How Insurance Adjusters Evaluate Your Claim

Personal injury attorney lawyerIt is part of the insurance adjuster’s job to put a dollar amount on your personal injury claim. While your final settlement amount will be determined in negotiation between the adjuster and your Orange County personal injury attorney, this initial estimate serves as a starting point, and it is thus very important for your attorney to look at what factors the adjuster is looking at.

The first major things that adjusters look at are your medical records, especially as they pertain to the accident. Any medical information that can corroborate your claim will be carefully examined. The adjuster will look for any discrepancies between the damages you claim and the severity and permanence of your injury. The adjuster will also look for alternative explanations for your injuries besides the accident, such as previous injuries or drug or alcohol use. This is where the term “preexisting condition” comes in, and such conditions may be used by the insurance company to escape liability.

To illustrate how this might come into play, imagine a claimant who is making a product liability claim because she injured her back when she fell out of a chair. She and her personal injury attorney file a personal injury claim alleging that the chair was defective. However, when the claims adjuster looks into her medical records and doctor’s evaluations, they make no mention of any fall from a chair. There was reference made to a hiking accident. In such a case, the insurance company will resist paying the claim, unless the claimant’s personal injury attorney can provide a very good explanation.

Experienced claims adjusters tend to know how much certain injuries tend to cost in medical bill and time off. Their suspicions will be raised if the claim’s demand is much larger than what is usually paid out for such injuries. Claims adjusters may accuse the claimant of artificially inflating the size of the claim with superfluous medical bills if the discrepancy is big enough.

In either case, having an experienced Orange County personal injury attorney is invaluable. Call dedicated Orange County personal injury attorney Samer Habbas today at  (888) 848-5084 for a free consultation.

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