How Understanding of Adjuster’s Role Can Hand Claimant An Advantage


After you have filed a personal injury claim with an insurance company, the insurer hands your fate to one of these individuals: a claims adjuster, claims specialist and a claims representative. All 3 of those people carry out the same function. Each of them must clear your file.

That means that each of them must close your case.

Each of them gauges the difficulty, with respect to closing a given case, by learning whether or not the claimant has shown an understanding of the claim’s worth. Adjusters face challenges: Have no extensive legal or medical knowledge, and have limited resources, plus limited time.

Adjuster’s investigation does not reveal the extent or degree of a given claimant’s pain. By the same token, it lacks the ability to show how long it has taken the claimant to recover to a full extent.

Personal Injury Lawyers in Sault Ste. Marie know that the claimants that take pictures on the day of the accident have other evidence that remains out-of-reach to any adjuster.

Adjusters’ constraints come on top of their challenges.

Their superior has given them a dollar amount; that represents the maximum size for any payout that might be promised to a claimant. Still, there could be time when a claimant’s injury has been serious enough to create medical expenditures that exceed the dollar amount given to the person with the injured victim’s file (the adjuster).

The emergence of such a situation would force the affected adjuster to consult with the appropriate superior. That could take time, and could cause a bit of a delay in the negotiation process. If faced with such a delay, smart claimants take the following action.

The claimants’ efforts should focus on discovery of the date when the superior’s decision should be shared with the employee that has been awaiting the same decision. Possession of that specific date should hand the claimant an advantage.

Claimants can demonstrate their patience by waiting until arrival of that stated date. Then, if there has been no word from the adjuster’s office, the claimants’ efforts ought to focus on a demonstration of their persistence. What would that demonstration look like?

It would involve sending a letter, one that requested the information that had been promised earlier. Adjusters recognize the potential effect of that piece of communication. It could signal a claimant’s readiness to sue the insurance company, if it has chosen to hold-up the negotiation process.

The breaking of a promise could be viewed as bad faith. According to the law, the filer of a personal injury claim has the right to sue an insurance company that has demonstrated bad faith. So, claimants’ advantage actually comes from what has been written into the specifics about injury law.