Dealing With the Insurance Adjuster After a Car Accident

After a crash, your own insurer assigns an adjuster to the claims you make on your policy: collision for the car, medical payments or personal injury protection for early bills, uninsured motorist if the other driver had no coverage. That adjuster works under a contract with you. The insurer owes you good faith and fair dealing, and in most states can be sued for bad faith if it unreasonably denies or delays what the policy owes.

The other driver's insurer assigns an adjuster to the liability claim, meaning your claim that their driver caused your losses. That adjuster has no contract with you. The duty runs to their own policyholder and to the company. The goal is to resolve the claim for the lowest amount the evidence supports, and the training, the scripts and the software are built around that goal.

Confusing the two is the most common mistake. People assume the pleasant voice from the other driver's company is there to help. It is there to close the file, and the help it offers, a quick check, handling the rental, an early settlement, is help with that goal.

The liability adjuster opens the claim, pulls the police report, contacts both drivers, and makes a preliminary fault decision. The early phone call to you has three aims: to hear your account before you have thought about it, to obtain a recorded statement that can be quoted later, and to get a signed medical authorization that lets the insurer pull your records, often your entire history.

The adjuster will also ask about your injuries, how you are feeling, whether you have seen a doctor, whether you have missed work, and whether you have ever been injured before. Answers given in the first days, while adrenaline is still masking symptoms, become the baseline the insurer compares everything to. Saying you are a little sore but basically fine is remembered when a herniated disc is diagnosed in week three.

On the property side, the adjuster inspects or reviews photos of the car, writes or approves a repair estimate, and decides whether it is a total loss. This part is usually straightforward and moves fast. The speed on the car is sometimes used to build goodwill before the injury discussion.

Some questions are routine and some are not. The ones that matter are usually phrased casually. Did you see the other car before the impact invites an estimate that can be turned into a failure to keep a lookout. How fast were you going invites a number that will be compared to the limit. Were you on your phone, were you in a hurry, had you had anything to drink, are all fair questions that deserve a short, accurate answer and no elaboration.

On injuries, the pattern is to get you to minimize. How are you feeling today usually gets a polite fine, which is then recorded. Have you had any back problems before is asked to set up a pre-existing condition defense. Are you still treating, asked a month in, is checking for a gap. Did the doctor say when you would be fully recovered is looking for a date to anchor the claim to.

None of this requires rudeness in response. State the facts you are sure of, say you do not know when you do not, say that you are still being evaluated when asked how you are, and say that you will provide medical records relevant to the crash rather than signing an open authorization. Those four habits remove most of the damage.

Suppose you were hit at an intersection by a driver who ran a stop sign, and the other driver's adjuster called the next day. Fault was accepted on the call. Your car was declared a total loss and a check for its value arrived within a week. You had neck and shoulder pain and had seen your doctor once, who prescribed anti-inflammatories and said to come back if it did not improve.

Ten days after the crash, the adjuster offered $3,000 for your injuries, on top of the medical bill so far, to close the claim now, noting that you seemed to be recovering well. The release attached covered all claims arising from the accident.

If you accept, the claim is over. If the shoulder pain turns out to be a rotator cuff tear requiring surgery in month two, as sometimes happens, there is no claim for it. The $3,000 was not the insurer's valuation of your injury; it was the price of eliminating the risk that your injury would turn out to be serious. The right response was to say that you were still being evaluated and would be in touch when treatment was complete. All figures are hypothetical.

A few habits, applied from the first call, keep the file clean and keep the claim in your control.

• Confirm which insurer the adjuster works for and write down their name, direct number and the claim number before discussing anything.
• Keep a log of every call and letter: date, who, what was asked, what you said. It takes one minute and becomes the record of what was really said.
• Give the other driver's adjuster the basic facts in writing rather than in a recorded phone statement; you have no duty to give them a statement at all.
• For your own insurer, cooperate as the policy requires, but still stick to facts you are sure of.
• Limit any medical authorization to providers and dates connected to the crash, and strike language that permits access to your full history.
• Do not estimate speed, distance or time; say you do not know if you do not.
• Do not discuss settlement until treatment is finished and a doctor has described the long-term picture.
• Keep every letter the insurer sends, including the ones that seem routine; reservation of rights letters and request letters have deadlines inside them.

Most states have unfair claims settlement practices laws, often modeled on a national association standard, that require insurers to acknowledge claims promptly, investigate reasonably, and pay undisputed amounts within a set time. The remedies for violating them vary widely. In some states, including California and Texas, an insured can sue their own insurer for bad faith and recover beyond the policy. In others, the only remedy is a complaint to the state insurance department.

Against the other driver's insurer, bad faith claims are generally not available because there is no contract, though a few states allow third-party bad faith claims in limited circumstances. In practice, the lever against a liability adjuster is the willingness to file suit, not an unfair-practices complaint.

No-fault states change who the primary adjuster is. In Florida, Michigan, New York and New Jersey, your own insurer's PIP adjuster handles initial medical bills regardless of fault, and that relationship is a contract one with good-faith duties. Deadlines run from the crash regardless of how long the adjuster takes: one year in Tennessee and Kentucky, two in Texas, California, Florida and Georgia, three in New York and North Carolina. An adjuster who keeps a claim open and friendly past the deadline has ended it.

Minor property claims with no injury are claims most people can handle with an adjuster directly. The point at which an attorney changes the outcome is when there is an injury with more than a few weeks of treatment, when fault is disputed, when the adjuster is asking for a broad medical authorization or a recorded statement, or when an early offer has arrived before treatment is finished. Most personal injury attorneys work on contingency, and once a claim is represented, the adjuster deals with the attorney and the phone calls stop.

Ask Legal Matters is a free claim-review request service, not a law firm. Requests may be shared with independent attorneys and legal services partners who handle inquiries in your state, and an attorney must evaluate the facts before anyone can say whether a claim is being handled fairly. If an adjuster is pressing you for a statement, an authorization or a signature, you can request a free claim review before you give one.

• Car Accident Claims in the United States: The Complete Guide
• Truck Accident Claims: Liability, Federal Rules and Compensation
• Motorcycle Accident Claims: Overcoming Rider Bias and Recovering Fully
• At Fault in a Car Accident? Comparative Negligence Explained
• What Is the Average Car Accident Settlement? What Sets the Value
• Back and Neck Injury Settlement After a Car Accident: Factors
• Bicycle Accident Claim: Hit by a Car While Riding
• Can I Sue for a Slip and Fall? Premises Liability Explained
• Can I Sue My Employer for a Work Injury? Workers' Comp vs Lawsuit

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