The Role of The Insurance Adjuster During Negotiation Process

The adjuster’s role changes during that process. The changes in that role reflect the different names for the different adjusters

Possible names for an insurance adjuster

• Claims specialist: Knows the procedure for handling a claim
• Claims representative: Represents the insurance company during the negotiations
• Independent claims analyst: Studies the different factors that work to determine a given claim’s value.

If you are asking how claimant has an advantage over the adjuster, it is essential to know that the claimant is more familiar with the facts that are related to the claim. The claimant’s focus is on a single claim; the adjuster must handle 50 or more claims at one time. Most of the claimants discuss the extent of their injuries and their pain, as caused by the injury.

In what way does the adjuster’s boss, a supervisor or manager direct the settlement process?

The supervisor or manager tells each of the company’s adjusters the maximum amount of money that can be given to the person whose claim was assigned to the adjuster.

If a victim’s/claimant’s case seems to qualify for a larger compensation, then the adjuster needs to consult with the supervisor/manager. If the supervisor approves, the claimant can receive that larger compensation package.

Claimants cannot ask adjusters to dispense with a required consultation with a supervisor or manager. Still, it is within claimants’ rights for any one of them to ask for the date when the approval process should be completed.

Claimants have the right to go after the person that directs a given adjuster, if that same adjuster has not followed through with delivery of a promised payment. Adjusters are aware of that fact. That is why smart claimants seek out the adjuster’s superior, when there is some slowdown in the settlement process.

If claimants’ communications with that superior fail to elicit the desired action, the claimant-lawyer team has the ability to file a lawsuit. The insurance company determines what happens next. The insurance company could follow through with the promised delivery of a compensation package. If it chose to undertake that action, then the claimant would have no reason to pursue the filed lawsuit.

If the insurance company continued to delay the delivery of the compensation package, then the claimant’s lawyer would have to pursue the lawsuit process. That would mean planning for a discovery session and, perhaps, a court date. Of course, the lawyer-claimant team might agree to meet the adjuster at a mediation session.

That way the mediator could work with the 2 sides, in hopes of arriving at an agreement. Eventually, the check for the promised money should arrive in the attorney’s office, so that it could be used to reimburse any deserving health insurance company. A portion of that same check would go to the Personal Injury Lawyer in Mississauga.

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