Cecily Zamora
After a car accident, an insurance adjuster is responsible for evaluating your claim, determining liability, and deciding on the amount you may receive as compensation. If you believe your insurance claim has been unfairly denied or undervalued by the insurance company, you can argue with the insurance claims adjuster. If your claim was denied or not fully paid and you believe the decision was unjust, it is recommended to speak with an attorney who handles bad faith insurance cases. To successfully sue an insurance adjuster and insurance company, strong evidence of bad faith is required. People who are successful in these lawsuits typically have the help of experienced injury attorneys who understand consumer insurance laws and how insurers operate.
| Characteristics | Values |
|---|---|
| Can I go to an adjuster after a lawsuit? | Yes, you can go to an adjuster after a lawsuit. However, it is advised to seek legal representation to handle communications and negotiations on your behalf. |
| Reasons to sue an insurance adjuster | Bad faith, unfair treatment, denied or delayed insurance claims, misrepresentation, etc. |
| Requirements for a lawsuit | Clear and strong evidence of bad faith |
| Possible outcomes | Up to three times the money from a properly processed claim, compensation for attorney's fees and court costs, 18% interest annually for delayed payment, and punitive damages |
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What You'll Learn
Understanding the role of an insurance adjuster
The role of an insurance adjuster typically involves the following key steps:
- Damage assessment and liability determination: After a car accident or any insured incident, the adjuster assesses the damage to property or personal injury claims. They may inspect the scene, review police reports, and gather evidence, including photographs and statements from those involved, such as drivers, passengers, and witnesses. This step helps determine the extent of the insurance company's liability.
- Review of policy and coverages: The adjuster reviews the claimant's insurance policy to identify which coverages are applicable to the claim. This step ensures that the claim falls within the scope of the policy's coverage.
- Communication and negotiation: Adjusters communicate with claimants, witnesses, and experts to gather information and clarify details. They must possess strong communication skills to ask the right questions and obtain the necessary information. During this process, they may negotiate with the policyholder to reach a settlement agreement.
- Report preparation and claim finalization: After gathering information and evidence, the adjuster prepares a comprehensive report for the claims examiners to review. Once the claim is approved, the adjuster finalizes the claim by arranging payment to the claimant.
It is important to remember that if you disagree with an adjuster's estimate or decision, you have the right to question it and seek negotiation. Speaking with an attorney who specializes in insurance cases can be beneficial in understanding your options and protecting your rights.
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Seeking legal representation
Choosing an Attorney
When selecting an attorney, it is advisable to choose one who specializes or has experience in the relevant area of law. For example, if your issue pertains to insurance claims and adjusters, an attorney experienced in consumer insurance laws and the tactics of insurers would be ideal. Before choosing, speak with multiple lawyers about their experience, fees, payment terms, your chances of success, and who will be working on your case. Be prepared to provide a clear and concise summary of your problem. Additionally, inquire about potential extra charges for services such as document copying, courier services, court filing fees, or research.
Free or Low-Cost Legal Aid
If you cannot afford private legal representation, there are alternative options available. You can explore free or low-cost civil legal assistance through legal aid or pro bono programs. Websites like LawHelp.org and the American Bar Association offer free legal aid and answers to those with low to moderate incomes. Additionally, specific programs cater to military members, veterans, and their families, while others focus on issues like eldercare, pension problems, or disability rights.
Role of an Attorney
An attorney can provide invaluable assistance by explaining your legal rights, drafting legal documents, filing a lawsuit, preparing your case for trial, and representing you in court. They can handle communications with insurance adjusters on your behalf, ensuring your best interests are protected. Additionally, attorneys can help you navigate the complex process of filing a lawsuit, including drafting complaints, petitions, or motions, and complying with relevant rules and procedures.
Evidence and Documentation
To build a strong case, it is essential to gather clear and compelling evidence. In the context of insurance claims and adjusters, this may include keeping detailed records of the claims process, saving emails, voicemails, and letters from the adjuster, and maintaining a journal documenting your experience. This documentation can support any arguments you make about unfair treatment or unjust decisions by the adjuster.
In summary, seeking legal representation is a crucial step in protecting your rights and interests. Experienced attorneys can guide you through the complex legal landscape, ensure your rights are upheld, and help you secure the compensation you deserve. By choosing the right attorney, understanding their role, and gathering the necessary evidence, you can approach your legal journey with confidence and increase your chances of a successful outcome.
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Documenting the claims process
- Keep Detailed Records: Save all relevant correspondence, including emails, voicemails, and letters from the adjuster. Start a journal or diary to record your experiences, interactions, and observations. This helps establish a timeline and provides valuable context for your claim.
- Photographic Evidence: Take clear and detailed photographs of any injuries, damages, or accident scenes from multiple angles. Capture visible signs of trauma, such as bruises, cuts, or swelling, as this visual evidence can be powerful in demonstrating the extent of the harm suffered.
- Preserve Physical Evidence: Physical evidence, such as damaged property or clothing, can play a crucial role in proving the extent of your injuries and the liability of the responsible party. Ensure this evidence is securely stored and accessible when needed.
- Document Medical Treatments and Expenses: Keep a record of all medical treatments, procedures, medications, and any related expenses. This includes doctor's visits, hospital stays, surgeries, rehabilitation, and any ongoing care or therapy. Such documentation helps demonstrate the severity of your injuries, their impact on your daily life, and the financial burden incurred.
- Witness Information and Testimonies: Obtain and document the contact information of witnesses. During the discovery phase of a lawsuit, witnesses may be required to provide testimonies and evidence. It is important to keep witnesses informed but isolated from each other to ensure their testimonies are based on their own knowledge and experiences.
- Compliance with Protocols: Ensure that all documentation is handled in accordance with the insurer's protocols and legal requirements. Improperly documented notes can lead to litigation issues. Understand the rules regarding claim notes, discovery requests, and the privacy and admissibility of certain documents.
By diligently following these steps, you can effectively document the claims process, strengthening your position in negotiations with insurance adjusters and potential lawsuits.
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State laws and your rights
State laws vary, but in Texas, for example, public insurance adjusters who work on your claim cannot act as your contractor. If you are having issues with your public insurance adjuster, you do have the right to sue. However, suing your insurance adjuster or insurance company can be a lengthy and costly process, and there is no guarantee of a successful outcome.
If your claim has been denied or not fully paid and you believe the decision was not made fairly, it is advisable to consult an attorney who handles bad faith insurance cases. A lawyer can help you understand your rights and legal options, and represent you in court if necessary. They can also help you to navigate your claim and avoid mistakes that might affect your compensation.
To be successful in a lawsuit against an insurance adjuster and/or insurance company, you will need clear and strong evidence of bad faith. If you are successful, you may be awarded up to three times the money you would have received in a properly processed claim, compensation for your attorney's fees and court costs, interest at the rate of 18% annually for delayed payment, and punitive damages to punish the adjuster and/or insurance company.
Before hiring a lawyer, it is worth noting that there are other ways to address issues with an insurance adjuster. For example, you could keep a detailed record of the claims process, including saving emails and voicemails, keeping copies of letters, and starting a journal of your experience. You could also try "going over your adjuster's head" by contacting their supervisor.
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Types of lawsuits and compensation
The role of an insurance adjuster is to evaluate your claim, determine liability, and decide on the compensation amount after a car accident. If you believe the treatment you received from the adjuster or the insurance company was not fair and honest, you can file a complaint or a civil lawsuit. However, it is recommended to seek legal representation and proceed with caution when dealing with an insurance adjuster to protect your rights and achieve a favorable outcome.
Now, let's take a look at some common types of lawsuits and compensation:
- Personal Injury Lawsuit: This type of lawsuit is filed when an individual suffers a personal injury due to another party's negligence or intentional actions. Personal injuries can be physical, such as a broken bone, or psychological, such as PTSD. To win this lawsuit, the prosecution must prove that the defendant breached a legal duty, and damages (compensation) may be awarded.
- Medical Malpractice Lawsuit: This lawsuit is filed when a patient believes they have received improper treatment or been negligently treated by a doctor or other medical professional, resulting in an injury. To succeed in this type of lawsuit, the patient must prove the existence of a doctor-patient relationship, negligence, and that the negligence caused their injury. The plaintiff must also demonstrate specific damages, such as physical or mental pain, additional medical bills, or lost wages.
- Workers' Compensation Lawsuit: Employees can file this lawsuit when they suffer a work-related injury or illness. It covers hospital and medical bills, disability payments, rehabilitation, and more. In some cases, an employee may file a lawsuit against their employer for gross recklessness or failure to pay workers' compensation.
- Breach of Contract Lawsuit: This type of lawsuit is filed when one party fails to fulfill the terms of a contract. It involves seeking legal action to enforce the contract or compensate for any losses incurred due to the breach.
- Defamation Lawsuit: Defamation occurs when a person makes a false statement about someone else, harming their reputation. A defamation lawsuit seeks compensation for the harm caused to an individual's reputation.
- Product Liability Lawsuit: If a person is injured by defective or dangerous products, they can take legal action against the product's manufacturer, distributor, or seller. This includes dangerous drugs and defective medical devices.
- Sexual Abuse or Sexual Assault Lawsuit: This type of lawsuit is filed by victims seeking justice and compensation for harm caused by sexual abuse or assault. It is considered a type of personal injury claim and is separate from any criminal proceedings.
- Wrongful Termination Lawsuit: Employees who believe they have been unfairly or illegally fired can file this lawsuit against their employer.
- Wrongful Death Lawsuit: This lawsuit is filed by the estate or surviving family members of an individual who died due to another person's negligence or intentional actions. It seeks compensation for the losses suffered by the deceased's loved ones.
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Frequently asked questions
Yes, you can sue an insurance adjuster, but it depends on the state law. People who are successful in these types of lawsuits usually have the help of experienced injury attorneys.
You can argue with the insurance claims adjuster. It is a good idea to seek the advice and representation of an experienced insurance lawyer to ensure your rights are protected and you get the compensation you deserve.
Adjusters may try to delay payment for as long as possible or try to make the claim go away for as little money as possible. They may do this by not responding until the last minute, requesting additional information, or making lowball settlement offers.
