What the Insurance Adjuster Says and What He Means are Two Different Things

September 2, 2022 / 1:09 pm

If you have been injured and are seeking compensation it will speed things along if you can properly communicate with each other. If you ever have tried to negotiate with an insurance claims adjuster, then you know that (1) claims adjusters are highly skilled negotiators; and (2) claims adjusters speak their own language (or, at the very least, speak a different language than you). All you want is a straight answer, but the adjuster never seems to say what he actually means!

The reason for this disconnect is simple: You and the adjuster have different goals. You want to settle your claim for a fair sum in a reasonable amount of time. The adjuster, on the other hand, wants to settle your claim for as little as possible, regardless of how long that takes.

You don’t have to be trained in the art of negotiation to achieve your goals, but you do have to recognize when the adjuster is employing a particular negotiating technique in an effort to achieve his goals. To help you communicate we have put together the following, most often used insurance statements and their translations:

When the Adjuster Says …, He Really Means ….

1. Silence.
This is, perhaps, the most frustrating stonewalling technique. The adjuster simply stops communicating with you. He does not respond to letters or emails or phone calls.

2 “I don’t have authority to settle for the amount you have requested.”
It is the nature of an insurance claims department that the adjuster has to get authority to settle from someone higher in the chain of command. If, however, the adjuster makes this claim repeatedly, you are probably being stonewalled.

3. “Your claim is being reviewed.”
Even though no settlement offer has been made, the adjuster assures you that the wheels are in motion: Your claim is “in committee,” or “being reviewed by the home office,” or “waiting for a supervisor’s approval.” By dangling the carrot of a pending settlement, the adjuster hopes you will continue to wait.

4. “I need more proof.”
The adjuster has copies of all your medical records and bills, and evidence of your lost wages, but says he needs “additional documentation” of your loss. If no offer is forthcoming, these repeated requests for documentation are a blatant effort to delay payment of your claim.

5. “I’m just getting up to speed on your file.”
Some insurance companies have a high turnover rate among claims adjusters; some insurance
companies routinely move claims files from one adjuster to another. If you are constantly dealing with a new claims adjuster, for whatever reason, the effect is to stonewall your claim and delay payment while the adjuster learns the file.

6. “We can settle all of your claims or none of your claims.”
The adjuster may try to leverage one claim against another. If, for example, you have an auto damage claim and a bodily injury claim, the adjuster may refuse to settle your auto claim unless you also settle your injury claim (right now, for a low amount).

If you encounter one or more of these tactics in your dealings with the insurance adjuster, you have a few options:
A. You can wait and let the negotiations play out on the adjuster's schedule for a while longer;
B. You can challenge the adjuster directly by sending a formal settlement demand letter, by certified mail, requesting a response by a certain date: and/or
C. You can enlist the help of a personal injury lawyer. Depending on how much time has passed, this may be your best option. insurance companies have little incentive to settle promptly and fairly with unrepresented claimants. Stonewalling is profitable for the insurance company. Accordingly, it often takes the involvement of an attorney to get the adjuster's attention and set the negotiation wheels in motion.

We hope this guide helps you in dealing with the insurance adjuster. If you would like to speak to a compassionate and experienced personal injury attorney - one who understands your goals and knows how to talk to the claims adjuster in a way that gets results - please call us.