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The insurer assigns claims to the insurance company’s various adjusters. Each filed claim represents a submission from someone that has been, allegedly, harmed by one of same company’s policyholders.
Adjusters view each claim as a demand for a payout.
It is the adjuster’s job to investigate and discover the reason for the demand/claim. That investigation should unearth details, about how the injury-causing accident took place. The adjuster’s task involves more than completion of an investigation. He or she must also estimate the submitted claim’s value.
By calculating each claim’s value, adjusters can prepare for their next role, that of presenting an initial bid.
Adjusters’ preparation for that task involves studying various pieces of information
• The total on each of the claimant’s medical bills
• The size of the claimant’s income loss, due to his/her inability to work, while in recovery
• The degree to which the claimant experienced pain and suffering
• Another part of adjusters’ preparation involves a study of information on-file at the insurance company
• The stated limits on the policy of the defendant/policyholder
• The strength of the claimant’s case.
A claimant’s awareness of the adjuster’s approach should indicate what factors the plaintiff’s attorney must consider.
Smart claimants take whatever steps are necessary, in order to strengthen their case
—Hire a personal injury lawyer in Hamilton
—Gather evidence
—Be certain that a doctor’s observations on any sustained injury get included in the claimant’s medical report
Smart claimants also compose a demand letter, and send it to the adjuster.
—That letter should indicate the minimum amount of money that the plaintiff would view as acceptable.
—The demand letter should also tell the adjuster the lowest amount of money that the claimant/plaintiff would view as acceptable.
Adjusters use a formula or a computer program to calculate a given claim’s value.
—Both the program and the formula use details on the reported pain and suffering, along with the medical bills, to estimate the claim’s pre-settlement value. When using the formula, an adjuster places a specific number in the space next to total for all of the claimant’s medical bills.
—When using a computer program, an adjuster feeds the computer software some information about the claimant’s health provider.
Adjusters seek to locate information that can verify or refute the claimant’s report, regarding his or her medical injuries. The medical report is the best source of such information.
A good medical report should reveal the extent and nature of a given injury. Using that information, the treating physician should keep the patient posted, on his/her progress.
A listing of adjusters’ tasks does not include that of checking for details on a claimant’s progress towards the point of maximum medical improvement (MMI). Claimants’ physicians should have that information.