How Soon After Filing A Claim Will An Insurance Claims Adjuster Be In Touch With Me?
There are two different claims adjusters you will probably be dealing with. If you have liability insurance (e.g., car insurance), you will initially deal with your own insurance claims adjuster. Those claims adjusters tend to be more responsive because they are providing a service that you are paying for; you are a customer, and there is a contract and rules and regulations that require them to work with you to resolve that claim. The insurance contract requires you to notify your insurance provider immediately when you are involved in a motor vehicle collision. The same goes for your homeowner’s policy if somebody is injured on your property or something happens to your home.
For the at-fault claims adjuster, let’s say, for example, after a motor vehicle collision or crash, that claims adjuster can be more or less responsive, depending on the insurance company. Some are very responsive and will get back to you within 24 hours, while some are less responsive, meaning you may not hear from them for a week or more.
The claims adjuster’s role from your insurance is to determine whether you have any liability to another party and whether the claim falls within the contract and should be paid. The claims adjuster’s role for a third party responsible for causing your injuries is to try to pay you as little as possible for your injuries. In some cases, they will show up at your door, days after the accident and strong-arm you into taking a settlement that is well below what the claim would be worth.
What Weaknesses Are California Claims Adjusters Looking For In My Personal Injury Case?
First of all, they are looking for who is at fault, and they will try to put some of the fault, if not all of the fault, on you. If they can’t do that, they will look at the damage to the vehicles and argue that there is not enough damage to have caused any type of injury in the collision. If they can’t succeed there, they will say that any injuries you’re complaining of pre-existed this particular incident and, therefore, they are not responsible for those injuries. Your pain, in other words, is really because of the pre-existing condition. However, there is a concept known as the eggshell plaintiff that says you take your plaintiff as you find them. If they are more susceptible to injury than another person, that’s not the plaintiff’s fault; you shouldn’t have injured them in the first place. The plaintiff doesn’t bear any responsibility because they are more susceptible to injury.
If the adjuster fails on any of those points, then they will claim that the injuries you’re complaining of are not severe or not serious enough to warrant any type of treatment. Then, they will attack the treatment and say that you over-treated to build a case, or if you didn’t treat, that must mean you weren’t hurt because you didn’t treat enough.
Also, if there is any type of break-in treatment (for instance, if you don’t go to the doctor for a week after the accident), they’ll claim this gap or delay in treatment indicates that you are not injured. Sometimes, there will be actual breaks in therapy where you will begin treatment and then not see a doctor for maybe a month or two before returning to the doctor because whatever problem you are having is not resolving. A claims adjuster will attack that. When they look at the bills for your treatment, they will claim that the doctors are billing too much and that your treatment should be billed at a lower rate.
The claims adjuster might also examine whether an intentional act or negligence caused your personal injury. Most insurance policies will not cover their insured’s intentional acts such as assault or battery.
Will Any Pre-Existing Conditions Be Used Against Me In My Personal Injury Case?
A claims adjuster will absolutely cite these pre-existing conditions. They’ll say there is a pre-existing condition, so we didn’t cause this injury in this particular incident. The pain you have is from the pre-existing injury; therefore, causation in this specific incident doesn’t exist. In other words, our client, the insured, was not a substantial factor in causing your injury. Rather your pre-existing condition or injury was the substantial factor in causing your pain or injury.
For more information on Dealing With Insurance Claims Adjusters in CA, a free initial consultation is your next best step. Get the information and legal answers you are seeking by calling (855) 675-2901 today.
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