Tough Questions Adjusters Don't Want You to Ask | The Legal View | Farah & Farah
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- Опубліковано 9 січ 2013
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Discussing your claim with an insurance adjuster can be challenging, as it is their job to minimize the value of your claim. Farah and Farah attorney, Eddie Farah, provides answers to common questions you may have in regard to speaking with an insurance adjuster:
• Will I recover more money if I hire an adjuster than if I try to settle the case on my own?
• Why do I have to give a recorded statement?
• Why do I have to give medical authorization?
If you've been injured in an auto accident in Florida or Georgia and are seeking legal representation, call us at 866-599-0806. There is never a fee for your personal injury consultation.
He is telling the truth.We the insured spend thousands on insurance coverages and it is so sad we are treatedharshly when we need help.
Actually, as a claims adjuster, I can tell you...most adjusters want to get your claim over with and move on since we have many other cases going on at the same time. If you think that there is someone wasting time finding a way to screw you over then you can get in-line behind the big foot chasers. If your claim looks legit on the surface and meets all the requirements on the contract that you have signed on your policy we are going to want it pushed through as fast as you do and as smooth as possible. Most laws are actually in benefit of the insured not the company and most adjusters are people like you who are just trying to do an honest days work. There is absolutely no perks or benefits to screwing you over. If anything, it gives us a bad customer service rating which is frowned upon and a headache. If you don't like the offer you are more than welcome to say so and usually we can rework(within our boundaries) to make you satisfied. Still unsatisfied? Well you can get another adjusters take...it's the law! Bottom line....you don't want to feel screwed after an accident? Read your policy like a responsible person and if you want all the good perks pay for them. There will be no surprises otherwise. We strictly follow the guidelines clearly printed on your policies'.
You apparently don't live in Florida. Insurance companies are not in the business of paying claims, they are in the business of making money. Deny Deny Deny. You have a torn up roof from a hurricane? We'll fix it, no problem. Your roof tiles may not match, the integrity of your roof may be compromised because the tile doesn't have the same interlocking system, but...to bad so sad, we signed up to pay to "fix your roof" not replace it, even though you have replacement cost coverage and ten times more insurance coverage then the price of a roof. So you're forced to get an attorney to file a bad faith claim.
What do you say to that, Mr. Insurance adjuster?
You must have missed california as well
I am a veteran adjuster. Here's some common sense answers to these questions I supposedly don't want to hear:
Question 1
"Is it true...if I hire an attorney, I'm likely to recover more money...". The answer is maybe. If you were injured in an auto accident involving multiple vehicles, if your injuries are serious or result in permanent disability that may exceed available coverage on a defendant's policy, or involving uninsured and underinsured motorists, or numerous other complex legal matters, an experienced attorney might be able to help you. If you were in a fender bender that resulted in your sore neck, you won't recover more. Sorry, Mr. Attorney, but the claim is settled at its value and attorney representation is irrelevant. Having settled thousands of these claims, I can tell you those represented by attorneys tend to seek more medical treatment which in turn tends to result in higher settlements although that does beg the question of why when necessary treatment is supposed to be determined by a doctor, not a lawyer and the chiropractor he has on speed dial. Regardless, if you hire an attorney, you pay the attorney's fees via a percentage of the settlement, not the insurance company. Therefore, for the same treatment for the same injury you obviously net less money in settlement if you hire an attorney. Occasionally, a hear about a claimant who figured this out at the end and wanted to fire their attorney, only to find out the attorney has you in a contract and will get their fee.
Brian Withers Spot on
Brian Withers WELL, WHAT ABOUT THESE OTHER INSURANCE COMPANIES, FOR SLIP AND FALL, JUDGE GRANTED PRE-EXISTING, MEDICAL, WORKMEN COMP. 8 YRS. WAITING, INSURANCE, TRYING TO HOLD OUT AS LONG AS POSSIBLE. AND MY LAWYER BEHAVES VERY INDIFFERENT TOWARDS ME. SHE DON'T SEEM TO BE ON MY SIDE AT ALL. FOUND OUT THESE LAWYERS, GET PAID, AS LONG AS CASE SITS ON THEIR DESKTOP, SMDH
I never gave permission to release my medical records but the at fault adjuster got ahold of my medical records anyway
Excellent! Thanks Farah and Farah. Viewed in Jan 2018. Thumbs up. UNITED KINGDOM
I wish I knew about the medical authorization part. The adjuster asked for mine two times and TWICE I had to go out of my way to have the papers faxed to him. He asked again for the papers and well...*sigh* This video would have been helpful if I saw it four months ago. Thank you!
+sarah18497 He is extreme;y incorrect. Its really to keep the customer from having to do so much paperwork
Bergis has a business located in a high crime neighborhood. When he applied for commercial insurance, he was denied. The underwriter noted that the issue of _________ had not been met.
Thank you sir!
have you had any cases with Safeco adjuster under valuing the damage ??
Insurance company is the biggest crook working through the adjusters. Attorney knows it and wants a cut. Both are shitty jobs that don't produce any goods. They make money out of people's misfortunes.
They totaled my SUV Equinox Hochhiem insurance , I said what good does it do to pay insurance if they totaled my SUV, I'm keeping my SUV . And I'm getting it fixed on my own. I need to find out my rights , need to reinstate my SUV . Making legal to drive
My drip edge fell off will my insurance pay for that?
Last question is "why do I have to give you a medical authorization...".
The simple answer is you don't. The more complex answer is medical information is guarded by HIPAA and Medicare/Medicaid and state's laws may play into how information is gathered. Also, Medicare/Medicaid, your private health insurer if you have one, individual medical facilities policies and collection procedures, etc. may all factor into how payment is to be disbursed. You can be responsible for gathering all the medical reports and bills yourself, if you don't. However, medical billing and doctor's reports are notoriously complicated and getting more so every year, it seems. Claimants often send their medical insurance "Explanation of Benefits" to the adjuster. That isn't a medical bill. Sending a bill with no report won't work either. The adjuster needs to see what they are being asked to pay for. Sending some of the reports and not others looks happens often and looks a lot like trying to hide some of the information such as contributing factors such as being overweight, prior unrelated medical conditions such as arthritis or a heart condition, etc. Again, the adjuster's job is to determine what, if anything, is owed and to whom based upon all available information. If you want to gather the information yourself, have fun with all that. I actually prefer letting someone else gather medical information. I don't have the time for you.
And this is supposedly a "question" I don't want to hear. Hmmmmmm.
Great subject. Public Adjuster PA and NJ, Philadelphia, South Jersey, Salem County, Vineland, Cherry Hill NJ
I question why an insurance adjusters asked for my social security number? Is it required to settle a claim?
Agree with Hmmmwhat?
A recorded statement is used to obtain additional facts of loss. It has nothing to do with how much you think insurance lowballs their customers. Not to mention, if everybody's claims were paid out 3.5x as much, i am certain the premiums would go up proportionally
Is this only when there is a physical injury involved? What about a case of my totaled parked car that was totaled by a drunk driver. The car although 10 years old only had 45,000 miles on it. They only want to give me what it can be traded in for value and also want to debit my $750 deductible towards what the other insurance guy is giving me so basically I'm out $750 bucks and a used car that only had 45,000 miles on it, besides having sentimental value attached to it because my Mom gave it to me when I died. This is in California.
Femmi Girlz unfortunately property is paid on actual cash value. this means it is paid based on what is is worth at the time of loss - sentimental value or replacement cost aren't considered. in regards to your deductible, you are responsible for any deductibles youbelected when purchasing the coverage. however, your insurance carrier should pursue recovery from the at fault party to include any out of pocket expenses you incurred. you are paid first from any recovery - the insurers job is to make you whole again - as best as possible. as a veteran adjuster of over 10 years - I can assure 99% of adjusters are working hard for your best interest.
Jim Wagner is wrong. Trying to settle a claim on your own is a bad idea. Plus, since when is a soft-tissue injury not a serious injury? If someone gets whiplash and has doctor visits plus physical therapy, that is serious, because you are now racking up medical bills, then you get to deal with your medical insurance on top of a motor carrier insurance company!
+agentk1986 I'm so sorry but soft tissue is not a serious injury, pt is not needed and you could have kept all that money in your pocket....
@@AdoRHOablySpoiled
How stupid an unrealistic you sound in your conversation
If your hurt your hurt period get therapy
Oh I just cant hold back ... its just so funny, listening to a lawyer try to put down and ENTIRE industry, knowing how lawyers love to get your pocket ha ha ha ha its just so funny, because adjustors are likely more honest then any lawyer
Is this guy really an attorney?? Being a claim adjuster I tell you he is way off on his information lets start with
1. Worked injury claims for 4 years both attorney represnted and unrepresented. Say you 2k in medicall bills and you extend a claimaint an offer of 3k. 2k medical one 1k for you. Then they decide to get an attorney and you get a settlement of 9000. Attoney gets 30-50% right off the top so lets say he got 3k, he sent you to a chiropractor to run up the medical bill thats how they get paid so lets add another 2500 to the medical you got 6k left and the medical bills are 5500 if you got an honest attorney he will try to get a settlement on the medical bill if not he will pay the full medical leaving you with 500 less than what the adjuster offered you upfront. The overall cost of the claim was more but the attorneys and medical providers are the ones reaping the benifits.
2. Recorded statement 99.9999% the officer didnt see the accident and an adjuster just wants a first party account of what happened.
3.medical auth is needed to get records and bills. Yes if there is something perneat in the records that you found you might follow up. But you cant send a blanket request for any and all medical records.
Now here is a question to ask the attorney if they care so much about the client why do they refuse to have anything to do witih the repairs on the vehicle
the question is if the money recovered will still be more AFTER attorneys fees. you did not answer this question. Does the insurance companies' own data and research also show that Claimants receive more AFTER all attorneys fees? i am much more interested in the answer to that question.
If I get "three and a half times more", as you specifically stated at the beginning of the video, yet all of your fees cause the net payout to my individual self to be less than if i had settled it myself, why would i ever want to hire an attorney?
Please note that i am a skeptic and am curious. I mean no disrespect. But it seems like a valid question to me, in the process of choosing proper representation, et cetera...
My SUV is fixable , don't I have that right im the state of tx
Funny ... a lawyer talking about how dishonest other people are HA HA HA HA HA ...
"Don't want to pay extra money on insurance? Come pay US, we'll take your money and make sure the insurance companies don't!"
That's not true!!! It depends on the limit of the insurance coverage!
yeah and the reason why you have said that is that you make lots of money ...that's the real truth ...
Thats a lie i had a accident 17,000.00 i walked awy with 4,000.00
Assertion regarding the police report
"...almost all the information the adjuster needs is in the accident report...". Not true. The police report is a public document, you can obtain one from the police yourself and you can read it for yourself. The officer records on the report what evidence is obvious at the scene of the accident - what drivers and what vehicles, position of the vehicles, path of the vehicles to arrive at that position, inasmuch as that can be determined. Also a summary statement from each driver describing the basics of what happened. The officer's job here is to first protect safety, second to secure property and last to determine if any motor vehicle laws were transgressed. They are not there to determine liability, although liability may be obvious and the report may show that. It is the adjuster's job to review the available evidence and determine who did what and how that weighs on on liability in respect to the laws of that state.
You should make clear which type of insurance adjuster you’re referring to. I’m a property claims adjuster and none of these are true from my own personal experiences. I’m an independent insurance adjuster with years of contracting background - my estimates are 95% of the time higher than the contractors unless it’s a complete BS estimate. I’m paid in tiers as are most independent insurance adjusters so trust me when I say WE ARE incentivized to write estimates for all legitimate damages related to whatever reason I’m out there.
PAs and/or Attorney fees will reduce a policy holders pay out to themselves for the damages if they’re working with a good adjuster.
There are good and bad adjusters, contractors, and attorneys just like in any other field or industry. Don’t blindly listen to these attorneys and public adjusters or state insurance companies and adjusters are against you and don’t like to pay out. WE LOVE TO PAY. When the claim is large we get paid more, contractor gets more to work with, and most importantly the policy holder gets more to work with and/or put towards their deductible.
Assertion regarding using the statement to devalue your claim
"...he wants to show inconsistencies in your statement and use that later on to try to devalue your claim...".
True, sort of. The purpose of the statement is first and foremost to determine who did what in order to determine liability. The value a claim is zero if the insured is not liable thus the value of a claim is not a consideration unless and until the insured is determined to be liable. So how is this sort of true? The adjuster will ask if there were any injuries and, if there were, whether an ambulance came to the scene, whether the injured person(s) were treated and released from an emergency room or hospitalized, etc. These questions begin to detail what the potential of a claim might be, relatively speaking. Obviously, if a person was treated and released, their claim is probably not worth as much as a person who had to be hospitalized and had surgery. As to "devaluing" - that would be a misuse of terms. Notice the emotion in the voice of this "attorney" when he uses this term. Loaded term, isn't it. Designed to incite anger and concern over what that dastardly adjuster is up to, eh? In truth, the adjuster values the claim at whatever that might be, based upon, once again, all available evidence. The popular notion out there is that the adjuster is somehow trying to get out of paying something that is owed. In reality, the adjuster is trying to close the file. To close the file, they must determine if something is owed and, if so, how much. No adjuster has the time to put into any one claim any effort at "devaluing", i.e. somehow paying less than what the facts of the claim indicate the claim should be worth.
Question 2
"Why do I have to give you a recorded statement...". The answer is if you are a claimant seeking recovery, you don't. You don't have to do anything you don't want to do. However, consider that the adjuster is tasked with defending their insured. That means paying a claim if the facts of the case indicate their insured was negligent and therefore liable. That means denying the claim if the facts of the case indicate their insured was not negligent and therefore not liable, or, denying if the claimant was also negligent, depending upon the laws in that state concerning contributory or comparative negligence. if you don't give a statement, the adjuster is still going to complete their investigation and make a decision on liability, based upon all available evidence. If you want your side of the story to be considered, a recorded statement is how you do that. Why recorded? Because the adjuster must document their file with how they came to a conclusion and all of that evidence must be preserved in case of future questions, audits or even suit. Nothing about the adjuster's actions is arbitrary, it is all supported by documented evidence. Oh yes, that humorous bit of invective at the end - asking the adjuster for a copy of the other party's recorded statement? The answer is no. The insurance company gathered that evidence and don't have to release that to you. If you want a statement from the other person, get it yourself. What about discovery? That is part of a suit, necessary to be certain both parties, plaintiff and defendant, fully understand the issues surrounding the case and useful for often avoiding actual time in court. Your claim isn't a suit but it is documented in order that if a suit were ever filed, all necessary documentation will be available at that time.
Adjusters are not on your side. They are trained to act like it but their best interest is to save the company money while screwing you as much as possible. I'm in the process of dealing with a nightmare of an adjuster at the moment. He's rude and defensive to me, to the car rental place and the auto shop. I'm going to file complaints against him until he's reprimanded. I want him to be fired and begging me to scrub my toilets for a living. Then I will be satisfied. Until then I will fight for this to happen even if it takes my whole life.
Response to givingmantoo: Something you should consider is that absolutely every single thing that is written by an insurance company is very well crafted for the insurance companies benefit by a team of attorneys. In addition the employees of each insurance company are trained with material to benefit the insurance company as far as the law will allow. Employee training is internally regulated by what most insurance companies call their compliance department or something similar which is a team of attorneys. For the most part, the term "Ethics" should not be used in the insurance industry. The real meaning of the term is "to do what you know is the right thing to do". For most people the personal understanding of the word ethics boils down to how you would want to be treated or how you would treat your best friends and family. All insurance is, is a contract governed by laws, so ethics are moved to the borders of what the law will allow. If you don't have someone helping you who knows the law, a trained insurance company employee, without going beyond the law, can easily convince the majority of people that they are getting all they are supposed to get. I know this is a very ugly commentary, but it is the truth. You may want to get a copy of The Crime of the Century by Ron Alford available at Amazon.com and other fine book stores near you :-)
Actually, this is pretty off....most complaints towards insurance companies are caused by agents not fully informing their insurers of their policy or the insurer themselves not being responsible enough to read through their policy. Most of the laws on insurance companies are benefits towards the insured and not the company. Also, it's actually in the claim adjuster's best interest to have a good settlement and have it closed quickly for no other reason except that they are personally held reliable for a lot of laws and contract agreements and they have many on-going cases that they are doing at the same time. Also, most people do not use their insurance all that often outside of doctor visits so the insurance company will profit every year. Like givingmantoo said...this is a lawyer trying to get into your pocket...most likely an ambulance chaser. Claims adjusters have no desire to screw anyone over and only follow the contract that the client themselves signed. Not saying there are never claims worth suing over, but most likely it was your own fault for not reading your contract or taking a cheap route with a shady insurance company.
HMmmwhat? I do my best to educate people with my experience in the insurance industry. I currently maintain a Life and Health license and worked for a public adjusting firm previously. What you are saying is what a lot of people believe because that is what they have been told. Reality hits really hard when someone actually goes through the process of filing a claim. Recently a friend of mine from church had a house fire. Of course she was distraught and not thinking well so I sat her down and went over the scenarios she would be dealing with. I had three public adjusting firms visit her home. I also have a construction background and told her there was over 100k in damages. She then received the letter from her insurance company offering 64K. After a little more investigation of the property along with the PA she hired it was obvious that the costs to repair the property would be over the limits of the policy which was 115K. She did have to make modifications with lesser quality materials in order to complete the work, but can you imagine if she had accepted the 64K offer. We know that the adjuster will come out and reassess if a little more is needed however this dramatically lengthens the repair process and if you are not a professional, you won't know what needs to be done. The proof of the cheapness of the adjuster is usually the number of items that are not even listed on the claim form. What is obvious to the trained eye is never obvious to the homeowner.
I am a claims adjuster with a full-lines license in Texas. My knowledge is first hand and how I make a living. While you are correct that many adjusters may have lack of construction knowledge therefore causing a claim to be off, you are off on your original comment. States govern the insurance laws for their own states. The laws regulate the companies and benefit the insured. The companies have no trouble profiting as they have more people who do not file claims in a year than insured's who do. Their lawyers also help them from being sued by lawyers like this ambulance chaser above that made a video to get into more people's pockets. Im not sure who you work for, but there is no way, or any reason to give a claimant less than they should get. None. Even companies with profit sharing benefits do not pressure their employees to do anything but satisfy their customers because they want them to resign another contract after their contractual period is over. If the claim doesn't seem right there are laws(that benefit the insured again) that say you can get another opinion and work on an agreement with the company. It takes longer to do because the claims adjuster must pass this along to higher ups in their division to work on the details that are being disputed. This is standard with anything in life and not isolated to insurance. My mother has also been an agent for over 25 years with so I grew up around the insurance industry. It's in everyone's best interest to have happy customers because in the end....returning clients and good reputation equal out to more money than screwing them on one claim.
Actually if anyone feels they are being treated unfairly, they can call the insurance board in their state. Each state audits claims and insurance companies can be charged heavy fines for unfair claims practices, so don't believe scare tactics by law firms who make money off of peoples accidents. Remember an attorney gets a lot more money than an insurance adjuster... while an adjuster wants to keep a job, the attorney wants to line their pockets. If the attorneys were merely good Samaritans, they would work for $50,000 a year. Think about it...
garland75043 both are crooks.
garland75043 State Commissioner in Ca was just caught taking money from Insurance Co. criminals!!!
You are full of it sir. The answer to your first question is that claimants can obtain MORE money if they settle directly with the claims adjuster on their personal injury case because they have just cut out the middle man. In regards to your second question- of course the adjuster wants to obtain your "recorded statement" Why? So you don't change your story and create a "he said / she said" finger pointing situation between you and the adjuster when they are trying to make a liability determination. Come on Mr. Attorney - what? People DON'T lie when it comes to injuries and money? Are you that naive or will you say anything yourself to get clients? Come on people - think about it. If you have a SERIOUS injury I would recommend getting an attorney, but the majority of accidents involved "soft-tissue" injuries - - that typically involve the neck and back (sprains and strains). You are much better off dealing with an adjuster directly.
This is so incorrect. I want a statement because police reports don't do anything other than clear up information and provide information on citations. Did the police officer witness the statement? No, so they can't determine liability based on statements provided after a loss. Additionally, more times than not, police document that they are unable to determine fault. Get your facts straight.