How Does Adjuster Arrive At Figure For Initial Offer?

During the settlement negotiations, each party has a chance to take part in the exchange of offers and counteroffers. That exchange starts with presentation by one party of an initial offer.

Studies that could guide an adjuster, concerning ideal figure to present in initial bid

Examination of the insurance company’s database: That would reveal how frequently the current claimant has submitted a claim in the past.

Requests useful documents from the claimant’s attorney

—Asks for permission to view claimant’s medical history
—Obtains copy of police report
—Seeks statement with proof of earnings
—Seeks proof of reported property damage

Before making initial bid, the adjuster estimates the value of the recently submitted claim

When using a computer program, the adjuster’s task is simple: Feed into the program the details on the claimant’s medical expenses. The program automatically selects the figures that it will use to calculate an estimate; it does not use any expense that arose from a visit to a health care provider that did not have an MD.

When using a formula, the task involves completion of more steps. First weed out the expenses that were created by a visit to someone that had not earned an MD degree. Then, calculate the total for the remaining medical expenses.

That total must be multiplied by a number between 1.5 and 5, depending on the severity of the reported injury. Sometimes, in cases of catastrophic injuries, that factor for the multiplication operation could be 6 or more. After obtaining the product, add that product to the value for the claimant’s lost earnings, as per Personal Injury Lawyer in Brantford.

So, how do adjusters make use of each calculated estimate?

Following consultation with a supervisor, adjusters take a given percentage of that same estimate. At that point, the adjusters’ figure for the initial offer has been partially uncovered.

Why does the percentage of the estimate not become the figure that gets used in the first offer? The sized of each claimant’s offer reflects the extent to which he or she had access to legal guidance. Those that have hired a lawyer receive a higher bid. Those without an attorney could receive a low-ball bid.

The method used reflects the insurer’s need to deliver on promises of a payout.

The insurer strives to make that payout as low as possible. Insurers tell their employees to ignore any medical bills that do not come from a medical doctor. Insurers tell those in charge of the Claims Department to reduce any estimated values by a given percentage of that same value.

Some estimates get reduced even further, if the claimant has not hired an attorney. Claimants without legal guidance feel forced to accept the bid that has come from the Claims Department.