What Should I Say to the Insurance Adjuster After an Accident?

Hey, everybody. Griff O’Hanlon here, attorney with Cooper Hurley injury lawyers. And I’m happy to be sitting here today with Daniel Jarman. He’s one of our lead analysts on our cases here at Cooper Hurley. And we’re here today to talk to you all about what it is that you should know if you find yourself after being involved in an accident, speaking with an insurance adjuster. So these are folks with the insurance company who handle the claims process and evaluate a claim and are the ones who eventually would discuss potential settlement. And again, I have Daniel here with me. Daniel has, before joining us, almost 20 years experience as a claims adjuster. So he provides us some great insight as to what the other side is thinking about a case or how they’re evaluating a case and is a great resource for us and our clients and really understanding the claims handling process. So today, what I wanted to really discuss, Daniel, is drawing on your experience, what people should know if they find themselves talking to an insurance adjuster after an accident. So I guess kind of the starting point would be what is a claims adjuster? Or who is a claims adjuster with the insurance company, and what role do they play in the claims process following an accident. First off, you’re going to deal with multiple people at an insurance company. So when you buy a policy or they service a policy, that’s going to be your agent or the people that work for your agent. So that’s different than what we’re talking about. We’re speaking about the actual adjusters who educate or settle claims. And these people can either be a property damage adjuster, an injury adjuster, or somebody that takes care of the liability portion of the case or the claim. Those people that you’re typically gonna deal with in an injury claim are going to be your injury adjusters. The vehicle is often taken care of early in the stage of the case or in the early stages of the claim, and then the actual injury adjuster be the person following up with you monthly to follow up on your status of your recovery. So if I go into, like, a brick and mortar shop that says an insurance company, and I go in and I speak to them and I’m purchasing insurance through them, that’s not the same person as an adjuster you’d be dealing with after an injury, is that right? Correct. Completely different relationship that you’re going to have with your agent as opposed to an injury adjuster or just any kind of claims adjuster. Two differently. Two different people. Okay, so let’s kind of role play if I’ve been in an accident and I’ve sought medical care. It’s the first thing that we always tell folks to do, get medical care. If anything feels off or wrong, just get checked out. But after that, the first call should be to my own insurance company and speak to an adjuster with my own insurance company. Is that right? Correct. You should be speaking with your insurance company as soon as possible. And I preface that before you ever get to the point of speaking with your adjuster, make sure that you have good information to give to them that’s accurate. Witnesses, police reports, police officers, damages, things like that. So you’re going to want to talk to your own insurance company to make sure that they know what’s going on in the accident, because the other person may also make a claim against you, and you want to make sure that you can head that off with good information given to your own insurance company. So in talking with adjusters, you may talk to someone from your own insurance company. You may find yourself talking to someone from the other driver’s insurance company as well. So there’s adjusters really, in multiple avenues of communication or multiple sides, you might be speaking with them, correct? That’s right. So you need to know who you’re speaking with upfront. So does the person represent you in a manner of them being your own insurance company, or are you dealing with the other person’s insurance company? You need to make sure that you know that before you have before those conversations. And I guess when you do begin having some of those conversations, you’ve said already that you want to have details, good information that you can give to the adjuster. Any witnesses, police report, things like that. What are some of the other need to knows for someone who’s speaking with an insurance adjuster? Maybe for the first time ever? Okay, so let’s go back to the day of the accident. That’s where your conversations are going to start, with your own insurance company or the other insurance company. So it’s very important that you get the proper information. If you have the ability to take photographs at the scene when you’re in the accident, sometimes you’re too injured that you can’t do that. But if you have the ability to use your cell phone, take pictures of your own property damage, take pictures of where the vehicles are sitting, and if you have the person’s driver’s license, the other person involved in the accident, take a picture of that as well, because sometimes these people disappear. They deny being involved in the accident or they deny the facts of the accident, and you’re setting the stage so that you can help yourself out when you’re dealing with your own insurance company or the other insurance company. So then you have that conversation with the insurance company. You give them copies of this information that’s beneficial to you. And I speak mainly as to your own insurance company, but you are going to have to provide some information upfront to the other person’s insurance company if you have not already sought representation. Well, that brings up an interesting point. So let’s say I have insurance company a, and I’m in an accident. I call whatever their hotline is, and I report that I was in an accident. Provide that, those details, that information you’ve discussed. The other driver has insurance company b. Do I want to call that insurance company and let them know as well that I’ve been involved with an accident where their driver was at fault, in my opinion? And if so, what sort of difference would there be in how you discuss your claim and the accident with your own insurance company’s adjuster and the at fault drivers insurance company’s adjuster. The main takeaway I can give to you on that is know that everything that you tell the other insurance company is going to be used against you. So if they want to record an interview, if you’re injured, you’re seeking treatment, I personally would consider, am I looking to get an attorney now, or am I going to try to handle this myself? Because if I’m going to get an attorney, why would I start getting into detailed conversations with the other person’s insurance company, potentially hurting my case? How would you do that, though? If I call the other person’s insurance company and I wanna report the claim and I wanna start the claims process, I assume they’re gonna start asking a bunch of questions. You know, where were you goin’where? Were you coming from? How fast were you going? What happened? What do I do in that circumstance? If I’m maybe uncomfortable answering those questions? How would I relay that necessarily to the adjuster? That would be the way to best protect myself while I still try to determine, do I want to hire a lawyer, do I want to handle this myself? How injured am I? Things like that. Well, you can refuse to give a recorded interview and simply give a generalized statement to an insurance company. There’s nothing requiring you to give the other person’s insurance company a recorded interview. I’m not talking about your own insurance company. I would let them know about your vehicle, like the damages that are added. If they want to take a look at the car so they can get the damages and the repair started. Absolutely. Give them the information on your car, get the appointment set to get your vehicle fixed. Ask them about rental coverage, and you can give them generalized information as to what happened in the accident. There can be a case by case situation where the liability is who is at fault and who’s not at fault may be in question. And at that point, you may want to take a step back and say, should I be getting an attorney involved now before something happens that could be detrimental to me? Yeah, that’s a good point. I mean, certainly, if you start feeling uncomfortable about the process, feel that the questions are getting in an area where you’re uncomfortable providing that information or you’re just not making the headway that you expected or were hoping for, an attorney may be able to really step in and speed the process along or assist, I would assume, in your experience, how does the claims process change from when, let’s say, the person involved in the REC is talking with you as an insurance adjuster, and then you get a letter from their lawyer and start talking to an attorney? Well, I think the biggest difference is that they may not be able to get that recorded interview that they want, and we have the ability on the plaintiff side to be able to make sure the information that’s going to them is correct and beneficial. Whereas if you give them a recorded interview, you may say something that you regret, and it may not be something that actually happened in the accident, but it’ll be used against you. Okay. So, I mean, as it sounds somewhat basic, but an attorney can kind of protect you from the fact that you don’t know the ins and outs of the claims process, whereas you’re speaking to an adjuster who does this every day. That’s right. And the adjuster may end up asking you questions that are leading in a manner that may point you to being partially at fault in the accident. These people are trained to do interviews, and they’re trained to dig information out, and sometimes they ask questions in a manner that may lead you to saying things that are not necessarily how they occurred. Yeah. And that kind of goes back, I guess, to the role of the claims adjuster. I mean, they work for the insurance company. Is it fair to say that their responsibility or their goal would be to limit the amount of money the insurance company is paying for claims? Yeah. The main job of a claims adjuster is to close claims and to close claims cheaply. So whenever you’re speaking to an insurance company, know that their goals are based off of closures and speed so. And as well as money. So if they’re paying a lot of money or they’re not closing claims and they’re not very efficient, then that harms profitability of the insurance company. And ultimately, that’s what a company is about, is profits. Yeah. Someone will come knock on their door and ask some questions. Right. So one of the questions I get a lot from clients and there’s some confusion about it and some worry which, which I can understand. How does the process change, if at all, when the insurance company that you have is the same as the insurance company that the at fault driver has? Are you speaking to the same adjuster? How does that work? No, they do have some privacy requirements that they must abide by when both people have the same insurance company. But I go back to my earlier statements where I said, you need to know who you’re speaking with. You need to know, does this person represent my insurance policy or do they represent the insurance policy other person? Because you may be saying things to your insurance company, who’s your policy, and it could still be construed against you not knowing that you’re talking to the other person. They will share some information. There’s no way around that. That’s just part of the process. You don’t want to give two recorded interviews or two interviews to each company. So they’re going to be like, let’s share the interview. So you do have to. There are concerns when both people involved in the accident have the same insurance company. And insurance coverage is certainly a complicated area. Who’s responsible for paying and how much policy limits are in play? Things like that. And I can tell you in a number of my cases, I have clients who exhaust the at fault drivers policy limits. The at fault drivers insurance company has offered to my client their entire policy limits, let’s say $25,000, and we can continue to pursue against my own clients insurance policy as underinsured motorist protection. So if you have $50,000 in coverage, that may provide benefits to you beyond the liability portions. It’s strange because when you start doing that, you’re trying on behalf of your own client to get money from their own policy, and sometimes they’re not willing to give it up. So is it true that even when you’re talking to your own insurance company, you still want to tread lightly? Would that be fair to say? That’d be fair to say, because as you get into a situation that Griff just spoke about, it becomes an adversarial relationship where you’re going after them for additional money. So they treat you as an adversary, just like the other person’s insurance company. So the roles can change and you have to be cautious. Okay. That’s good to know. So even when you’re talking with your own insurance company, remember, you may have a great relationship with your agent that you purchased the policy through, or maybe purchased several policies through. You have homeowner’s policy, you have your child’s policy, who’s off at college, and your own policy. Remember, this is different than your agent. No matter how great of a relationship you have with your agent, that agent doesn’t have any control over the claims process. Is that fair to say? Correct? Yeah. So it’s different. And be mindful of that. So tread lightly. Think about what you’re saying, and if you get uncomfortable, contact an experienced personal injury lawyer who can step in and kind of know some of those pitfalls. And, you know, we describe them as dirty tricks. What are some of you mentioned one earlier of insurance adjusters maybe kind of leading an accident victim into saying something in a manner and a way that wouldn’t help them down the road. What are some of the other kind of dirty tricks or tactics that adjusters may use to try to finish a case fast and finish it cheaply? I think one of the biggest ones is they want to pay less on your injury case than the case is actually worth. So they may make an offer to you that’s less than medical bills, plus a pain and suffering award, knowing that your health insurance already paid for the bills. Another one is they try to sell the cases out as quickly as possible. So many companies have goals to settle out their claims cases within the first 90 days, 180 days. So they really, really push to try to sell these people out before they get attorneys. The whole goal of an early settlement with an insurance company is to prevent somebody from seeking representation and getting the treatment that they need. They know that when somebody doesn’t settle in the first month or two, that they’re probably going to seek additional care. That’s going to cost quite a bit more and it’s going to cost them a lot more money. So they do everything in their power to try to sell those claims out very fast and cheaply. The next thing that they may do is they may delay certain things. So it’s technically not something that they’re allowed to do. They can’t delay a payment on your car in anticipation of an injury claim issue. They can’t delay their medical payments, payments based on some issues that they may have with their other portion of your injury claim. But that’s something that may occur where they stop returning calls, they stop communicating with you, they stop making their offers, they’ve made their position known, and then they just fall by the wayside and they will often just close a claim out. And if they don’t hear back from you quickly, and sometimes people go away. They do that because they know that people often go away. Wow. And there are several tricks that the insurance companies use, again, to try to finish these claims quickly and cheaply. We’ve highlighted some of these in what we’ve called the five dirty tricks that insurance companies use. You can go on our website to request a copy of it. We can provide it, you know, in hard copy or electronic form. So feel free to go on the website, cooperheroey.com, or call in, and we can certainly provide that to you in whatever manner would be best for you. Daniel, we’ve talked a little bit about how the attorney changes the process, how insurance companies would like to get a case resolved or a claim resolved without a lawyer ever being involved. And you discussed how the process changes with a lawyer. What happens if during a call, someone says, you know what, a call with an adjuster. You know what? I think I’m going to get a lawyer. Will that stop the calls from the insurance company while you look for a lawyer? Generally, no. And actually, you could get a host of different responses from an adjuster. Sometimes you’ll get the talk, the attorney’s going to take this much money from you. The attorney’s going to do this. The attorney’s going to do that to try to dissuade you from getting representation. That’s going to help you out, because they know that once you get an attorney, that you’re going to have the pressure taken off of you and that you can seek the treatment that you need. The whole goal of them is to try to get you to settle early and fast. So those conversations often occur. I think that they can also get to the point where they just stop communicating with you after you say that you are going to get an attorney, which is probably the best thing to do. And if they get the letter of representation, if they know that there is somebody that’s representing you, they’ll stop all communication. But oftentimes you’ll just get the conversation. The person’s just going to take money from you. So you should just settle with us now. It’s interesting. Yeah. One of the first things that we do when a new client hires us is we send out letters of representation to the insurance companies that are involved to stop those communications. As Daniel’s discussed, once they get the letter of representation, there should be no more communication between the insurance adjuster and our client. If there is, that’s a problem. But it’s very rare that I’ve ever come across that being an issue. I mean, when you were working in this field, when you would get a letter of representation, was that then a hard, hands off wait to hear from the lawyer or contact the lawyer rather than the individual? Yes, it’s a hard stop. They’ll never talk to you again unless there’s something that the attorney has allowed to communicate, like your car or your personal items, something like that. That’s permissive conversations that have been given through the communication with the attorney. But the minute they get that letter of representation, they cease all communication. They don’t want to get in trouble. They can get in trouble with the state insurance commission, and they can also get a nasty call from the attorney. Yeah. You know, we’ve discussed a lot about why you may want to get a lawyer or the tricks that an insurance company may use to try to take advantage of the claims process or an individual’s lack of knowledge about the claims process. But there are some circumstances where it would make sense for someone who’d been involved in a wreck to talk with the insurance company themselves right away and try to see if it can get worked out. Is that right? Yeah. Well, first being is, if you’re not injured, there’s not really much that can occur with a personal injury attorney to seek representation. So if you have a simple car accident, you just handle it just like you would any other claim that you make. If you have very minor injuries, you just went to a doctor’s visit, you don’t have any, any other need to seek any additional treatment. A case like that is probably better just handled directly with the insurance company and not involving an attorney. And those are the two situations that I can think of. Yeah. I’ll echo what Daniel said. There are certainly claims in cases where it is not in your interest to pay a lawyer any portion of that settlement fee that you may get in order to resolve a claim. If you’re in an accident and you have some bumps and bruises, and you go and get checked out at urgent care and come home, and now a week has passed, two weeks, and you feel fine, don’t hire a lawyer. Don’t necessarily pay a lawyer a portion of your settlement fee, because a lawyer can only do so much to increase the value of that claim for you. It’s just not worth paying a portion of it. So that’s a good circumstance where see if you can get it resolved. Look, if the insurance company says kick dirt, we’re not paying you anything. Well, sure, call a lawyer. But if it’s something like that, you know, it may make sense for you to go ahead and just deal with it yourself and speak with the adjuster again, be mindful of what you’re saying. Be aware that it’s an adversarial process. Right. They’re not on your side or looking to necessarily help you out, but, you know, that’s something that you can probably handle on your own without the need to pay a lawyer or give up any portion of that. That’s right. Let’s kind of flip it. Now, we’ve discussed what folks should know. Are there any things based on your experience in this world, that insurance adjusters wouldn’t want folks to know about? Wouldn’t want them to know about going into the process? You mentioned one kind of is, and you mentioned it a little bit in passing, but it’s always interesting to speak to clients who’ve had communications with adjusters about the health insurance covering bills. They say, oh, no, your health insurance paid 60% of your bills, so we’ll give you money for the 40% or your deductible that was unpaid and then some money for pain and suffering. That’s not how it works in Virginia, right? Yeah. Virginia has some generous laws when it comes to personal injury. So you’re entitled to have your health insurance pay for bills. You’re entitled for your medical payments, insurance through your own insurance company to pay the bills, and you’re entitled to make a claim against the at fault person’s injuries for the entirety of your medical. Bills, regardless of what health insurance. Regardless of what health insurance did. And there are caveats in terms of sometimes people have health insurance that has to be paid back. Sure. Like the government. And that’s mainly the person. Sometimes the government has to be paid back, but you’re entitled to that full bill. So that’s something that may not be communicated properly by the insurance company to you, that you are entitled to that. Yeah, that’s interesting. So, I mean, to try to state it as basic as possible. One of the things that adjusters would not like you to know is if I go and get a $100 bill at the hospital and my health insurance pays $60 of that, the insurance adjuster may say, okay, well, we’ll pay you that other 40 and then some pain and suffering. Whereas a lawyer would know, no, no, no. You are on the hook for all dollar 100. Doesn’t matter what insurance did. You need to pay my client all dollar 100. And, you know, then we can deal with any sort of payback or anything like that. But that, that’s an interesting area that adjusters maybe try to kind of keep hidden from an injured person. The other major situation that could occur, too, is, let’s say they offer their policy limits. They are not going to create a claim with your own insurance company for something called underinsured motorist bodily injury coverage. Their only goal at that point is to protect their insured from excess payments. What’s an excess payment? Excess payment would be any money over their policy limits. They want to obtain a release of their insured so that that claim is extinguished. So if they tender the limits to you, they’re not going to say, hey, you know what? You can also make an underinsured bodily injury case. They are not going to tell you that. So at that point, I personally would obtain counsel because you’re going to want somebody who can actually review your own insurance policies, policies of your relatives and things of that nature, because there may be a lot of other coverage out there to help protect you. Yeah, that’s. That’s interesting. I hadn’t ever really actually thought about that. But let’s say the at fault driver has $25,000 in insurance limits, and that insurance company says, okay, we will give you all $25,000. They’re not going to say to you, hey, you might also want to contact your insurance company because you have $100,000 in underinsured limits that may provide additional money to you. That’s not something an adjuster would really tell you about. Correct. Because they can actually get in trouble with their own insured for creating exposure that may not exist. So their duty is to their insured to make sure that they get the release and to not create exposure. They can actually get in trouble if they create additional exposure. And exposure, would be seeking any additional. Money outside of their policy limits. Okay. Right. And that’s something that could happen if they clued in an injured person. Hey, you might want. Not want to finish this altogether and keep pursuing it. That’s right. So their insurer could actually have a claim against them for not properly protecting and acting in good faith. Well, Daniel, thanks for sharing your information with us and your experience. As I mentioned, Daniel’s been with us for several years now, and we really rely on his experience as an insurance adjuster. Prior to joining our firm, his knowledge about insurance coverage and helps us navigate kind of what is the other side looking at this case and saying to themselves, as well as how can we protect our clients from these dirty tricks? Right. What sort of things can we tell folks that will help them protect themselves from some of these tactics? Daniel, thank you for sharing your information with us. I thank everybody for watching again, I’m Griff O’Hanlon. Daniel Jarman with Cooper Hurley injury lawyers. If you have any questions, or want any additional information again, please visit our website, cooperhurley.com, or feel free to give us a call: 757-333-3333. Thanks. Cooper Hurley injury lawyers at 757-333-3333