Insurance Adjusters

Secret 1: The insurance adjuster is trained to control the direction of your claim in order to provide maximum benefits for the insurance company and minimum benefits to you.

A claims adjuster is the eyes and ears of an insurance company. The claims adjuster is trained to interview, investigate and to make decisions that affect whether or not money or benefits will be issued. The adjuster reports his or her findings to the insurance supervisor who either authorizes payment of the claim or instructs the adjuster to deny payment completely. For those claims where there is authorization for payment the adjuster is trained to do two things: 1) close the claim as soon as possible and 2) pay as little money as possible. If a claims adjuster is well trained and experienced, there should be little conflict between him and the injured person. The claims adjuster is educated to create a “relationship” with the injured person. In fact, the claims adjuster will often call every two to three weeks to check on the status of medical treatment for the injured person. These calls are often disguised as a caring inquiry to “document the file;” but, beware. The information that the adjuster obtains through their “friendly” phone calls is often used to benefit the insurance company… not you.Information is power and the adjusters are using your information to gain even more power. The adjuster, who may have no medical training at all, many times will suggest that the claimant receive less medical treatment or even suggest that the injured person stop receiving medical treatment altogether. Remember, the injured person and the claims adjusters have competing interests. We believe that the injured person should receive the appropriate medical treatment that is needed and deserved without pressure or influence from the claims adjuster.

The adjuster rarely warns you that the comments or statements you provide in the recorded interview may produce the consequence of diminishing the value of your claim or outright denial of it.

See Secret 2: Statements Given To Insurance Adjusters

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