in favor of coverage. An attorney can help the claimant ask the right questions and present evidence in a manner that will give the claim a better chance of being approved.
For over 50 years GGRM Law Firm has helped clients in the Las Vegas area recover compensation in personal injury, auto accident, and workers’ compensation cases. If you have been injured please don’t hesitate to reach out to discuss your case with an attorney. Our initial consultations are free. Call us today at 702-384-1616 or contact us through our website.