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The Role of the Adjuster in Insurance Claims and Disputes

Insurance claims adjusters (also called “insurance adjusters” and “claims specialists,” depending on the company) are assigned by the insurance company to investigate your claim, with the ultimate goal of settling it. They work for the insurance company, and handle homeowner’s claims, vehicle accident claims, disability insurance claims, and other types of policy claims.

Sometimes, an insurance company will refer your claim to an outside adjuster, but usually claims are handled in-house. Usually, the key difference between in-house claims adjusters and outside adjusters is the amount they can offer in settlement. In-house claims adjusters can usually make a higher offer.

The claims adjuster negotiation process

The first step in any claims process is to verify that the policy exists, and that the claimed losses are covered. If the policy is valid, then the claims adjuster investigates the claim. The adjuster and his/her staff will examine the damaged property. They will try to take statements from you and everyone who may be a witness. (It’s best to speak with your lawyer before giving any statements.) They may review police reports as well as any photos or videos that exist of the damage and/or of the event which led to the claim.

Claims adjusters normally don’t have any legal training. They work with appraisers and experts who understand the value of homes, the materials needed to build homes, the value of businesses, and other valuation issues. Your settlement offer will depend on two things:

  1. What your policy says: Do you have a replacement cost policy, or an actual cash value policy?
  2. What the Xactimate and other estimating software says: This software is designed to where it can automatically factor in depreciation, which may lower your overall settlement offer.

Adjusters are required to act in good faith. This means they can’t deny claims they know are valid. They can’t purposefully delay reviewing your case or delay trying to settle it. They can’t require you to use contractors who aren’t reputable or experienced. In short, they must play fair.

But the insurance company as a whole is in the business of making money. The claims adjuster works for the insurance company. All of this means that even when your claims adjuster is acting in good faith, he or she is still answerable to a company whose sole goal is to keep the money it takes in.

What does an insurance dispute attorney do to help with a claim?

Claims adjusters know what their authority is to settle a case – somewhere between a set figure and the policy limits. They will normally make a first offer that is low. Experienced insurance dispute lawyers understand how adjusters negotiate so that they can maximize the last final offer. We also understand when a final offer from the adjuster is fair, and when it is not. If it is not, we negotiate on your behalf, or represent you in trial or arbitration to secure the more just award.

Anyone who suffers losses and puts in a claim should consult with an Alabama insurance dispute lawyer, because once you settle your case for a low figure (which is what the claims adjuster wants), you can’t renegotiate when the costs to fix or replace your property are much more than you thought.

At Warhurst Law, our team works together to secure a better settlement award. We are comprised of former claims adjusters and experienced litigators who understand how estimating software such as Xactimate works, and what methods insurance companies will use to keep your offer low.

For nearly 25 years, Warhurst Law has helped policyholders fight for full compensation for the damages and losses to their properties and businesses. To speak with an aggressive insurance dispute attorney, call us at 251.207.1296 or use our contact form to schedule an appointment in our Mobile office. We represent homeowners and business owners throughout the Southeast including the Florida panhandle, the Gulf Coast, and Louisiana.

Text Us251-207-1296