How Adjuster Carries Out Investigation of Personal Injury Claim

After a policyholder has reported his or her involvement in some type of accident, the insurer puts that report in a file. One of the insurance company’s adjusters receives that particular file. The recipient of the same file wants to gather all the facts; therefore, he or she launches an investigation.

The adjuster’s initial tasks

• Reading the policyholder’s report
• Speaking with the policyholder
• Adds to acquired information by studying official documents, such as the police or accident report.

Adjusters wait to see if the other party submits a claim.

If the insurance company does receive a claim, then the adjuster must carry out some other tasks.

–Contact the other party and explain the policy limits
–Speak with the injured party
–Check to see what the injured party might have posted online

Some adjusters use an authorization form during their investigation.

Much of the adjusters’ time must be spent on an examination of the claimant’s medical records. In order to obtain those records, an adjuster might use an authorization form. Smart claimants refuse to sign such a form, because it guarantees the adjuster’s access to records that do not relate to the reported accident.

Smart claimants promise to make a copy of the relevant medical records, and give those copies to the insurance company. No claimant has an obligation to sign an authorization form.

Another request that claimants should feel free to refuse

Some adjusters ask those that have submitted a claim to provide the insurance company with a recorded statement. That request should not be acknowledged, unless the personal injury lawyer in Mississauga for the claimant feels that the making of such a recording would not jeopardize the case.

The final step in the adjuster’s investigation

Before taking part in the negotiations, the adjuster works on creating an estimate of a given claim’s value. That involves adding up all of the claimant’s medical bills and using that total as one factor in a multiplication operation. The other factor is a multiplier.

The multiplier is usually a number between 1.5 and 5. If the reported injuries were minor in nature, then 1.5 would be the chosen factor. If the reported injuries could be described as catastrophic in nature, then the chosen multiplier would be 5 or more.

The product of the multiplication operation gets added to the value of the claimant’s lost wages. The resulting sum represents the estimate for the claim’s value. Adjusters use that estimate as a guide, when trying to decide on the figure to present as the insurance company’s offer, at the start of negotiations.

The estimated value could be shared with the adjuster’s supervisor. The supervisor could suggest what percentage of the estimate to use for the initial offer.

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