The Insurance Adjuster Called. Who Are They Actually Working For?

When an insurance adjuster called you after the accident, they were working for exactly one party: the company that employs them. That is true even when the adjuster is warm, sympathetic, and says they want to “get you taken care of.” An adjuster is a claims employee. The job description is to investigate, value, and resolve claims at the lowest defensible cost. Nothing in that job involves representing you, and the adjuster is not obligated to explain what a claim is worth or what you may be leaving on the table.

Which insurance adjuster called: two kinds, one employer each

The first call usually comes from the at-fault driver’s insurer. That adjuster’s employer is the company that will pay your claim if fault is established. Every question serves that interest. The second kind is your own carrier’s adjuster, who handles your collision, medical payments, or uninsured motorist coverage. That person is closer to being on your side, but still works for a company that profits by paying less. Neither adjuster is a neutral referee. There is also a third type, the independent adjuster, who contracts with insurers. The name is misleading. An independent adjuster is independent of a single company, not independent of the industry.

What the friendly tone is for

Claims training emphasizes rapport. A claimant who likes the adjuster is more likely to give a recorded statement. That person also tends to sign a medical authorization and accept an early offer. So when the insurance adjuster called with a warm tone, that tone had a purpose. None of those steps is required. Each one gives the insurer information or leverage it didn’t have before. The broad medical release is a good example. It typically authorizes access to your entire medical history, not just the crash records. Prior complaints then become “pre-existing conditions” in the file.

The quick offer and why it arrives early

An early settlement offer often arrives before you’ve finished treatment or even received a diagnosis. Accepting it means signing a release. A release ends the claim permanently, including for injuries that show up later. Insurers know that soft-tissue and spinal injuries frequently take days or weeks to fully present. An offer in the first week prices the injury as it looks in the first week. That timing is the strategy.

What the adjuster owes you under the law

Most states have an unfair claims settlement practices law. Regulators usually model it on a standard from the National Association of Insurance Commissioners. Those laws require insurers to acknowledge claims promptly, investigate reasonably, and not misrepresent policy terms or the facts. They don’t require the adjuster to advise you, volunteer the policy limits, or point out that you might have a claim you haven’t mentioned. When an insurer crosses the line, the remedy is usually a complaint to the state insurance department or, in some states, a bad-faith claim. Bad faith is a high bar and typically applies to your own insurer, not the other driver’s.

How to handle it when an insurance adjuster called

You can be courteous and still decline. Confirm the basics: names, date, claim number. Decline a recorded statement. Decline the blanket medical release. Don’t discuss fault or how you feel. Ask for anything substantive in writing. If you hire a lawyer, the adjuster will generally have to communicate through that lawyer, which is one reason adjusters try to get the recording and release done early.

The bottom line

When an insurance adjuster called you, the friendliness was real and the loyalty was to the insurer. The law requires the adjuster to deal with you fairly, not to look out for you. Every request — the recording, the release, the early offer — is a normal part of the job and every one of them is optional for you. The gap between what the adjuster must do and what the adjuster wants you to do is where claims get undervalued.

Keep reading: Talking to an insurance adjuster after an accident · Why the insurance company’s first offer is low · What an independent medical exam really is

This article is general information about insurance claims handling and is not legal advice. Laws differ by state and change over time, and the facts of your situation matter. For guidance on your own circumstances, consult a licensed attorney in your state.