Dealing with Insurance Adjusters: What Are Your Rights?
by Christian Scranton
When communicating with insurance adjusters, it’s natural to want to be as helpful and forthcoming as possible so you are seen as cooperative rather than obstructive. Sadly, this good faith is often used against you—and if it feels like the other party’s insurance company is always trying to catch you out, they probably are. There is a number of tactics used by insurance adjusters to try and catch you doing or saying something that could undermine your own case, including: asking your friends, family and employer about your life after the accident without your permission; turning up at your home or workplace unannounced; and trying to dissuade you from seeking legal advice. All of these should raise suspicions but it can be so difficult to know where you stand legally as you work through your case.
Although unscrupulous insurance companies may not want you to be aware of your rights, you actually have more than you might think when dealing with the other party’s adjuster. So, what are you allowed to insist on when dealing with the other party’s insurance adjuster?
A letter of identification
You can insist that the insurance adjuster provide you with a letter identifying them and their belonging to the company. The letter should clearly state the policy number and any claim number(s) as well as evidence that the company covered the responsible party on the day of the accident. A failure or refusal to provide a letter of identification raises concerns either that the person is not actually a direct representative of the insurance provider or that the company is too disorganized to provide the right paperwork at the right time.
You have the right to refuse to discuss your case if the insurance adjuster turns up at your home address or workplace without an appointment. The purpose of showing up announced is to catch you doing something that indicates you are not injured or that your injuries are not as serious as you claim. If the adjuster turns up to your house and you are using a ladder to clear your gutters, despite this being possible with your particular injury, it will almost certainly count against you. This attempt to catch you out suggests that the other party’s insurance company intends to fight your claim as well as highlighting their willingness to violate your boundaries to do so.
You have the right to access legal advice and consult a personal injury lawyer at any time during the insurance investigations. If the insurance company refuses to pay you anything or you are offered a minimal amount, you can contact a lawyer and discuss the offer before accepting it. Remember that the insurance adjuster’s opinion is not necessarily final: you have the right to request the adjuster’s reasons for refusing to compensate you in writing and you can take this information to your lawyer to get more information from a legal perspective. Even if the adjuster thinks your case is worthless, a personal injury lawyer may still be able to achieve a settlement on your behalf so you’re not left out of pocket after your accident. Don’t let the insurance adjuster pressure you into signing your acceptance of an offer without seeking legal advice first.
Refusal to sign a consent form
You have the right to refuse to sign an “authorization” allowing the adjuster to obtain your medical and employment records. You are obligated to provide evidence of the nature and extent of the damage caused by the accident but you can source these documents yourself and provide them to the insurance company. It is important to note that there is a key difference between reports and records: if you request medical reports and employment reports (if you wish to add loss of earnings to your case), the information is restricted to what is relevant to your case. However, signing over access to your records will grant the insurance adjuster full access to all of your past—and future—medical and employment records, whether these are relevant to your case or not. No insurance company needs this level of access to your private information and there is a risk that irrelevant information could be misused.
Refusal to be examined by a “company doctor”
You have the right to refuse to be examined by a “company doctor” even if the insurance adjuster requests this. There is a risk that the company doctor chosen by the adjuster could make a biased judgement in the other party’s favor, so we generally recommend refusing this request entirely. If the insurance company insists and refuses to progress your case until you have done so, seek legal advice as soon as possible. This indicates that they are expecting their doctor’s findings to contradict your own providers’ reports, and they may then use your medical assessment in a misleading way. For example, if you are examined months after the accident, their doctor may claim that your injuries cannot possibly have been so severe based on your current condition, even though you required surgery and a lot of physiotherapy to aid your recovery.
Although it might feel like you are obligated to do whatever the insurance adjuster says, this is often not the case. It is, however, worth noting that you may in fact be obliged to cooperate with requests from your own insurance adjuster. The vast majority of insurance policies have “cooperation clauses” built in that force you to cooperate with your own insurance adjusters, meaning that you may be in breach of your own policy contract if you refuse to carry out their instructions. As with most legal matters, it’s best to consult a lawyer if you are uncertain at any point.
Our team of lawyers here at Scranton Law has extensive experience in dealing with insurance companies in personal injury cases. We are more than familiar with the tactics used by insurance adjusters to make you feel uncertain and worried about not cooperating. If you ever have any concerns when communicating with the insurance company representing the other party or your own insurance company, you can contact us for free, no-obligation advice. We even offer you a free case review so you can work out for yourself if the insurance company is taking your case seriously. After all, knowledge is power.