After the victim of an accident has submitted a personal injury claim with the insurance company of the responsible driver, then the insurer creates a new file, and hands that same file to one of the company’s adjusters. Later, the same adjuster contacts the claimant/victim.
Adjuster’s role during investigation of submitted claim
• Determine who is responsible for the accident, and who should be held liable for payment of the damages
• Examine all of the factual data
• Using a formula or a computer program, calculate the value of the submitted claim
• Study the stated limits in the policy that the allegedly responsible driver had previously purchased from the insurance company
• Assess the strength of the claimant’s case; look for any evidence that could support an allegation of shared fault
• Strive to avoid a lawsuit; that usually means working to settle with the claimant
• Make an initial offer: It could be one that is based on the adjuster’s findings, or it could be a low-ball offer. The initial offer represents the start of negotiations.
Role of attorney that has been hired by the claimant/victim
Personal Injury Lawyer in Whitby will study the stipulations in the insurance policy of the allegedly responsible driver. Study the stated limits in the terms of the same policy and will use acquired knowledge of insurance policies, in order to obtain a fuller understanding of the studied policy.
Claimant’s role during pre-settlement investigations
Share all relevant facts with the hired attorney
Appreciate attorney’s familiarity with insurance policies
Acknowledge significance of stipulations and limits in the policy of the allegedly responsible driver
Have a lowest acceptable bid in mind; use the envisioned value of that lowest acceptable bid, when deciding on a counteroffer to one of the adjuster’s offers.
Be ready to change the lowest acceptable offer, after hearing the value of the adjuster’s initial bid
—If the figure for a low-ball bid were in the range of an agreeable and envisioned offer, then the claimant ought to plan on increasing the size of that envisioned figure.
—If an adjuster were to demonstrate the existence of some weakness in the claimant’s argument, then the claimant ought to decrease the size of the agreeable and envisioned offer.
How roles would change, following settlement
Adjuster would ask for claimant’s signature on a release form and the hired attorney would study the release form, before giving it to the client/claimant. The claimant’s only task would be that of signing the release.
The attorney would return the signed release to the insurance company; then he/she would arrange for reimbursement of the health care provider that had paid for the client’s treatment, before completion of the claims process. The attorney’s last task would involve taking the contingency fee and paying client.