What Motivates The Adjuster’s Actions?

All adjusters have 2 goals: offer the lowest possible payout and avoid a lawsuit.

The adjuster’s offered payout reflects the information on the claimant’s damages

• The expenses linked to treatment of the claimant’s injuries
• The income lost, while the claimant was recovering from the accident-caused injuries
• The amount of pain and suffering that the claimant had endured
• Any other negative effects from the claimant’s injuries, such as the development of scar tissue
• In addition, any need for the claimant to spend money on additional medical equipment would count as a negative effect.

Adjusters must also take other factors into consideration, when trying to arrive at the appropriate offer for a payout.

Each adjuster checks for any limits that were mentioned in the policyholder’s insurance documents. An insurance company would never agree to give a claimant more money than what had been stated in the defendant’s (policyholder’s) insurance documents.

Adjusters’ considerations include an assessment of the strength of the claimant’s case. That requires an analysis of what a jury might offer as a verdict, if provided with the existing evidence. Would that verdict ask that the plaintiff be paid a large sum of money, or would the jury feel that a small payment would match with the plaintiff’s reported damages?

If an adjuster’s experience were to suggest that a jury might feel inclined to give the plaintiff a large award, then that feeling would motivate a specific action. Namely, it would cause the adjuster to focus on coming forward with a satisfying offer. In that way, the insurance company would probably not have to face a lawsuit.

When are insurance companies apt to face a lawsuit?

Insurance companies are expected to act in good faith, so any action that could be viewed as bad faith might lead to the initiation of a lawsuit. That is why adjusters read the relevant insurance policy so very carefully, as per personal injury lawyer in Barrie.

If a policy had promised a certain level of coverage, then the insurance company ought to offer that level of coverage. Otherwise, the policyholder might feel inclined to file a lawsuit against the uncooperative and dishonest insurance company. By the same token, if a customer/policyholder had agreed to pay a certain premium, then the insurance company would have reason to expect that payment. If it had not been made, then the promised coverage would not have to be offered.

Adjusters are well aware of how any customer’s behavior might affect their own obligations. That awareness could motivate them to send a warning in response to a submitted claim. That warning should be viewed as evidence that the sender/adjuster did not expect a lawsuit, because the filer would be a customer that had fallen behind in payments.