Filing an auto insurance claim isn’t on your list of things that you’d like to do in your lifetime.
In fact, pretty much anyone who owns a car would prefer that they could avoid filing a car insurance claims at all costs simply because of how stressful it can be to pick up the pieces after a car accident.
Unfortunately, a majority of drivers get into at least three accidents in their lifetime.
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Since the likelihood of you having an accident is very high, knowing the standard claims process is crucial.
While some insurers have a more streamlined process than others, all car insurance providers will assign a claims adjuster to your file to represent both you and the company along the way to a claims settlement.
What is a car insurance adjuster?
If you’ve never filed a car insurance claim and you’re not a professional in the industry, you’ve probably never even heard of the term claims adjuster.
In the car insurance world, the claims adjuster is the agent who’s assigned to handle one aspect of the claim or the whole claim.
With many carriers, there’s a physical damage claims adjuster and an injury-related claims adjuster. Each professional is responsible for investigating their own area of the claim based on their expertise.
After the claim is filed and assigned to the adjuster(s), their primary job is to settle the claim as quickly as possible without involving a supervisor.
Who does the claims adjuster represent?
When you file a first-party claim against your own policy, the claims adjuster that you will communicate with is employed by the carrier that you pay for protection.
While the carrier is legally required to use fair settlement practices when making an offer to a claimant, they represent the company and they have a goal to pay as little as possible for the claim.
If you’re filing a third-party claim after being hit by someone, you’ll still speak with your adjuster but who the adjuster represents will shift.
Instead of trying to negotiate with you to keep settlements low, they will negotiate with the other party’s insurance to get you a fair settlement that’s in your best interests as their client.
Determining Fault After the Claim is Filed
If you call your company up to report that you’ve had a loss, you’re not going to speak with your adjuster right away.
You will talk to a claims representative or to a customer service agent who will gather very basic information, but the file isn’t actually assigned to an adjuster for at least a day or two.
After the file is assigned, the adjuster will get straight to work to determine who was at fault for the loss when there was more than one party involved.
Fault determination is an important step in the settlement process because the adjuster needs to know which company will be paying out before anything else can be done.
How does the insurance adjuster determine who was at fault?
It would be very easy if every driver who caused an accident would just fess up to their mistake and admit fault but this isn’t common.
Since a single at-fault claim can double someone’s insurance rates, drivers often ignore their actions and try to play the not-at-fault role to attempt to keep their premiums low.
Since most people don’t admit fault, the adjuster has to use information that’s reported in the file to determine which party caused the accident. They will communicate back and forth with all of the other adjusters to negotiate and appeal decisions.
Here are some of the ways that fault allocation is performed:
- The adjuster will review the description of the accident and the drawings of the scene that were taken by the officer who reported to the accident scene
- The adjuster will look at photos taken by insureds and witnesses at the scene
- The adjuster will ask the insured, passengers, the third-party driver, and witnesses who gave their contact information to make separate statements
- The adjuster or an estimator will inspect the vehicle and document where the vehicle is damaged
- An estimator will visit the other vehicle owner to inspect damage reported for the other vehicle
- The adjuster will check for cameras in the area if there are contradictory or suspicious stories
If you’re filing a first-party claim or a claimant is trying to collect on your policy, the adjuster needs to verify that you have the coverage and sufficient limits.
They will access your most current policy and will also review the drivers on your policy just to ensure that you’re covered and there aren’t any coverage issues.
Determining How Much Your Vehicle is Worth
If you have physical damage coverage, your adjuster will be in charge of determining the value of your car so that the insurer will pay for repairs or a new replacement car. There’s not a single guide that tells the adjuster exactly how much each and every car is worth.
Since there are several different reference tools, adjusters will average out values by accessing more than one report. These reference tools include:
- National Automotive Dealer Association value guides
- Kelley Blue Book value guides
- Sales listings
- Sales records reported in the area
- Appraisals by third-parties
- Valuation guides for aftermarket features
After all is said and done, the adjuster will compile the information and make a settlement offer. It’s you who can negotiate or appeal a decision.
If you’re not happy with your insurer, you might want to look for a carrier with a better claims service reputation. Get instant online quotes now and find affordable premiums from a trusted carrier.