What to Say (and Not Say) to an Insurance Adjuster

Engaging with an insurance adjuster is an important part of resolving an insurance claim. The adjuster plays a central role in investigating and evaluating the claim on behalf of the insurance company. Understanding how to communicate effectively during this process can help ensure a smoother experience and a fair outcome. This guide aims to prepare you for these discussions, highlighting what information is helpful to provide and what statements are best avoided.

Understanding the Adjuster’s Purpose

An insurance adjuster is a professional assigned to investigate an insurance claim. Their primary responsibility involves gathering information about the incident, documenting evidence, and analyzing policy coverage to determine if the insurer should pay for damages or injuries. Ultimately, they assess how much the insurance company should pay for a covered loss.

Adjusters work for the insurance company, meaning their loyalty is to their employer and the company’s financial interests. They evaluate claims to ensure they are processed fairly and correctly, but they also aim to prevent fraudulent or exaggerated claims.

Their goal is to establish a clear, factual basis for the claim, balancing fairness to the policyholder with the company’s interests. This requires strong analytical and communication skills to evaluate information, determine damages, and negotiate settlements.

Initial Communication and Essential Details

The first conversation with an insurance adjuster sets the foundation for your claim, making it important to communicate carefully. When discussing the incident, provide only factual information such as the date, time, and exact location of the event. You should also state the parties involved, including names, contact information, and types of vehicles. Describe what happened objectively, without offering opinions or speculating on causes.

It is important to avoid admitting fault or using apologetic language, even if you feel partially responsible. Phrases like “I’m sorry” or “it was my fault” can be misinterpreted as an admission of liability and used to reduce or deny your claim. Refrain from speculating about what might have caused the incident; if uncertain, simply state “I don’t know.”

You are generally not obligated to give a recorded statement. Insurance adjusters may request one to “get your side of the story,” but these statements can be legally binding and used to find inconsistencies later. It is often advisable to politely decline a recorded statement until you are fully prepared or have sought legal guidance.

Do not discuss specific dollar amounts for damages, injuries, or potential settlement figures at this early stage. You may not yet know the full extent of your losses, and offering an amount could undervalue your claim. Avoid making definitive statements about your health, such as “I’m fine,” as some injuries may not be immediately apparent or could worsen over time.

Ongoing Interactions and Documentation

After the initial contact, maintaining clear and consistent communication with the insurance adjuster is important. Document every interaction, noting the date, time, who you spoke with, and a summary of the conversation. This record can be helpful if any disputes arise. For communications, consider using written methods like email or online portals to create a clear paper trail.

The adjuster may request additional documents, such as police reports, medical records, or repair estimates. Provide these promptly, ensuring they are accurate and directly relevant to your claim. For medical records, avoid signing broad medical releases that give the adjuster access to your entire medical history; instead, provide only records pertaining to the current incident.

When responding to follow-up questions, maintain a factual and objective tone. Avoid emotional language, opinions, or unnecessary elaboration. Stick to what you know for sure, and do not speculate or guess about details you are uncertain of. Consistency in your statements is important, as discrepancies, even minor ones, can be scrutinized.

While cooperating with the adjuster is necessary for the claim to proceed, avoid oversharing personal information that is not directly relevant to the incident. This includes details about your personal life, unrelated past claims, or conversations with other parties involved. Provide only the information directly asked for, and remain polite but firm in limiting discussions to the scope of the claim.

Discussing Claim Resolution

As the claim progresses, the adjuster will present their findings and potentially an offer for resolution. During this phase, listen carefully to the information the adjuster provides about damages and coverage. It is important to understand the basis of their offer, including how they calculated medical expenses, lost wages, and other related expenses. The adjuster may use various methods to determine a settlement amount, considering liability, policy limits, and the severity of injuries.

You have the right to ask clarifying questions about the offer or their investigation. Inquire about how specific items were valued or if certain expenses were included. Initial settlement offers are lower than the true value of the claim, as insurance companies aim to minimize payouts.

It is important not to feel pressured to accept an immediate offer. Take your time to review the proposed settlement, considering all current and potential future expenses related to your claim. Accepting a settlement typically involves signing a release of claims, which means you forfeit the right to seek additional compensation later, even if new complications arise. Therefore, a thorough evaluation of the offer against your full losses is important before making a decision.