Common Ploys and Tricks Used by Insurance Adjusters (2024)

After an accident, Insurance adjusters don’t play fair. Know what to expect, and don’t fall for their tricks.

Common Ploys and Tricks Used by Insurance Adjusters (1)

In a perfect world, insurance companies would simply pay victims what they’re owed following a serious car accident. Unfortunately, insurance adjusters often unfairly deny claims, blatantly lie to claimants, and will use every trick in the book to skirt liability.

If you’ve been injured in a car accident, the most important thing you can do is file a claim with the insurance company and then speak to an attorney. Most of us have dealt with the insurance claims process before, but understand that your personal injury claim (which is separate from your property damage claim) will be heavily scrutinized by the insurance adjuster.

Filing your claim is only the beginning of the process. Without an attorney handling your case, you are almost guaranteed to face a drawn out, one-sided battle with the insurance company. While they may try to offer you a settlement before you even know the full extent of your medical expenses and other damages, they only do this for their own benefit. They may tell you that you don’t need an attorney because they’ve already accepted liability, only to later (months down the line) reverse course and claim that you were partially—or fully to blame.

Victims of car accidents are essentially at the mercy of the claims adjuster. If the adjuster won’t offer a fair settlement or unfairly denies your claim, your only option is to file a lawsuit. Adjusters know that people are often hesitant to hire an attorney (even though personal injury lawyers work on a no-win no-fee basis), and unfortunately this works to their advantage.

Claims adjusters spend most of their day investigating insurance claims by collecting statements, consulting police and hospital records, inspecting property damage, and looking at how similar claims have played out in the past. The only thing is, they’re only looking at it from one side. Their ONLY goal is to save the insurance company money by paying out as little as possible on every single claim.

You would think that a claims adjuster would be required to look at the accident from an objective point of view (or at least follow some set of official guidelines) before denying a claim, but that’s simply not the case. There is no law that requires insurance companies to pay out on ANY claim unless a settlement agreement has been made (and signed) or they’re compelled to do so by a court order.

This rest of this article will dive into some of the most-common tricks, lies, and shady tactics that claims adjusters and insurance companies employ, as well as how best to avoid them.

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Can Insurance Adjusters Lie to You?

Yes, insurance adjusters are allowed to lie to you. In fact, many are even encouraged to do so. An adjuster might tell you that their driver is not liable for the accident when they know that they are. They may claim that they can’t contact the other driver for weeks on end — or that they’re “still investigating” two months in… They’ll sometimes even tell you that they’re accepting full responsibility up front, only to put 50 percent of the blame back onto you when you’re done treating and ready to settle.

The truth is that without an attorney, the insurance company sees you as an easy target. They’ve defended thousands of cases just like yours, and they know every trick in the book. As someone who deals with insurance companies on a daily basis myself, I strongly advise that you take everything they say with a grain of salt. Be extra skeptical, and never agree to anything regarding your personal injury claim without discussing you case with an attorney first.

Scouring Your Social Media Accounts

It’s surprisingly common nowadays for insurance companies to delve into your social media accounts and online activity simply because you filed a claim. Make no mistake, the only reason they’re looking through your Facebook profile or Twitter feed is to find dirt they can use to potentially weaken or otherwise lower the value of your claim.

If you post a status update telling friends and family that you’re “feeling okay” following your car accident, they’ll use this statement in order to deny your entire injury claim. If you post a dance video on TikTok, same deal. Have you previously commented about an accident or injury in the past? They’ll claim that your current injuries are related. Have you ever taken a photo or video while driving and posted it to Instagram? They could even use that to claim you’re an unsafe driver and likely shared fault for the crash.

Making a Recorded Statement

When someone files a car accident injury claim, the insurance company will ask the claimant and/or policy holder to provide a brief recorded statement over the phone detailing the facts of accident and how it occurred. They’ll often say that giving them a recorded statement will speed up the claims process. In reality, they’re only hoping to lock you into a statement in order to potentially use your own words against you later.

Making a recorded statement at this point of your claim is not in your best interests for many reasons. If all the facts are not readily available (or are still unclear) to you, then you may very well make a seemingly-innocent comment that can jeopardize your entire claim. What if you forget a fact or later discover pertinent information that fundamentally changes your frame of reference?

Additionally, you may not have a full understanding of the extent of your injuries at this point. Some types of injuries (e.g., whiplash, soft tissue injuries, internal damage, etc.) can take days or weeks to present themselves—especially if you have other significant or overlapping injuries. For example, what may initially seem like a sprained knee could eventually reveal itself as a permanent disability.

When you do make a recorded statement to the insurance company, you want to ensure that you are honest and forthcoming at all times—but stick to the facts! You do not need to answer personal questions, discuss your medical treatment to this point, or opine on any facts of the case that you are not 100% sure of. The best thing you can do is speak to an attorney before making any statements, and have them advise you on how to best move forward.

Issues of Liability

The biggest part of any car accident injury claim is liability, which is the first thing that the insurance company will look at. Did their driver miss a payment on their policy? No liability; Claim denied. Was the collision caused by anything other than their driver’s negligence? Claim denied. Could it be argued that the collision was an intentional act? Denied. Could it be argued (even if a stretch) that both parties are equally to blame? Easy deny.

The thing is,insurance companies don’t owe you anything if their driver wasn’t at least 51% at fault for the accident, and any percentage of liability that they can place onto you reduces their overall liability. Even in cases where it’s obvious that their driver was 100% to blame, the insurance company will almost always claim that you failed to take preventative measures and thus share in liability—even if that assessment is completely unfounded. This is a very common tactic used by insurance companies in an attempt to unfairly reduce the value of your claim.

How To Scare an Insurance Adjuster

The only way to truly scare an insurance adjuster is to hire an attorney. I know it’s probably not what you want to hear, but the unfortunate truth is that insurance companies hold all the leverage when it comes to a car accident injury claim. During the claims process, the insurance company controls everything. They get to decide who’s at fault, how much your injuries are worth, whether or not to extend a settlement offer, what that offer is—and they can take as much time as they please.

Insurance companies know that unless you have an attorney willing to take them to court, they have the ultimate authority when it comes to your claim. You can threaten to sue all you want, but the insurance company has no reason to take these threats seriously until an attorney sends them a letter of representation on your behalf. That’s the point in which they begin to take your claim seriously.

Low-Ball Settlement Offers

Insurance companies will never offer an unrepresented claimant the full value of their claim. It’s just not in the best interests of the insurance company to pay a dollar more than they can get away with, even when it’s the decent thing to do. If you’re being offered a settlement, it’s going to be at an amount that favors them.

If they can get you to settle, you waive all rights to pursue any additional compensation later. If you accept a settlement offer early on and later discover that your damages are much higher than you originally thought, guess what? They don’t owe you a penny more than what you previously settled for. This happens all the time, and is why you shouldn’t even entertain the idea of a settlement before you have completely finished treatment.

If you’re eventually given a low ball settlement offer by the insurance company, there are ways to fight back. The unfortunate truth is that without an attorney handling your claim, you’re simply at the mercy of the insurance company. Technically speaking, they’re under no legal obligation to pay out on any claim unless compelled to do so by court order.

Insurance companies know that victims are in a tough spot after an accident, and will use this to their advantage. Many accident victims end up accepting a settlement worth a mere fraction of what they’re truly owed simply because they’re tired of fighting—or because they don’t realize that a personal injury attorney can fight the insurance company for them at no out of pocket cost.

Why You Should Consider Hiring an Attorney

Has the insurance company unfairly denied your claim? Has the insurance adjuster lied to you? At Montgomery Law, we’ve been around the block a time or two and know how to deal with these underhanded tactics. We won’t let the insurance company dictate the process, and will fight for every penny you deserve. Consultations are always free, and we never charge attorneys fees unless (and until) we win.

If you have questions, we’re happy to answer them for you. If you’d like to have us review your case and determine whether or not we can help, contact us today at 214-720-6090(local) or 1-833-720-6090 (toll-free),orsend us an emaildirectly from our website. The earlier we can get started on your claim, the better chance you’ll have at recovering the compensation you’re truly owed.

Common Ploys and Tricks Used by Insurance Adjusters (2024)

FAQs

Common Ploys and Tricks Used by Insurance Adjusters? ›

Claims adjusters have three main goals when settling claims: accurate claim assessment, timely settlement, and customer satisfaction. They investigate and evaluate claims, ensuring that the claim amount accurately reflects the covered losses.

What are the 3 key goals of a claims adjuster when settling claims? ›

Claims adjusters have three main goals when settling claims: accurate claim assessment, timely settlement, and customer satisfaction. They investigate and evaluate claims, ensuring that the claim amount accurately reflects the covered losses.

How do you answer an insurance adjuster question? ›

If they do insist on the recorded statement, you should be brief with your answers, listen carefully to the questions and reply only to what is asked, avoid admitting any fault or wrongdoing, and regarding injuries, report the pain and symptoms you are dealing with and simply say that you are not a doctor and you don't ...

How to maximize your insurance claim? ›

Develop your claim strategy based on your reasonable understanding of your coverages, endorsem*nts, exclusions and policy limits. Document everything. Present your position and documentation to your insurance claims adjuster. Negotiate for the settlement you want, need and deserve.

How do I argue with my insurance adjuster? ›

Tips for Negotiating With an Insurance Claims Adjuster
  1. Come well-prepared with supporting evidence. Records and documentation are critical components of the process. ...
  2. Calculate a full settlement amount. ...
  3. Know your bottom line. ...
  4. Beware of the first offer. ...
  5. Get the settlement offer in writing. ...
  6. Read the fine print.
Feb 17, 2023

How to negotiate a settlement with an insurance claims adjuster? ›

How to Negotiate a Settlement with an Insurance Claims Adjuster
  1. Know Your Claim Inside and Out. ...
  2. Know Your Rights. ...
  3. Determine the Value of Your Claim. ...
  4. Be Prepared to Negotiate a Settlement with the Insurance Claim Adjuster. ...
  5. Be Professional and Polite. ...
  6. Get Everything in Writing. ...
  7. Consider Hiring an Attorney.

How do I prepare for a claims adjuster? ›

How to Prepare for a Meeting with an Insurance Adjuster
  1. File Necessary Reports with the Police or Fire Department. ...
  2. Take Clear Photographs of the Damage. ...
  3. Make Temporary Repairs that Prevent Further Damage. ...
  4. Create or Submit Your Home Inventory. ...
  5. Gather All Documents and Receipts. ...
  6. Showcase Evidence for Your Claim.

What not to tell a Claims Adjuster? ›

5 Things You Should Not Say to Car Insurance Adjusters
  • Do Not Admit Fault. ...
  • Do Not Minimize Personal Injuries to Adjuster. ...
  • Do Not Describe Your Injuries. ...
  • Do Not Hypothesize What Happened During the Accident. ...
  • Do Not Provide a Recorded Statement.

What should you not do when making an insurance claim? ›

When speaking to insurance after an accident, the following are things you should not say:
  1. Don't admit fault.
  2. Don't say that you are not injured.
  3. Don't sign any releases.
  4. Don't make an official or recorded statement.

Can you disagree with insurance adjuster? ›

If you find yourself at odds with a claims adjuster over a settlement amount, it's important to advocate for the payment you deserve. Don't simply accept an offer you believe to be inadequate. Instead, arm yourself with evidence, negotiate firmly but politely, and don't be afraid to dispute their decision if needed.

How to get the most money out of an insurance claim? ›

It's essential to gather all the necessary evidence to demonstrate the extent of the damage and the costs of repair or replacement. To show proof, you should start by taking photos and videos of the damaged property. You can also keep a detailed inventory of damaged items, including their age, condition, and value.

How to make a successful insurance claim? ›

You'll need to include copies of all paperwork that will help your claim, including receipts or medical certificates. You should also keep copies of the originals in case your claim is queried or refused. Your insurer may ask if you have other insurance that may cover the claim.

How can I improve my insurance claim process? ›

10 Ways to improve insurance claims processes
  1. Streamlined Claims Reporting. ...
  2. Automated Claim Processing. ...
  3. Enhanced Data Analytics. ...
  4. Real-time Claims Status Updates. ...
  5. Digital Documentation. ...
  6. AI-Powered Damage Assessment. ...
  7. Chatbots for Customer Support. ...
  8. Predictive Analytics for Fraud Detection.

What are the top 3 most important aspects to a claim? ›

The three most important aspects of any medical claim include:
  • Basic patient information, including full name, birthday, and address.
  • The provider's NPI (National Provider Identifier)
  • CPT codes that reflect the provided services.

What are the basic objectives in the settlement of claims? ›

Basic Objectives in Claims Settlement

The first objective in settling claims is to verify that a covered loss has occurred. This step involves determining whether a specific person or property is covered under the policy, and the extent of the coverage.

What are the primary goals of the claims function? ›

GOALS OF THE CLAIMS FUNCTION

The goals of the claims department include keeping the insurer's promise made in the policy and supporting the insurer's profit goal. People purchase property-casualty insurance policies to protect against finan- cial losses.

What are 3 important tips on filing an auto insurance claim? ›

Important Tips
  • Read your policy. ...
  • If you don't understand your policy, ask your agent and/or company for clarification.
  • If you have an accident, call the police. ...
  • Get as much information as possible at the accident scene to furnish to your agent and/or insurance company.

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