Insurance Claim Adjuster Secret Tactics (2019 Edition)

Davis Law Group has represented thousands of car accident victims over the years. With that experience comes an expert understanding of how the insurance industry deals with victims. 

(Hint: it’s not very fair)

Most insurance adjusters are highly trained adversaries, although most people would never think this, at least not in the beginning of the claims process. Like many others in your position, you are likely unaware of how sophisticated, yet simple, the methods the adjuster will utilize to help minimize the value of your claim.

Insurance Claim Adjuster Secret Tactics

Here are the 8 secret tactics the insurance adjuster will use to wear you down during the claims process in hopes that they will accept much less money than what the claim is worth.

Tactic #1: Using Delay Tactics

The adjuster is a master of using delay tactics to wear people down. He knows that many people (80-90%, according to some insurance company estimates) will grow tired of the delaying tactics and simply throw up their hands and say, "Enough!" These people will accept the low-ball offer just to be done with the entire unpleasant process.

Tactic #2: Requesting Unnecessary Information 

It's true that the insurance company will need records, receipts, bills, reports, and other documentation to support the claim, but sometimes the request for documentation is unnecessary. For example, asking for medical records from ten years before the accident or tax returns from the same period typically is unnecessary and is only being requested to delay resolution of the claim. Insurance adjusters know that repeated requests for unnecessary documentation can easily frustrate people and wear them down so they're more likely to accept low settlement offers.

Tactic #3: Disputing the Medical Treatment

Despite the absence of any medical training, the adjuster may question the need for treatment or certain procedures or worse; second-guess your own doctor. Many times it does not matter to the adjuster that your treatment has been recommended by a reputable, licensed physician.

Tactic #4: Disputing the Medical Charges

Sometimes the adjuster will only agree to "accept" 70, 80, or 90% of your past medical charges. Again, such an assertion is made without having any medical background to support such a position. By nickel-and-diming the consumer, the well-trained adjuster knows that most people will not hire a lawyer to challenge the refusal to pay a small portion of the medical bills.

Tactic #5: Telling You Not to Hire an Attorney

Other times the insurance company will tell you that hiring an attorney is unnecessary. Sometimes the adjuster will try to prevent you from retaining an attorney by falsely stating that any settlement money you receive will go entirely to the attorney. Still, other times the adjuster may threaten to "deny" the claim if you hire a lawyer. If a claims representative tries to steer you away from retaining an attorney, this should be your first clue that using an attorney may actually produce a much higher recovery for you-even after deducting the attorney's fee.

Tactic #6: Misrepresenting Insurance Policy Benefits

Sometimes the adjuster will misrepresent the amount of insurance coverage that is available to you. Worse, the adjuster won't tell you that the insurance coverage or certain types of benefits even exist. This tactic may be used to entice you into accepting a smaller settlement than what would otherwise be warranted.

Tactic #7: Acting as Your Friend

There are times when the claims adjuster will "befriend" you and make it appear that he is watching out for your interests when in fact that is not the case. Sometimes the adjuster will give you advice about the type or frequency of your medical treatment, and then decide later on not to pay for the treatment because it is "excessive."

Tactic #8: Making False Promises

There are times when the adjuster will make promises to you that she knows can't be met. The adjuster's primary loyalty is to her employer (the insurance company) and to her insured (the negligent party).

Any adjuster who makes promises "for your benefit" inherently creates a conflict of interest. Oftentimes the adjuster already knows that a conflict is created by promising to protect your interests, but she knows this is one way to get you to lower your guard and agree to terms that your attorney would never allow.

These are just a few of the tactics that the insurance industry will use to accomplish its goal of getting people to accept smaller settlements. You need to be aware that you are dealing with professional negotiators who strive to fulfill the insurance company's primary objective: to settle claims for much less than they are worth. Lower settlements mean bigger company profits. If you begin to feel overwhelmed, you should not hesitate to consult with an attorney,

9 Tips for Dealing with the Insurance Adjuster

Follow these nine simple hacks to make sure you do not jeopardize your personal injury claim during a phone interview with the insurance adjuster:

9 tips

1. Remember: the adjuster is not on your side

The larger your personal injury claim the more likely it is the adjuster will be friendly. On the flip side, if you claim is relatively small, they may be rude or abrupt.

Despite how friendly the adjuster sounds on the phone, it’s important to know that this person isn’t on your side. There is a reason the adjuster will try and discourage you from hiring an attorney.

If you have been in a car accident you will be interviewed by both an adjuster from your own insurance company and by an adjuster from the other party’s insurance company. Both adjusters are trying to minimize the amount of money that their company will pay.

2. Write down basic facts about the insurance company

Write down the name, address, and phone number of the insurance adjuster and insurance company.

3. Provide your full name, address and telephone number

Make sure the insurance adjuster has all the correct information for you. This will help you stay in the loop.

4. Take notes of the conversation

Having a record of the conversation can be helpful down the line, and if you hire a personal injury attorney, they may want to see these notes.

5. Beware what you say

It’s not a good idea to give a recorded statement to an insurance adjuster after an accident. But if you absolutely must do so…

  • Be extremely careful what you say
  • Don’t let the adjuster put words in your mouth
  • Contest loaded questions
  • Don’t agree with everything the adjuster says

6. Ask the adjuster if they are aware of any witnesses

It’s OK to ask questions to the adjuster. This isn’t a one-sided affair. 

7. Watch for negative comments

Again, the adjuster’s main goal is to pay you as little money as possible. 

Adjusters achieve this by making small, off-hand remarks about the value of your claim. These comments are usually implied, but tallied up can massively decrease the claim. 

8. Be very general when you describe your injuries

Tell the adjuster you will provide a complete, detailed, medical description of your injuries after you and your doctors have done a full assessment.

9. Navigate settlement traps

Many adjusters are taught to settle claims before a victim even gets a clear diagnosis of their injuries. By settling early, the insurance company has shifted all the future medical bills onto you.

Adjusters know that mounting medical bills are stressful. But insurance carriers do not pay medical bills as they are ongoing. The adjuster may entice you to settle quick to help you pay those bills. 

8 things not to do

8 Things Not To Do When Speaking with the Adjuster

If you want to receive the money you deserve for your injuries and property damage, you should avoid the following things when speaking to an insurance adjuster:

1. Do not agree to an audio recording of the conversation

What you say may be taken out of context. You have no obligation to make a recorded statement at this time.

2. Only provide basic facts about the accident

Adjusters will engage you in an informal conversation in an effort to relax you and get as many details about the accident as possible. Do not discuss anything but the basic facts of the accident: 

  • Where the accident occurred; 
  • Date and time of the accident; 
  • Type of accident: motor vehicle, slip and fall, etc.

3. Don’t discuss details about your work

You do not need to provide details about your work, such as income, schedule, or details of what you do at your job.

4. Don’t answer family questions

You are under no obligation to give any information about your family.

5. You are not obligated at this point to identify witnesses

This information is not necessary at this time. 

6. You are not obligated to give the adjuster the name of your doctor

The adjuster will look to get any information they can. Don't fall into their trap.

7. Do not agree to anything

The process is ongoing. Let it play out.

8. Do not sign anything

Consult with a personal injury attorney before signing anything from the insurance company.

8 tough

8 Tough Questions for the Insurance Adjuster

Over the years, our office has compiled a list of questions that insurance adjusters don’t want to hear.

What you’ll read below will often make the adjuster squirm. No, they don’t like it when you ask these questions because they either cannot answer the question, or worse, the answer is one they do not like to hear.

Question 1: Isn’t it true that if I use an attorney I’m likely to recover more money in settlement than if I try to settle the claim on my own?

ANSWER: The insurance adjuster will most likely lie to you and say “no.” But a study by the Insurance Research Council (a nonprofit group funded by major insurance companies across the nation) found that victims with an attorney get 3.5 times more in settlement money than those without an attorney.

Question 2: How can the insurance company verify that the settlement amount being offered to me is fair and reasonable?

ANSWER: They can’t and won’t. Unless you are in the business of negotiating and settling injury claims there is little chance you will know whether the settlement amount that is being offered is fair.

Question 3: Why do I have to give you a recorded statement when you can get information about the accident from the police report?

ANSWER: Because the insurance company will try to use your own statements against you. If you reveal any information, it will impact how much money comes your way via settlement.

Question 4: If I give you a recorded statement, can I then get a recorded statement from your own insured, i.e., the other driver?

ANSWER: This will never happen, but that doesn’t make it right. If you have to give a statement about the accident, then why can’t you also get a statement from the other driver? The insurance adjuster will never allow this for the same reasons you should never give a recorded statement to the insurance company.

Question 5: Why do I have to give you an unrestricted medical authorization before I can settle the claim?

ANSWER: So the adjuster can go fishing into your past medical history and find anything about your prior health which will help the company either deny your claim or pay out as little as possible.

Question 6: Shouldn’t I wait to settle the claim until my medical treatment concludes, or until I’m sure that I have made a full recovery?

ANSWER: The insurance company knows that the quicker you settle the claim the less money it will have to pay out. Most insurance companies have in place written directives to its claims department to settle every claim as quickly as possible so the accident victim can’t re- open the case later if the person’s condition gets worse.

Question 7: Why hasn’t anyone told me about Uninsured Motorist (UM) or Underinsured Motorist (UIM) coverage?

ANSWER: Many insurance companies obviously don’t want you to know about this coverage because it may mean that you are entitled to more compensation

Question 8: If you are claiming that my medical treatment is excessive or unreasonable, will you pay my doctor to write a detailed report explaining why my treatment has been appropriate and related to the accident?

ANSWER: The insurance adjuster will always refuse this request. Although the adjuster has absolutely no medical training, nothing stops him or her from arguing that your treatment was excessive or unreasonable.

Chris Davis
Attorney Chris Davis is the founder of Seattle-based Davis Law Group, P.S.