insurance adjuster

Personal injuries are unpleasant enough without the added burden of learning the adjuster has made what you believe is either merely a token settlement offer or has used incorrect information when making the offer. One option New York State offers is for you to file an official complaint via the Department of Financial Services.

Before you do that, it pays to understand other steps open to you. Let us begin with the Insurance Adjuster and their role.

The Insurance Adjuster

The adjuster is responsible for understanding the circumstances that led to your claim and to decide how the insurance company should respond. The adjuster will also handle any negotiation on the claim made and compensation offered. An independent adjuster may have limited authority and may have their compensation offers approved by an in-company supervisor. Some organizations use attorneys instead of regular adjusters but the process for handling a claim are the same.

It is worth remembering that adjusters are not specifically medically or legally qualified, and they have a responsibility to settle claims quickly and for the least amount. They will know more about the claims process than you but you will probably know more about your case than they do. They are busy people.

If You Disagree with the Adjuster

When you receive the claim offer and you disagree with it, there are some basic steps to take:

  1. Understand the details of the offer - what is included, why, how the amounts were calculated, what has been excluded, what has been valued at a lower amount than you consider fair, etc.
  2. Stay calm and go through the details. Adjusters are used to angry or upset claimants, and they know how to deal with high emotion.
  3. Check you included all documentation in your claim and that the adjuster assessed the docs correctly instead of ignoring them or misunderstanding what you sent. This simple "error" can lead to miscalculation on their part.
  4. Understand how the adjuster used the "multiplier" to put a monetary value on pain and suffering, mental anguish, etc.
  5. If you believe the adjuster has misunderstood the severity of your injuries, consult with suitably qualified medical professionals. Have them provide appropriate documentation to support your claim against the adjuster's offer.
  6. Consult with financial professionals if you disagree with how the adjuster calculated your actual financial losses.
  7. Always keep in mind there may be a statute of limitations which may limit the time you have to collect and submit all necessary documentation and to renegotiate with the adjuster.
  8. Make copies of everything you provide to the adjuster and send your documents via a trackable method to confirm they received them.
  9. Finally, if your personal circumstances make it difficult or impossible to handle the disagreement and renegotiation on your own, please remember that Smiley and Smiley are experienced in handling such matters, and we will be happy to advise and represent you. If you would like to ask questions or discuss your claim with us, please just click here to contact us.