How the Adjuster Will Investigate Your Personal Injury Claim

Once you submit an injury claim to the insurance company, the investigation phase will commence as an adjuster from the company begins the process of determining who was at fault. An Irvine personal injury attorney will be able to help you through this process.

The insurer is primarily interested in the answering the question of coverage: who was responsible for the accident? Does the person have proper insurance and is not in default? Are there any reasons to deny coverage of your accident? Typically, the adjuster performs an investigation him or herself, by phone or by personally interviewing people, taking statements, and keeping notes.

In small to medium cases, the adjuster is trained to look for specific red flags, such as pre-existing injuries, chiropractic treatment, and unsubstantiated soft-tissue complaints. Low-impact collisions and claims of chronic pain from soft-tissue injuries will be looked at closely, and adjusters will also search to see if you have made prior insurance claims and how well-documented those claims were. The file will go through a medical audit, in which an independent evaluator puts a value range on your injury based on other claims of the same nature or regarding the same injury. This audit will not take into account personal facts or factors that might heavily distort the value of your case, such as if you are a classical pianist and your hand has been injured.

For normal cases, the investigation will first look into the question of property damage (especially in auto cases) and how much is going to be paid out. The insured parties will give statements to the adjuster, but insureds often exaggerate their statements to help themselves, as they are worried about premiums being hiked or their insurance being canceled. The adjuster will also obtain a statement from you, and ideally, you will already have an Irvine personal injury attorney by this point, who can be present while you give your statement.

Going through the process of a personal injury claim can be confusing and will require the help of an expert who will fight for you. Contact Irvine personal injury attorney Samer Habbas for a free consultation.