Insurance Adjustors and Claims

On Behalf of | Aug 3, 2013 | Personal Injury

People often wonder what happens to the money they pay to insurance companies year after year. It seems as though thousands of dollars go down the drain for no reason. However, insurance is a good protection when an accident happens, some will argue. However, even then, it seems that the insurance claim process is geared against claimants and in favor of big insurance companies.

Then again, insurance companies are businesses and they have an inherent incentive to maximize their profits. They do this by cutting costs, which includes minimizing payouts by relying on a variety of mechanisms, including insurance adjusters.

Insurance companies use adjusters as field agents to gather relevant information, review claims and make a report to the insurance company. Adjusters generally use a laptop with adjusting software that the insurance companies provide to evaluate claims. Yes, you heard right. People’s claims are determined using software from the same company that has an incentive to deny their claims.

Now, not every insurance company employs questionable tactics in evaluating claims. Few will dispute, however, that they do not enjoy the best reputation.

Information that a claimant gives at the adjusting stage is crucial and can come back to haunt them down the road. Insurance companies will take the information gathered and cross-reference it with the insurance contract, which they drafted, to find potential grounds for denying a claim.

The point is that insurance companies specialize in denying claims and can work the system to their benefit. Often, claimants will start a claim and go through the adjuster meeting only to find out that they need professional legal help with their claims.

Indeed, a good attorney can mean the difference between the claimant recovering their full coverage amount (for which they paid regular premiums) or settling for substantially less. This is especially true for complex cases that involve multiple defendants in different states.

If you have an insurance claim, you should consult a personal injury attorney who knows the system and how insurance companies operate. At the Bettersworth Law Firm, we have many years of experience representing Texas clients with their legal needs.