The Role of the Insurance Adjuster

When you are injured in a Texas car or truck accident there can be an incredible amount of money on the line. Naturally, the insurance company that covers the defendant in your case will do whatever it can to make sure you get as little as possible. Make no mistake about it, the carrier involved in your case has every intention of limiting your payout or paying you nothing at all.

How an Insurance Adjuster Can Trick You from Attorney Mike Grossman on Vimeo.

Covered in This Article

• How an Adjuster Can Deny You Compensation
• The Adjuster will Exploit our Laws
• Trick No. 1 – "Don't Worry about it"
• Trick No. 2 – "The Stall Tactic"
• Trick No. 3 – "Similar Questions Technique"
• The Terms of Your Negotiation
• NEVER Submit Medical Bills to the Adjuster
• The "I'm Your Buddy" Approach

If a commercial truck caused your accident, the trucking policy you will be taking legal action to pursue will be worth a minimum of $1 million, and as a consequence, you will have to deal with the guardian of that policy, the insurance adjuster. Trucking policy adjusters are the most experienced, and most valuable, claims professionals. They are also the smartest, possessing a very high level of trucking accident law knowledge – not to the extent of a lawyer, but very close. These adjusters are very good at what they do. One of the main purposes of their job is to settle your case for less than your initial asking amount.

If you think that you can act as your own lawyer in your case and defeat this highly-qualified opponent, you will be bitterly disappointed. At Grossman Law Offices, our Dallas truck accident lawyers have two decades of experience in truck accident litigation, and we can help you win your case by helping you avoid many of the common pitfalls associated with dealing with an insurance adjuster. It is critical you hire a skilled Texas attorney who can defeat the tactics the trucking policy insurance adjuster assigned to your case will employ.

How an Adjuster Can Deny You Compensation

"Why wouldn't I get what I have coming? I know the truck driver was at fault for my accident."

We field numerous calls from Texas truck accident victims everyday, and we hear this all the time. The truth is that in a Dallas personal injury case, the law isn't on anybody's side. The law simply seeks to be equitable in all matters; compensation is not inherent, nor is it explicit in value. In Texas, unlike some other states, compensation is not "scheduled," meaning there are no set amounts awarded for specific injuries. It is up to your attorneys to prove how severely you were injured. A failure to do so will result in reduced payment. So even in a case where the defendant is certainly liable, you must still take an aggressive approach to proving that they are liable for an amount that you are happy with and not an amount of their choosing.

Furthermore, truck accident injuries come in a wide variety; from muscle pulls to neck and spinal injuries to broken bones, brain injuries and many more. Your injury has very likely resulted in you incurring some sort of monetary losses, known in legal parlance as "damages." And while some damages are tangible, such as lost wages, repair bills and present medical expenses, there are others that can be extremely subjective, such as lost earning capacity.

For instance, if you are a secretary and you lose your right pointer finger in an accident, while it will be extremely difficult to type on a keyboard, you will, more than likely, eventually be able to adjust and return to work. If you are a SWAT team sharpshooter, on the other hand, and lose your trigger finger, your career will more than likely be over. With these two very similar scenarios, the resultant economic losses stemming from nearly identical injuries will be quite different. The secretary's claim may be worth hundreds of thousands of dollars, while the sharpshooter's could be worth millions respectively.

The name of the game is not to simply show that you suffered an injury, rather, it is to show how that injury affected you in the big picture. Therefore, you must have an attorney who knows the specific nature of the damages you have incurred, and can make a persuasive argument that will sway the court into ruling in your favor so that you can secure fair restitution. If the insurance adjuster is not worried about your ability to sway a jury, then he or she will have no incentive to offer you fair compensation.

The Adjuster will Exploit the Subjectivity Inherent in our Laws

There is some degree of subjectivity in the interpretation of Texas' injury laws, and most insurance adjusters will try to use that to their advantage. A good way to illustrate this concept is to consider criminal infractions and their range of penalties. If you are caught speeding in a work zone, for example, you will face a fine of up to some certain amount of money. In many public places you will see "no loitering" signs that threaten fines up to $200. But ultimately a judge and jury will decide what fine you should pay within the range of possible fines. The same concept applies in truck accident cases. Since every situation is different, there is a range of possible awards that are fair given the unique circumstances of a particular case, and because the circumstances of nearly every case are different, the court needs to have latitude.

As it pertains to your personal injury case, again, since damages are not scheduled in Texas, the defense will argue that your compensation should fall within the lower end of the spectrum, while your attorney will, of course, argue the opposite. Insurance adjusters love to exploit this inherent flexibility in our laws and when they win against an unrepresented plaintiff, it is usually because the plaintiff sees the defendant accept liability and then therefore assume that they have won. Not so. Such a plaintiff has only one part of the case and must still prove up their damages in order to get adequate compensation and win the other part of their case.

The defendant has the right to defend itself, and it has the motivation and the means to keep you from securing the restitution that you feel you deserve. And letting an insurance adjuster loose on your case is one of the main weapons it will deploy in an effort to achieve its objective of reducing your compensation as much as possible. Here are some of the tricks these operatives typically use in an effort to either reduce claims substantially or deny them completely.

Trick No. 1 – The "Don't Worry about it" Approach

The adjuster will likely try and lull you into a false sense of security, making it seem like since the insurance carrier is accepting liability for your property damage claim, that means it will assume blanket liability. That is simply not the truth in any way, shape, or form. If a vehicular accident results in property damage only, the insurance company is basically locked into the amount of compensation it needs to pay, due to the nature of our state's property laws. However, when an injury is involved, in a manner of speaking, "all bets are off." The insurer could conceivably offer to pay you nothing for the suffering you have experienced. Never allow an adjuster to make you think that everything will be just fine. It is in your best interest to be on guard at all times and hire a lawyer who can make sure your rights are protected.

Trick No. 2 – The Stall Tactic

Irrespective of how badly you have been injured, if it has been a month since the accident and you still have not received a settlement offer, something is probably awwry with your claim. These claims do take time so there may be a perfectly logical explanation for the amount of time that has lapsed, but trust your instincts. If it feels like they are stalling, they probably are.

Why would the adjuster do that? The answer lies in the statute of limitations that is applicable to your case. In Texas, the statute of limitations to take legal action after incurring a personal injury is two years. This means you have two years from the date you were hurt to file a lawsuit. Said lawsuit is based on a "cause of action," and that cause of action exists only as long as the statute of limitations does not bar your recovery. For instance, two years from the time of your accident occurred, your cause of action expires. And when that happens, your case expires as well.

We have spoken to several people who let their statute of limitations run out and therefore no longer have grounds for legal action because they were victims of the insurance adjuster's stall tactics. If your statute of limitations expires, the insurance company will not have to offer you a dime. But here's the tricky part. They don't have to wait you out for the full two years. In fact, each day that passes whereby you are self-represented will make your case less and less attractive to a law firm. The bottom line is that when non-attorneys represent themselves they tend to make a lot of mistakes that harm their case. If you call an attorney a day after your accident, he will be inclined to help you. But if you wait until you've let six months pass and the adjuster has denied liability then your case becomes very risky, and most attorneys won't want to assume that type of risk. If you let the adjuster get away with it, they will stall your claim just long enough that an attorney is unlikely to want to get involved.

Trick No. 3 – The "Similar Questions Technique"

Even if you are able to track down the adjuster working on your case, you could easily make a mistake that could kill that case. That adjuster will, in all likelihood, ask a line of questions he or she has refined over the years, and this questioning can easily trick you. It is simply human nature to elaborate and fill the silence in a conversation – we're hard-wired to do so. But the main way an accident victim hurts his or her case is by offering too much information, and when the adjuster phrases the question multiple different ways, the answers end up sounding different from one another. This can be exploited by the adjuster in an effort to make you seem dishonest.

Additionally, they can just ask misleading questions and take advantage of the way you answer. Here's a brief example of how this could be used against you when you talk to an insurance adjuster:

Adjuster: "How did the accident happen?"

Victim: "The truck driver rear-ended me."

Adjuster: "How closely was he following you"

Victim: "Fairly close."

Adjuster: "Yeah, I hate when that happens. Do you ever slow down just a little bit to make a tailgater back off? I mean, I do it a lot because it's so annoying."

Victim: "Oh definitely. I do it all the time. I can't stand it when somebody's riding my bumper, so I'll slow down a little bit just to 'send a message,' if you know what I mean. Man, I can't stand that stuff."

And that is where the insurance company has you – right there. You have basically admitted that you were partially to blame for your accident because you likely "brake-checked" the truck driver. That slip-up could damage your case to the point that no attorney will be able to salvage it. Attorneys do not want their clients to speak with adjusters because they do not want to have to play damage control. Never, ever provide any sort of statement to an insurance company adjuster without your attorney being present. Otherwise, a skilled adjuster can get you to utter seemingly innocuous statements that can later be used against you.

The insurance company does not have to win it's case flat-out to consider it a success. If it can get away with paying you $20,000 less than it has to, then it will be happy. And you will be out of luck. The less you say to an adjuster, the less of a chance you have of making a mistake that will help the insurer achieve its objective.

Do Not Let the Adjuster Dictate the Terms of Your Negotiation

Your attorney will submit a list of damages demands to the defendant. Included on this list will be the amount of money for which you will settle, the time frame as to when the offer will be taken off of the table, and the consequences ("I have an attorney and I will sue you.") the defendant will face if your demands are not met.

NEVER Submit Medical Bills to the Adjuster

Insurance adjusters often ask you to submit your medical bills to them as you receive them. Do not comply with these requests, since this only serves to hurt your case. Medical bills are not admissible in court by default. The only way that a Dallas jury will ever hear about your medical bills is if you "prove them up" consistent with the Texas Rules of Civil Procedure. Without going through the proper procedures to make your medical bills count as evidence, they are little more than useless paper. As we have stated time and time again, the one of the leading factors of an adjuster giving you fair compensation is knowing your case and having an attorney in your corner who will stand by your side for the best possible outcome in your favor.

Never Fall for the "I'm Your Buddy" Approach

A usual tactic that an insurance adjuster can perpetrate is convincing you that you do not need an attorney. Although you are not required to hire an attorney, it is within your right to hire one to protect your interests fully.The adjuster may try and act like your friend and say something like, "Don't worry about it; I'll take care of everything and give you what you deserve."

While adjusters are intelligent, they employ a plethora of tricks they can use to keep from paying you a settlement, they can be defeated by an aggressive, skilled and experienced attorney. At Grossman Law Offices, we have litigated a multitude of Texas truck accident cases over the past two decades and helped our clients obtain fair compensation for the suffering they were forced to endure. We know all the tricks that insurance adjusters try to use, and we are more than up to the task of defeating them. Please do not hesitate to call Dallas attorney Michael Grossman at 1-855-326-0000 (toll free) for a confidential and free consultation if you or someone close to you has been injured in a trucking accident.

By E. Michael Grossman