Adjusters Approach To Personal Injury Claims

Adjusters receive their claims from their supervisors. Investigation of any given claim commences soon after the file has come into the designated adjuster’s hands.

What each adjuster aims to accomplish

Every adjuster strives to make any necessary payout as small as possible. At the same time, it is every adjuster’s desire to avoid any chances that the insurance company might become the target of a lawsuit.

Adjusters’ considerations, while determining a given claim’s value

The nature and extent of the reported losses: Do the details in the report on the accident match with the claimed damage and reported injuries?

Policy limits: The terms in any policy limit the maximum size for any loss that must be covered by the same policy.

Strength of claimant’s case

—Has the claimant hired a personal injury lawyer in Niagara Falls?
—Is there clear evidence of fault on the part of those on either side of the dispute?
—Has the claimant provided the Claims Department with a demand letter?

How claimant might influence the outcome from a given adjuster’s considerations

Claimants must be honest, when describing the details that relate do a given accident. Claimants should avoid introducing any of the following:

—Utilization of a device such as a cane or crutch, when emerging from a vehicle that has collided with one or more other vehicles.
—Detailed explanation of injury, before the treating physician has declared the patient’s arrival at the point of maximum medical improvement (MMI).

If the insurance company were to question an honest assessment of the situation, then the availability of a lawyer’s help could prove beneficial.

—For instance, during the initial examination of the injured victim, the physician might reach a conclusion that does not match with the victim’s entire medical history. At that point, a lawyer might need to intervene, in order to request an examination by someone that was more familiar with the nature of the victim’s medical condition.
—If the report from any follow-up examination had problems, then a lawyer might be able to account for the existence of such problems. Perhaps the report had come from the desk of the physician’s secretary, and not directly from the physician’s own desk, or own computer files.

Why could the existence or non-existence of a demand letter prove so important?

If that letter were written with the help of a personal injury lawyer, then that would encourage a greater level of communications between the attorney and the client. Those communications might aid the discovery of significant facts.

For instance, maybe one of the vehicle’s occupants had been a minor. If that were true, then the attorney would have grounds for seeking extension of the deadline for filing lawsuit.

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