The Short Answer:
An insurance adjuster works for the insurance company or a third-party firm hired to handle claims. Their job is to review the details of your accident, figure out who was at fault, and decide how much compensation the insurer is willing to offer. In Massachusetts, adjusters often appear helpful, but their goal is to protect the insurance company’s money, not to make sure you’re fairly paid.
A personal injury lawyer can help ensure your rights and interests come first.
Key Takeaways
- Insurance adjusters investigate claims and decide whether you should receive a payout, and how much.
- They are employed by or represent the insurance company, which means their loyalty is not to you.
- You do not have to accept their first offer or give a statement without talking to a lawyer.
- Be careful what you say when speaking with an adjuster. They may use your words to limit your claim.
If you disagree with their decision, you have the right to challenge it and work with a Massachusetts injury attorney to seek a fair outcome.
Table of Contents
What Is the Role of an Insurance Adjuster in Massachusetts?
The insurance adjuster, also called a claims adjuster, independent adjuster, or claims agent, is the person who investigates the accident to determine the company’s liability. For the company to be liable, the insured must have been at fault for the accident that caused your injury, and the accident must have been a covered event under the insurance policy.
Investigating the Accident
The insurance adjuster’s first step is to gather information about how the accident occurred. This could include reviewing police reports, photos from the scene, medical records, and statements from you or other witnesses. They may also try to contact you directly, which is why speaking with a lawyer can be incredibly beneficial.
Reviewing Injuries & Property Damage
Next, the adjuster evaluates the damage, both to property and to your body. They review bills, records, and estimates, but they may also rely on cost-cutting formulas and software tools designed to reduce the amount the insurer pays. That means the number they come up with may be far lower than what you actually need to recover.
Deciding Who’s at Fault
Massachusetts follows a modified comparative fault rule, which means if you’re found to be more than 50% responsible for the accident, you may not be able to collect damages. Insurance adjusters know this, and they may try to assign some blame to you to reduce or eliminate the company’s obligation to pay.
Offering a Settlement
Once the adjuster completes their review, they may present a settlement offer. But don’t be fooled, this amount may not fully cover your medical expenses, missed work, or long-term suffering. And if you accept the offer, your case is closed. You won’t be able to go back and ask for more later, even if your condition worsens.
What To Know About Dealing With Insurance Adjusters
Steps the adjuster may take when investigating an injury claim include:
- Visiting the accident scene
- Evaluating the car, defective product, or other item involved in causing your injury
- Obtaining a copy of the police report
- Requesting and reviewing your medical records
- Interviewing you, the insured, and any eyewitnesses
- Consulting expert witnesses
After completing the investigation, if the adjuster determines the insured was at fault and the event is covered under the policy, they must then calculate the value of the claim. Many factors help determine the value of a claim, including the severity of your injury, your out-of-pocket costs, property damage, the length of your recovery, and whether you suffered any permanent impairments. The adjuster files a report with the insurance company detailing their determination of fault and their valuation of your claim.
If the insurance company agrees with the adjuster’s findings, they may make an offer of settlement. You are free to accept, reject, or counter the offer. However, you must remember one very important thing: once you accept an offer, the claim is complete. You are not permitted to go back to the insurance company to request additional compensation, even if you discover additional injuries or require additional medical treatments.
Therefore, our Boston personal injury lawyers strongly urge you to consult with our office before you accept a settlement. In fact, we encourage you to consult one of our attorneys before you provide a statement to or sign a medical release for the adjuster. The insurance adjuster does not work for you and is primarily focused on protecting the insurance company’s interests.
FAQs About Insurance Adjusters
Insurance adjusters may seem polite or casual, but what you say during these conversations can be used to lower or deny your claim. Be careful not to say anything that could be taken out of context.
Avoid saying things like:
- “I should’ve seen them coming.” (Admitting fault)
- “I’m fine, really.” (Minimizing your injuries)
- “I think I was going about 30 mph.” (Guessing details)
- “Sure, you can record this.” (Agreeing to a recorded statement)
Even offhand comments can be twisted to make it seem like you’re to blame or that your injuries aren’t serious.
It’s smart to speak with a Massachusetts injury attorney before answering any of their questions.
Insurance adjusters rely on a variety of tools to estimate how much your claim is worth. These might include:
- Repair quotes from auto shops or contractors
- Medical bills and documentation from your treatment
- Accident photos, surveillance footage, and police reports
- Computer programs and formulas used by the insurance company
- Opinions from medical or technical experts
Even with all these tools, the numbers they come up with may not reflect the full cost of your recovery. In many cases, the first offer is far less than what you could be owed under Massachusetts law. That’s why it’s important to have someone like Attorney Jim Glaser on your side who can fight for the full value of your claim.
You’re not stuck with the insurance adjuster’s decision. If you feel the offer is too low or the facts of your case were overlooked, you have options.
Here’s what you can do in Massachusetts:
- Request another inspection or a second review of your case
- Provide updated medical records or additional expert analysis
- Work with a Massachusetts injury attorney who can handle negotiations for you
- Take legal action if necessary to pursue the full compensation you may be owed
The adjuster’s offer isn’t the final word, and with the right support, you can push back and fight for a better outcome.
Insurance Adjusters Aren’t on Your Side—But We Are
At all times, the insurance agent is working for the insurance company. They may tell you that they are here for you and will do everything they can to resolve your claim quickly for full value. However, the fact remains that an adjuster works for and has the best interest of the insurance company as their first priority.
Therefore, you need to take steps to protect your best interests by consulting with an experienced Massachusetts accident attorney. You need to put the weight of our experience and resources behind you when you are trying to negotiate a settlement for your injury claim. Our lawyers understand the tactics used by insurance companies and their claims agents. It is our goal to obtain full compensation for all of your damages from the insurance company.
The injury lawyers of Jim Glaser Law help individuals injured in an accident that wasn’t their fault navigate the claims process and deal with insurance adjusters so that they can focus on their recovery. We protect you from aggressive adjusters who want to settle your claim too quickly and for much less than the claim is worth.
If you’ve been involved in a car accident, suffered property damage, or experienced a slip and fall accident, it’s essential to have a dedicated attorney on your side. Our firm has experience in these types of lawsuits and is committed to ensuring you receive the compensation you deserve. Additionally, we handle cases involving insurance denials, providing the support and insight needed to challenge these decisions effectively.
Contact Jim Glaser Law today by calling or filling out our online form to request a free case evaluation. Understanding what an insurance adjuster does is the first step in protecting your rights and securing the compensation you need.
