Nothing is more frustrating than setting up your claim after someone else causes a car wreck, and then suddenly, the adjuster ghosts you. You want to put this behind you and move on. As car accident attorneys in Houston, TX, we hear this question from prospective clients regularly:
“Why isn’t the adjuster calling me back?”
One reason an auto insurance claim adjuster is not calling you back maybe because they are just overworked and dealing with other claims—in your case or in others. But they may not be returning your call as a tactic to save money or to avoid your claim entirely. This article will discuss the reasons an adjuster may not be returning your call and when you should be concerned.
Sometimes, an adjuster does not call you back promptly simply because he is busy. Understanding the basics of adjusters’ roles can help one understand why they may not be calling. Most insurance companies split their adjusters between property damage adjusters and bodily injury adjusters. They each have a slightly different role in the claim process.
Property Damage Adjusters
Property damage adjusters deal with the damage to the vehicle and physical property in the vehicle. After a claim is reported, it is assigned to a property damage adjuster. Their role involves determining who they believe is liable and what percentage they are liable for, then negotiating a settlement for what they owe. Their job requires them to do many things, such as:
- interview parties and witnesses
- take statements
- inspect the vehicle
- work with the body shop to get the repairs approved
- assist in obtaining a rental car
- negotiate a property damage settlement
- confirm ownership and protect bank liens
- accepting or denying liability
- cutting settlement checks to the proper party or parties
But your claim is not their only claim. There are over 6 million car accidents every year in the United States, according to the Bureau of Transportation Statistics. Most car accidents result in two or more wrecked cars. Thus, at any given moment, an adjuster may be handling hundreds of claims in various stages of the process. Thus, property damage adjusters have much on their plates.
Bodily Injury Adjusters
While a few adjusters may handle property damage and bodily injury claims, most focus on one or the other. Bodily injury adjusters do their own evaluation of your injury claim. Just because a property adjuster pays to fix your car does not mean that the bodily injury adjuster will pay for your injury claim. They may pay all, part, or none of your medical bills, lost wages, and any other compensation you are asking for. Their job includes the following:
- reviewing witness statements and taking additional ones
- determining liability
- evaluating medical bills submitted for reasonableness and necessity
- evaluating injury/damages documentation
- evaluating other claim exposure in the case
- negotiating a settlement or rejecting the claim
- obtaining settlement agreements and releases for any claims they pay.
Like bodily injury adjusters, they may be responsible for evaluating hundreds of claims at a time. Additionally, the claims they handle may be at any stage of the process, including litigation and trial.
Insurance Adjuster Stalling Tactics
While adjusters are busy with claims, there are also times when insurance adjusters will not return your call as part of a delay tactic. This should be alarming. Delay tactics can be a negotiation tool, but they may also indicate that there are other factors affecting the claim, such as policy limit issues with multiple claimants or subrogation claims. If you suspect these things are occurring, you should immediately talk to a car accident lawyer to determine the best way to protect your rights.
Delay Tactics as Negotiation Tools
There are two reasons why delaying by avoiding the claimant can be a useful negotiation tool for an insurance claim adjuster. First, bills often start piling up when a person has been injured and off work. Time is the friend of the defense, not the plaintiffs. The longer the process takes, the more the process becomes both a financial and a mental burden. This makes the claimant start just to want it to be over. Plain and simple, the adjuster uses the process to wear the claimant down so he will accept less money to make it go away. Desperate people settle for less.
Second, injured people are often their own worst enemies when it comes to filing claims. Nobody wants to be injured. They want to get back to their normal life. The more time that passes, the more likely people are to “rebel” against being injured. Gaps in medical care make it look like an injured person is not really that injured. Trying to return to normal activities before you are ready and getting caught on camera or posting it on social media can be a claim killer. These activities can support a suggestion that the person is faking the injury to make a claim. This is the adjuster’s goal–let you harm your own claim because you get tired of going to the doctor.
Multiple Claimants and Limited Policies
You need to be wary whenever there are multiple claimants to the same insurance policy. An insurance adjuster has no legal obligation to try to be fair to all claimants. In fact, the opposite is true in most states, such as Texas. Under Texas law, when there is limited insurance coverage and multiple claims that exceed the policy limits when considered on their own, the adjuster must pay the first reasonable demand that gives them a limited but reasonable time to settle within policy limits. This is known as a Stowers demand letter. If other claimants get their Stowers demands in before you get your claim in, you may be left without any insurance to pay your damages.
Delays After Settlement
Sometimes, you agree to a settlement, and then the delays seem to start. Often, there are liens and subrogation claims that must be settled out of your proceeds. If you were unaware of this before you agreed to settle for a set sum, you may receive a lot less than you expected or even nothing. We have seen adjusters completely (and sadly legally) screw clients by getting them to agree to a set amount to settle when they know the claimant does not understand that the health insurance company or the hospital has a lien or even that a child support or tax lien must be paid from the proceeds. The adjuster will not give you any of it until that amount goes directly to the lien holder. Ensure you understand what liens you are legally obligated to reimburse before settling your claim.
Get an Attorney Involved
If you were injured and the claims adjuster is not returning your calls, this could be due to them being overworked, or it could be a strategy to devalue your case or deny you justice. A Houston car accident attorney can evaluate your case and tell you whether you need to be alarmed by the delay. Furthermore, having a lawyer fighting for you and advising you can help you ensure you are not getting the runaround so as to cause damage to your claim. The attorneys at Simmons and Fletcher, P.C. have been helping car accident victims recover since 179. We offer a free consultation and charge no attorney fees or court costs unless we make a recovery for you.