by BillTheBuilder » Sat Aug 09, 2008 02:37 pm
What is the process of an injury insurance claim? Is this process different with ot without a lawyer/attorney? Also an adjuster job is to save the insurance company he or she works for money right? If that is correct, how come we hear about claim adjuster pushing injured people to an attornery? Why dont they just settle with the injured party? In a claim where liability is pretty much clear. I hear from adjusters I know that sometimes they deny claims hoping the injured person would just go away? Why not pay a little to the injured person instead of pushing them towards a lawyer? Does that make any sense if their job is to save the insurance company money?
Posted: Sat Aug 09, 2008 08:37 pm Post Subject:
First, I really don't know of any adjuster that 'pushes' (recommends) the person toward an attorney. I've handled claims for very difficult people would did not/would not understand the process so I've _wanted_ them to get an attorney. This is different though.
A person's vehicle is tapped at 2mph and there is just a scratch on the bumper. The person waits for 2 weeks before they are treated by a chiropractor with manipulations (expensive massages). Would you think this person is treating just so they can put some money in their pocket? Probably. This happens all the time. Would you reward this person by paying them "a little" just so they go away? What kind of message is this going to send? You hear about the people who get an attorney but you don't hear about the people who drop their case as they know they were only treating to put money in their pocket and even when they get paid something you may not always be told the truth about their settlement. But sometimes the message from the insurance company can same a lot of money on the next 100 claims. That is, they will only pay what they owe (don't over pay claims just to make them go away).
Posted: Sun Aug 10, 2008 10:08 am Post Subject:
Is this process different with ot without a lawyer/attorney?
No other than it takes longer to settle and you cannot talk to the person but have to go thru the atty...oh and of course the atty get's a third (min) of the settlement.Also an adjuster job is to save the insurance company he or she works for money right?
Well yes and no, it's their job to pay what is owed no more no less...If that is correct, how come we hear about claim adjuster pushing injured people to an attornery?
I'll tell you the truth in over 20years I've 'hoped' a few people would get an atty, because they just didn't get it...but like T I've never 'pushed' anyone to an atty....Why dont they just settle with the injured party?
They do...In a claim where liability is pretty much clear. I hear from adjusters I know that sometimes they deny claims hoping the injured person would just go away?
Never heard of an adjust 'denying' any claim that was owed in the hopes that it would go away, you can't do that....Why not pay a little to the injured person instead of pushing them towards a lawyer? Does that make any sense if their job is to save the insurance company money?
Sometimes (more than you'd think) that's exactly what happens, (not the lawyer part) a person has a sore neck decides not to treat, but wait it out for a week they might be offered a few hundred for the pain and discomfort they had....Posted: Mon Aug 11, 2008 07:29 am Post Subject:
Does that make any sense if their job is to save the insurance company money?
Well, the adjuster's job is not to save money for the insurance company but to compensate the claimant properly. This is a general misconception that the adjusters always try to lowball the claim amount to save the insurer's money.
However, at times, the adjusters encounter with claimant, who refuses to see any reason, and keep on pressing with his own view. Then it leaves on option but to ask them to see an attorney.
The involvement of an attorney only lengthen the claim process and also costs huge (court fee and attorney fee) at the same time. The insurance companies generally try to sort out the matter with the claimant only.
Nevertheless, some situations genuinely demands the involvement of an attorney, but that shouldn't be regarded as a general phenomenon.
Regards,
Juanita
Posted: Mon Aug 11, 2008 02:30 pm Post Subject:
I'd like to add one thing... this is really the question of the glass being half full or half empty. It depends if your pouring or drinking.
You can say that the adjusters job is to pay the appropriate amount on the claim. You can also say the adjusters job is to pay as little as possible. These are/can be the same things... it just depends on which side you are standing on.
You also have to factor in that some claims, injury claims, have no set amount. So who is to say it was under paid, paid just right, or over paid. To three different people it could be all three. But this can also be true on a property damage claims, such as a total loss. One person might feel the vehicle is worth far more then someone else. Both might be correct on their amount.
One more thing... an adjuster may offer, lets say, $5000 on an injury claim. This could be a very good offer. The person refuses and obtains an attorney. The attorney may offer additional information showing that the claim is worth more, so the amount of the offer/settlement increases. Or the insurance company may even offer more just because of the "more real" possibility of suit being filed. In the latter case the claim is not "worth" more but the insurance company may offer more because a defense costs can cost a lot more then the claim itself. But it does not make sense to offer that higher amount initially because, as stated, a good amount was being offered all along. Am I saying that some insurance companies don't low-ball offers initially? Nope. It happens all the time, each and every day. Is this fair? Yes... if both parties agree to the amount. Same thing happens when you buy a car. A person might spend too much when they buy the car but this does not make the agreed upon price unfair/incorrect/too high or too low.
Posted: Tue Aug 12, 2008 07:22 am Post Subject: hi
Does that make any sense if their job is to save the insurance company money?
See, I'd rather have more reasons to believe that it is the adjusters' duty to earn a name in terms of his carrier's prompt service & justified settlements than for saving money through unjust settlements.
Insurance carriers are always focussed to elevate their service levels to ensure a long-term bond with their clients.
So, I'd see no reason why an adjuster would push a client to an attorney!
It could be the client's choice to hire an attorney in order to derive something out of nothing..or may be a fraudulent activity committed on the part of the insured.
In a claim where liability is pretty much clear.
Sometimes the liabilities are not that much clear initially...& thats perfectly the reason why adjusters would often convey such claims to the claims investigators for further investigation purposes. It might take them a considerable bout of time before they may arrive at a proper worth of settlement. FatmanPosted: Wed Jul 28, 2010 01:43 am Post Subject: adjusters denying claims makes no sense
Wife was recently involvrd in accident were she suffered broken ankle, this happened in chicago. The police report indicates only what was said by both drivers , does not determine fault. I have provided pictures of intersection that clearly shows that my wife had protected left turn and second driver struck vehicle more that likely ran light. I was told by adjuster that the insurance company would have no liability. What gives?
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