Do an b.i adjuster ever re-evaluate a claim? Do it often happened? And under what circumstances?
Total Comments: 11
Posted: Fri Aug 22, 2008 09:57 pm Post Subject:
Lets say that a B.I. adjuster settled your B.I. cliam for $100,000, if they could not find any aftermarket parts to put on your car they can get really mad and sometimes change their mind and want the $100,000 back, hopefully the money was not spent or you will be in...................... :lol: :lol:
Just kidding, hopefully a B.I. adjuster can answer you question :wink:
Posted: Sat Aug 23, 2008 04:51 am Post Subject:
Hi dean, welcome aboard :D
Can you just throw some more light upon the situation you are in?
Re-evaluation of the claim normally won't occur after the claim check is written and disbursed. However, it may happen when the adjuster suspects fraud in the amount claimed for the damages. It can be in terms of
Inflated medical bills
Inflated Chiropractor bills
Fake injury and/or disability
Exaggerated wage loss or other economical losses
claiming for prior injuries
With the cases of insurance fraud growing everyday, the job of the adjusters is gradually becoming more and more difficult. They are required to investigate whether the claims are genuine or build-ups.
Please, elucidate the situation little more, that might help us to find the reason behind the requirement of the re-evaluation of the claim. Awaiting your reply…..
~Jeremy
Posted: Sat Aug 23, 2008 07:08 am Post Subject:
Not sure if I have understood your problem properly :(
What do you imply by the word re-evaluation?
The adjuster may quote a tentative figure before receiving all the required information regarding the injuries and associated costs. However, he can go further with the evaluation of the claim amount once he has all the required documents. That's normal.
But if the adjuster suspects fraud, then it would be an issue of serious nature. I'd agree with Jeremy, we need more information to evaluate the situation.
Posted: Sat Aug 23, 2008 08:07 am Post Subject:
Im sorry for not being more detailed. If a claim was denied because they felt their insured was not at fault. Do they ever re-evaluate the claim if new information comes up or do they just evaluate each claim just once?
Posted: Sat Aug 23, 2008 08:47 am Post Subject:
Hi Dean..adjusters would take into account all of the said factors when they are questioning the assumed worth of a claim initially-
Such factors could come to them in different forms eg.
But to tell you the truth such factors won't ever hold good when a particular settlement case gets complicated with fresh inputs.
Such a case would then pass on to the Insurance investigators. Investigators' primary job is to evaluate the claim-sources & match them out with the estimates depicted. If they do not tally they could begin another round of investigation involving further analysis.
Regards,
ArindamSenIndies
Posted: Sat Aug 23, 2008 10:48 am Post Subject:
Yes, they will re-evalute at a claim if new information came to light that would or could change a liablity decision....but it would be rare...
How long ago was the claim? and What new information is there that you would like to be considered? What state are you in? Perhaps we could let you know if it sounds like there is a chance...
Posted: Sat Aug 23, 2008 12:39 pm Post Subject:
Good morning, Lori. the accident happened in a well known supermarket. There was pictures that a friend of the injury person took. The store never took any pictures of their own. The claim wasnt long ago and was recently denied. We all know a person or company cant be liability for a incident they didnt know or couldnt have know about. Some of the pictures that was snapped didnt look important so they were put a side and only the ones that looked important was submit to the adjuster. The adjuster denied the claim because of lack of notice. But than looking over all the photos the defect that caused the accident take a while for it to be in that condition. The pictures that we thought wasnt important was after all. The adjuster dont have these pictures. Couldnt that change the liability status? Also you say it is rare, why is that?
Posted: Sat Aug 23, 2008 12:56 pm Post Subject:
It's rare because typcially a through investigation is done in the first place, and nothing is missed that could change the liablity decision..
Is this a slip and fall or what type of claim, inside outside, little more information and I might be able to help better, are you saying that (as an example) a sidewalk deteriorated over time and someone fell? What did you submit and what EXACTLY do you have to submit that is DIFFERENT or may change the outcome? Meaning making this company negligent now and not before? Also if this is an injury on property was the injured person offered med pay? No negligence need be found on the property owner for medpay to come into play.
Posted: Sat Aug 23, 2008 01:13 pm Post Subject:
Good morning, Lori. the accident happened in a well known supermarket. There was pictures that a friend of the injury person took. The store never took any pictures of their own. The claim wasnt long ago and was recently denied. We all know a person or company cant be liability for a incident they didnt know or couldnt have know about. Some of the pictures that was snapped didnt look important so they were put a side and only the ones that looked important was submit to the adjuster. The adjuster denied the claim because of lack of notice. But than looking over all the photos the defect that caused the accident take a while for it to be in that condition. The pictures that we thought wasnt important was after all. The adjuster dont have these pictures. Couldnt that change the liability status? Also you say it is rare, why is that?
Posted: Sat Aug 23, 2008 01:32 pm Post Subject:
You hit it right on the head. This was outside the store right at the automatic doors. yes med pay was giving for medical. The person fell over a piece of the sidewalk. Which came from the bad sidewalk. Seem like someone kick it from the site of the bad sidewalk. We only submit photos of what caused the fall. Not the ones that should where the piece of sidewalk came from. a bad sidewalk talks a while in the condition it was in. If they fixed it a person wont have a chance to kick the piece of the bad sidewalk and the incident wont happen.
Posted: Fri Aug 22, 2008 09:57 pm Post Subject:
Lets say that a B.I. adjuster settled your B.I. cliam for $100,000, if they could not find any aftermarket parts to put on your car they can get really mad and sometimes change their mind and want the $100,000 back, hopefully the money was not spent or you will be in...................... :lol: :lol:
Just kidding, hopefully a B.I. adjuster can answer you question :wink:
Posted: Sat Aug 23, 2008 04:51 am Post Subject:
Hi dean, welcome aboard :D
Can you just throw some more light upon the situation you are in?
Re-evaluation of the claim normally won't occur after the claim check is written and disbursed. However, it may happen when the adjuster suspects fraud in the amount claimed for the damages. It can be in terms of
With the cases of insurance fraud growing everyday, the job of the adjusters is gradually becoming more and more difficult. They are required to investigate whether the claims are genuine or build-ups.
Please, elucidate the situation little more, that might help us to find the reason behind the requirement of the re-evaluation of the claim. Awaiting your reply…..
~Jeremy
Posted: Sat Aug 23, 2008 07:08 am Post Subject:
Not sure if I have understood your problem properly :(
What do you imply by the word re-evaluation?
The adjuster may quote a tentative figure before receiving all the required information regarding the injuries and associated costs. However, he can go further with the evaluation of the claim amount once he has all the required documents. That's normal.
But if the adjuster suspects fraud, then it would be an issue of serious nature. I'd agree with Jeremy, we need more information to evaluate the situation.
Posted: Sat Aug 23, 2008 08:07 am Post Subject:
Im sorry for not being more detailed. If a claim was denied because they felt their insured was not at fault. Do they ever re-evaluate the claim if new information comes up or do they just evaluate each claim just once?
Posted: Sat Aug 23, 2008 08:47 am Post Subject:
Hi Dean..adjusters would take into account all of the said factors when they are questioning the assumed worth of a claim initially-
Such factors could come to them in different forms eg.
* Exaggerated injuries
*Accelerated hospital charges
* Pre-existing conditions
But to tell you the truth such factors won't ever hold good when a particular settlement case gets complicated with fresh inputs.
Such a case would then pass on to the Insurance investigators. Investigators' primary job is to evaluate the claim-sources & match them out with the estimates depicted. If they do not tally they could begin another round of investigation involving further analysis.
Regards,
ArindamSenIndies
Posted: Sat Aug 23, 2008 10:48 am Post Subject:
Yes, they will re-evalute at a claim if new information came to light that would or could change a liablity decision....but it would be rare...
How long ago was the claim? and What new information is there that you would like to be considered? What state are you in? Perhaps we could let you know if it sounds like there is a chance...
Posted: Sat Aug 23, 2008 12:39 pm Post Subject:
Good morning, Lori. the accident happened in a well known supermarket. There was pictures that a friend of the injury person took. The store never took any pictures of their own. The claim wasnt long ago and was recently denied. We all know a person or company cant be liability for a incident they didnt know or couldnt have know about. Some of the pictures that was snapped didnt look important so they were put a side and only the ones that looked important was submit to the adjuster. The adjuster denied the claim because of lack of notice. But than looking over all the photos the defect that caused the accident take a while for it to be in that condition. The pictures that we thought wasnt important was after all. The adjuster dont have these pictures. Couldnt that change the liability status? Also you say it is rare, why is that?
Posted: Sat Aug 23, 2008 12:56 pm Post Subject:
It's rare because typcially a through investigation is done in the first place, and nothing is missed that could change the liablity decision..
Is this a slip and fall or what type of claim, inside outside, little more information and I might be able to help better, are you saying that (as an example) a sidewalk deteriorated over time and someone fell? What did you submit and what EXACTLY do you have to submit that is DIFFERENT or may change the outcome? Meaning making this company negligent now and not before? Also if this is an injury on property was the injured person offered med pay? No negligence need be found on the property owner for medpay to come into play.
Posted: Sat Aug 23, 2008 01:13 pm Post Subject:
Good morning, Lori. the accident happened in a well known supermarket. There was pictures that a friend of the injury person took. The store never took any pictures of their own. The claim wasnt long ago and was recently denied. We all know a person or company cant be liability for a incident they didnt know or couldnt have know about. Some of the pictures that was snapped didnt look important so they were put a side and only the ones that looked important was submit to the adjuster. The adjuster denied the claim because of lack of notice. But than looking over all the photos the defect that caused the accident take a while for it to be in that condition. The pictures that we thought wasnt important was after all. The adjuster dont have these pictures. Couldnt that change the liability status? Also you say it is rare, why is that?
Posted: Sat Aug 23, 2008 01:32 pm Post Subject:
You hit it right on the head. This was outside the store right at the automatic doors. yes med pay was giving for medical. The person fell over a piece of the sidewalk. Which came from the bad sidewalk. Seem like someone kick it from the site of the bad sidewalk. We only submit photos of what caused the fall. Not the ones that should where the piece of sidewalk came from. a bad sidewalk talks a while in the condition it was in. If they fixed it a person wont have a chance to kick the piece of the bad sidewalk and the incident wont happen.
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