CORONAVIRUS UPDATE: What We Are Doing to Protect Our Clients

Pretending to Be Your Friend

Pretending To Be Your FriendInsurance company adjusters are trained – in general, very thoroughly trained – how to interact with people who are submitting claims to them.  The insurance companies understand that the claimant-adjuster relationship is one that is very important to them, and from which they can benefit if they carefully manage the relationship.  In both first-party claims and third-party claims the insurance companies understand that there is money – sometimes very significant money – riding on the outcome of claimant-adjuster phone calls and letters, and that managing those communications well can result in significant profits to the insurance companies.  An adjuster who establishes a good, friendly rapport with a claimant is more likely to be able to persuade that claimant to settle his or her claim for a lesser amount, more quickly, and more to the insurance company’s benefit -- not the claimant’s benefit.

Approaching a conversation with an insurance adjuster should be done in the same manner as approaching any other important business conversation on which you have a lot of money riding.  The individuals in the conversation are in an adversarial or at least semi-adversarial situation -- one is asking for money that is due to them, while the other is at least obligated not to pay out more than is due, and may even be graded in their job performance at least partly upon how little money they pay.

Insurance Adjusters Are Not Your Friend

Many customer service professionals are taught that establishing sympathy, rapport, and even lightheartedness in their conversations with customers can help “break the ice” and establish a positive tone that can help the customer service rep get his or her job performed.  When that customer service rep is an insurance adjuster, his or her job that is being performed is judging how much money you should receive on an insurance claim and – from the insurance company’s perspective – paying you as little money as it can.

Anyone who has sustained a personal injury in a motor vehicle accident needs to realize that the insurance adjuster has a job to do, and being your friend, is not it.  The information that is or is not transmitted to the adjuster in conversations, emails, and letters will ultimately have a great impact on the claim’s final resolution.  Managing this information transfer is a key job that an experienced personal injury attorney can perform for a client, and someone who is handling their own claim needs to carefully consider whether and how to perform this task for themselves.

How to Interact with an Insurance Adjuster

There are several communication methods to keep in mind when communicating with an insurance adjuster about a personal injury claim:

Keep it businesslike. There’s no reason not to have a little casual chitchat about the weather or your favorite sports team – although this is a business conversation, it’s perfectly appropriate for both parties to be polite and friendly in tone.  But recognize that this type of talk can quickly veer into topics that are not appropriate for chitchat or which need to be approached very carefully.  Casual talk can turn to a person’s health -- “How are you doing today?” -- or to their employment -- “How’s work going for you?” -- or to their home and family life -- “How are the wife and kids?” -- that can be very touchy subjects with regard to a personal injury claim.  Obviously, a personal injury claimant’s health status is the primary factor in valuing the claim, and how or whether their injuries are having negative impacts on their job status and/or home life are significant secondary factors.

Keep it on point. In the example above, the question of, “How are you doing today?” is a relevant question – in fact, a very relevant question regarding the facts and status of the personal injury claim.  Transmitting information about a personal injury claimant’s health status is important – the insurance adjuster is in a better position to promptly and reasonably settle the injury victim’s claim when they are kept up to date on the victim’s health status.  But how that information gets transmitted and which parts of the information get transmitted are key – the health status needs to be kept on point to the diagnoses that we know will be appearing in the medical records when those medical records are eventually presented to the insurance adjuster in an effort to reach a settlement.  The information should not include speculative guesses or assumptions, and it should be both accurate (true) and precise (exact in detail).

Keep it brief.  When a personal injury claimant’s medical records are eventually presented – in a controlled manner – to an insurance adjuster, they may comprise dozens, hundreds, or even thousands of pages of text to wade through.  But the fundamental diagnoses and ongoing symptoms that may be provided to an insurance adjuster in a routine update phone call can and should be reduced to no more than a sentence or two or a few bullet points.  What are the diagnosed injuries?  What are the ongoing symptoms?  What current or near-term medical treatment is underway? If there are any disputes over how the accident happened, then keep to the evidence – the police report, witness statements, photographs, or other specific items relating to the incident.

How Not to Interact with an Insurance Adjuster

Essentially, by not doing the things listed above.  Not approaching the conversation as a serious, business communication can result in unintentionally providing bits of information – information the adjusters are trained to listen for – that allow the insurance company to pursue lines of argument that they shouldn’t pursue, or at least should only be allowed to pursue at the proper time.  Not keeping the conversation on point can also introduce topics that are irrelevant but beneficial to the insurance company’s arguments -- information about past accidents and injuries, for example – that they will happily spin into arguments about why they should pay you less for your claim.  And not keeping it brief gives the insurance adjuster a gold mine of additional details they can process to prepare arguments against you.

We frequently caution our clients to approach communication with an insurance company adjuster as though they are the suspect being “read his rights” in a television police drama – anything you say to the insurance company can and will be used against you in your claim if they can figure a way to do so.

To see more insurance companies' tactics and practices, click on the links below:

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