If you’ve been injured in an serious accident, you probably received medical attention and gone through a recovery period. If the accident was not your fault, you may be entitled to compensation for medical treatment, lost wages as well as pain & suffering. But to get the ball rolling with the insurance companies, you must first submit a personal injury demand letter to the insurance carrier. Unfortunately, you may not receive the response you were expecting. Here’s three typical insurance adjuster responses and how you can deal with them.
1. Denial of Your Insurance Claim
The claim may be rejected outright. Valid claims are routinely rejected. There are adjusters whose sole purpose is to say “no” to would-be claimants. Reasons for rejection include:
- They believe you might settle for less. A number of claimants will simply give up after their claim if it’s denied. This reduces the number of claims paid annually and ultimately saves the insurance company a lot of money.
- The insurance adjuster challenges liability. Not all accidents are straightforward and there may be a question of fault. If liability is questioned, the initial response will be a denied claim. The burden then shifts to you to prove liability. Typically, you’ll be required to hire a personal injury attorney to file a lawsuit and present evidence of a contrary theory of liability.
- Lastly, claims are denied when the insurance adjuster suspects that your claim is based upon fraud.
2. A Counter Offer to Your Claim
A counter offer is an offer of a lesser amount of money. The insurance adjuster typically will not accept the first offer submitted. The reasons they might counter-offer are:
- They believe that you might settle for less; many people would rather settle for less than run the risk of pushing a matter to trial or losing the opportunity to get a settlement altogether. As the injured party, you may accept the counter offer or submit your own counter to theirs.
- There are a number of injured people involved, such as a vehicle with a driver and passengers. The amount available must then be divided amongst all injured parties. In this case, the adjuster would have to counter a demand to make sure that all injured parties who are not at fault can receive some compensation.
3. An Insurance Settlement Offer
There is a remote possibility that the insurance adjuster will agree to pay the amount you requested in your demand letter. There are times when the injuries and circumstances surrounding the accident warrant settling for the amount requested, or for policy limits, such as:
- You requested an amount in your demand letter that is within policy limits, even though your actual expenses were much higher. It is possible that an insurance company would settle for policy limits because this does not even cover your medical bills and they realize that their exposure in a trial would be far greater than the settlement amount.
- Both parties have gone back and forth with counter offers. For example, if you demanded $38,000, but the insured countered at $20,000, they might ultimately settle for $25,000.
The starting point to achieve the best possible outcome is a strong demand letter, with exhibits to support each claim. Additionally, the skilled personal injury attorneys in our office have relationships with insurance adjusters and understand the insurance industry. We are in an excellent position to help you negotiate the best settlement possible.