Insurance Adjusters

After you are involved in a car accident, but before you retain an attorney, you are in a critical and dangerous time. You begin dealing with insurance company representatives in an effort to get compensation for your personal injury or damage to your car or other property. Even the most fair and honest claims representative does not have the mandate to get you the most he can for your injuries, or even to get you a fair amount. His job is to provide you with the least amount he can that will quickly resolve any claims you have. In doing so, there are a number of things adjusters do, either on purpose, or just by the nature of the situation, that push you to quickly resolve your claim, and in doing so, you run the risk of settling for far less that you would otherwise be entitled to.

While the guy you buy the insurance from works out of a small office with one or two employees, and is always available on the phone, or Saturday on the golf course, or Sunday in church, he is not the person who is making the decisions on what your will receive from your car accident. That person is usually in a different city, and will handle sometimes up to 150 separate claims in a variety of geographic locations at any one time. In contrast, you have only one case that you are concerned about. Discussing the claim in a timely matter may therefore mean different things to the adjuster than to you, even assuming the adjuster is not purposefully ignoring your claim. You may become impatient for a resolution and quickly agree to a settlement, dreading protracted negotiation. Resist that urge.

If you are having constant communication problems, consider making all your requests by letter. Insurance companies can face unfair and deceptive trade practices lawsuits on claims handling even on cases they have the right to deny if they fail to reasonably make an investigation and timely notify you of their denial or acceptance of your claim. Keep in mind that in a motor vehicle claim you have three years under the North Carolina statute of limitations to file your complaint. In most cases, just because you are trying to get cooperation from the insurance company, or even when you are actually communicating, the statute of limitations does not stop running. If the adjuster wants to take a recorded interview of you, consult with an attorney. While it may seem to you that their insured is at fault in the accident, an innocent statement by you, admitting to any contribution to the wreck, will immediately provide the adjuster with a large bargaining chip to lower the value of your claim. North Carolina has contributory negligence, meaning that if a jury were to find you to have even a small amount of fault, you would not recover anything, even if the other party was much more negligent.

Typically, when they determine that their insured is at fault, the insurance company will provide offers to settle the property damage claim (damage to the car and contents) and the personal injury claim. Usually the property damage claim is easier to settle. They simply go by the Kelly Blue Book value for the car. As a result, oftentimes this claim gets settled before any personal injury. When you accept money for the property damage, be sure it follows the typical practice of only settling the property damage and not the personal injury. The personal injury, even when fault is not an issue, will typically take longer. Agreeing to a value on pain and suffering, the amount of injury that is caused from the motor vehicle collision as opposed to a pre-existing injury, questions of what is “reasonable” medical care, and ongoing treatment, make settlement of the personal injury claim harder. Unlike a worker’s compensation claim, the insurance company will have no interest (and there is no law to force them) in paying your ongoing medical bills as you go. They will write one check and you will release them permanently. Once that is done, there is no going back, even if additional, unforeseen medical bills arise later out of the same car wreck. So again, don’t sign away your personal injury claim just to get a quick resolution (the goal of the insurance adjuster).

Be immediately suspicious if the claims examiner tells you that you don’t need an attorney, and if you do, you’ll just reduce the amount of money you receive. While this may be true in some cases, don’t take the word of the claims examiner. Most personal injury attorneys will offer a free consultation where they can let you know the risks and benefits of proceeding with an attorney. A good attorney will tell you when not to hire them. With a property damage only case, or a personal injury case that simply involved an E/R visit and maybe some X-rays just to confirm there are no broken bones, it usually would make economic sense to proceed on your own. Any additional amount an attorney could get would be eaten up by the fee. If it involves ongoing treatment, it usually makes sense to hire a personal injury attorney. Again, in either case, take a free consultation first.

–Bradley A. Coxe is a practicing attorney in Wilmington, NC with Hodges & Coxe PC who specializes in Personal Injury, Medical Malpractice, Homeowner's Associations, Contract and Real Estate disputes and all forms of Civil Litigation.  Please contact him at (910) 772-1678.