Insurance Companies and Claims

One of the parties which you will be in contact with after you make a personal injury claim is the insurance company. You will also be most likely in contact with the adjuster. The adjuster will investigate, value, and settle the case, or not.

After you have filed a claim with an insurance company, what do you do? What can you expect? You should know that the insurer wants to get all the facts before they agree to settle the claims. All insurance companies, as much as possible, would want to resolve the case in the cheapest way possible. They will not settle if something is missing.

If they do not get all the facts, you can expect the attorney to try and make a lowball offer or just let the case go to trial. This is because most insurers believe that whenever they cannot get their hands on the necessary facts, the injured person is hiding something.

Investigating the claim

Before making a settlement, there are certain facts which adjusters want to know and they are the following:

  • Police reports connected to the incident
  • The medical records of the injured person
  • What the insured says about the incident
  • All other written reports which are related to the accident
  • Proof of earnings of the injured party
  • Information about prior personal injury claims

Analysing facts

After the adjuster has all the necessary facts of the case, he will review it. Injured parties should know that adjusters read every page of the medical record. If there is any page which has not been photocopied, the adjuster will notice it. Any missing facts is potentially damaging to the plaintiff.

After reviewing the facts, the adjuster will analyse them and think about the case’s value. The value of any claim is based on the damages and liability. What is used to calculate a settlement amount? The injuries you suffer, as well as the financial losses connected to these injuries are used to compute a settlement amount.


There are numerous considerations when settling claims and one of the most important is whether the plaintiff is able to prove that the defendant was indeed negligent. The adjuster also looks at the plaintiff’s chances of winning at trial.

How badly is the plaintiff injured? This is another question which the adjuster looks at. What damages are the jury likely to award at trial? What are the intangible facts? What are the facts and circumstances which are likely to sway the jury? When we say intangibles, it means the following:

  • Did any of the potential witnesses lie?
  • Is the plaintiff a likeable person?
  • Does the plaintiff have a criminal record?
  • Has the plaintiff been treated with quality medical care?


Inconsistencies with your story is a dynamite in a personal injury claim. If there is any lying and if that lying is exposed, he or she will lose. If one of the defendant’s witnesses or if the defendant himself lies, there will be a substantial verdict at trial. Lying and potential lying are factored into the claim valuation by the adjusters.