How Does The Insurance Claim Process Work?
Insurance companies are in business
to make a profit.
The insurance company’s profit is the
difference between what it collects in
premiums and what it pays out in claims.
So the insurance adjuster’s job is to
settle your claim for as little as
possible – after delaying as long as
possible.
Our job is to settle your claim for its
maximum value with the minimum possible
delay.
Insurance companies have developed a
huge bureaucracy to fight claims, to
sort out bad claims, and to pay as
little as possible.
I remember visiting an insurance claims
office in Kirkland. It was a room as
large as a gymnasium, and it was
organized like a first grade classroom,
with rows of desks facing the front. At
the front was a glassed in room for the
teacher.
So when the adjuster settles a claim for
$10,000 he takes the little file to the
supervisor in the glassed in room. And
the supervisor is likely to say “You
paid too much. This file does not
support a $10,000 payment.”
But, if that same adjuster settles a
claim for $100,000 and brings the
supervisor a thick and well-documented
file that includes complete witness
statements, complete medical opinion
letters, and comprehensive records of
all medical care, wage losses, and other
expenses, the supervisor is more likely
to say, “Good job, it could have been
worse.”
Our job is to help the insurance
adjuster build a file that supports a
full and fair claim settlement.
Our goal should be to maximize your
financial recovery.
We have a reputation for honest dealing;
for a fair but firm settlement posture;
for refusing to settle for a penny less
than the claim is worth; and for being
prepared to take a claim to trial if
necessary to get a full and fair
recovery.
There are basically five steps the
insurance adjuster takes in handling a
personal injury claim:
1. Collecting Information
2. Setting Reserves
3. Evaluating Damages
4. Negotiating Settlement
5. Defending in Trial if Necessary
Lets go through them one at a time.
1. Collecting Information.
Since the adjuster has to collect
information in order to understand your
claim, we provide all the required
information to establish that it is a
valid claim.
Sometimes insurance adjusters are so
busy looking for damaging information
about you or your claim that they miss
favorable information.
We collect and highlight that favorable
information: witness statements,
photographs of the accident, photographs
of your injury, opinion letters from
experts in medicine, accident
reconstruction, and economic loss.
We present the claim to the adjuster,
with full evidentiary backing, so the
adjuster understands the significance of
your claim.
2. Setting Reserves.
When a claim comes in, the company must
set reserves, an accounting entry, to
assure government regulators that the
company has set aside adequate money to
pay the claim.
If initial reserves are set too low,
when the time comes to settle the claim,
the adjuster will sometimes be too
limited in the amount of money he can
offer in settlement.
We get the appropriate information to
the adjuster as soon as possible to
assist the company in setting high
enough reserves that the ultimate
settlement can be for the full claim
value.
3. Evaluating Damages.
Since the adjusters must evaluate the
claim value, we provide them with all
relevant information, including
comparable cases from state, regional
and national publications, computerized
databases, and our own evaluation of the
claim’s value.
We don’t just wait for an offer; we help
create it.
4. Negotiating Settlement.
There is an old saying, “A lawyer who
represents himself has a fool for a
client.”
Likewise, a personal injury victim who
attempts to negotiate a settlement with
a professional insurance adjuster is
likely to recover far less than the
claim’s true value.
Do not attempt to negotiate a settlement
of your personal injury claim without
professional advice.
5. Defending in Trial if
Necessary.
If a settlement cannot be negotiated,
the insurance company must defend its
position in court.
Your lawyer must have a track record of
exceptional verdicts, so that the
insurance company realizes that trial is
NOT an easy way out.
In dealing with insurance companies, our
job is to take the stress off our
client's shoulders
and put it back where it belongs: on the
shoulders of the insurance company for
the negligent party who caused the
problem in the first place.
We've been doing this for 36 years.
Insurance companies know us. They know
our reputation for thorough claim
documentation, compassionate care for
our clients, and fair but firm
negotiating and litigating skills.
In fact, since insurance companies know
how well-prepared we are, over 90% of
our claims are settled out of court.
We have won multiple million and
multi-million dollar verdicts and
settlements and have established record
high verdicts and settlements in several
Washington jurisdictions.
Anybody can tell you how the insurance
claim process works. We know how it
works.
We have been doing this for 36 years.
