If you are involved in an accident, there are chances of working with an insurance adjuster to help you claim compensation from the at-fault insurance company. Dealing with an insurance adjuster is not a walk in the park, and it can be a devastating experience if one is not careful enough. If it becomes hard to deal with the insurance adjuster, you should hire a professional attorney to help you with your insurance claim. We at Las Vegas Personal Injury Attorney Law Firm are ready to offer the best legal services if you fall out with your insurance adjuster.
Definition of An Insurance Adjuster in Nevada
Under NRS 648 A. 020, an adjuster means any person involved in the compensation of a claimant or a policyholder without limitation ion a fee or commission, and reports to his or her principals to claims:
- That has risen under an insurance contract for surety insurance, property, workers compensation insurance, on behalf of the insurer or insured
- Rising against a self-insurer who is provided under a similar coverage according to the statute
The adjuster is limited to:
- registering in more than one type of adjuster
- Involving in any business of repairing auto bodies or own an interest in such businesses
- Licensing as a producer of property. Surety or casualty expect as a bail agent.
There are four types of licenses that an insurance adjuster can get in Nevada. The licenses are as follows:
A person is considered to be an independent adjuster in Nevada under the following:
- A contract for adjustment with an insurance company or self- insurer
- Is considered by the Internal Revenue Service as an independent contractor other than being an employee of the self-insurer or insurance company
- Is involved in negotiating, investigating and settling property claim, surety or compensation claims on behalf of the self- insurer or insurer
A person is considered as a company adjuster under the following:
- Is an employer of an authorized insurance company and
- Is involved in the investigation, negotiation, and settlement of workers' compensation claims
A person is considered as a public adjuster if he or she represents the financial interests of the policyholder and is not involved in the investigation, negotiation, and settlement of workers' compensation claims.
A person is considered as a staff adjuster if he or she investigates, negotiates, and settles workers' compensation and is an employer of a third party administrator.
Nevada has a license for an associate adjuster, but such kind of licensing will be available as of January 1, 2020.
Licensing Requirements for an Insurance Adjuster in Nevada
For anyone to become a qualified Nevada insurance adjuster, he or she must:
- Have attained eighteen years of age and above
- A resident of Nevada for 90 days before submitting the applications
- Have two years of experience ( within the last five years ) handling adjuster claim
- Successfully passed a state insurance examination in line with the job that one is applying for.
Types of Claims from an Insurance Company after an Accident
To get more from your compensation claim, you need to know what types of damages that you can include in your demands. You can decide to get compensated for your injuries through negotiation with the insurance company or a lawsuit in court. Generally, your claim includes three categories which are:
Special Damages: Hard Costs
These sorts of damages are directly related to your injuries and can be documented and calculated. Proving special damage is a matter of gathering the receipts, bills, and other documents that show the actual costs of your expenses during your treatment. Four sub-categories fall under special damage, and they include:
- Medical costs
- Lost income
- Personal property damage
- Out-of-pocket expenses
General Damages: Pain and Suffering
This sort of damages include non-economic losses such as emotional distress, pain and suffering, loss of consortium, and loss of enjoyment. These kinds of damages do not have a dollar value on them, and it is hard to itemize their bills.
The insurance company will compensate for the general damages based on the kind of insurance that you have. Some auto insurances, such as workers' comp and no-fault auto insurance do not consider compensation for this kind of damage.
This kind of compensation claim is done on behalf of a deceased person following a vehicle accident. You will be seeking compensation for:
- Pain and suffering before the death
- Funeral expenses
- Medical expenses before death
Surviving family members can also seek compensation for:
- Emotional distress
- Loss of services such as home care
- Loss of financial support from the deceased
- Loss of consortium
How to Deal with the Insurance Adjuster
There are a couple of factors that define whether you will successfully engage your insurance adjuster and get compensated as per your expectations. Here is a process that explains how a typical claiming process should be.
Notify your Insurance Company
The first thing that you need to do after an accident is to notify your insurance company. This is as per the clause provided in most insurance that requires the policyholder to inform the insurance company after an accident.
Some people prefer to file a first-party claim with their insurance company to have their vehicle repair costs covered by the company and have it claim compensation from the at-fault insurance carrier. Working with your company can be a remarkable idea rather than working with an adjuster. However, your collision coverage can fail to be covered as per your expectations since your insurance company will try to cut down your expenses. Therefore, choosing an adjuster is quite reasonable if you want coverage that matches your expectations.
First Contact with the Adjuster
Soon after you have notified the insurance company that is at fault, an adjuster will be assigned to help you in your claim. The adjuster will either call you, write to you or meet you at your home, depending on what seems convenient.
Do not be fooled by the adjuster to record a statement or sign a release to access your medical records since there are no legal requirements that require one to give any statement to the insurance company. Once you decide to meet the adjuster in person, record a statement, or sign anything, you need to be ready to handle your claims without the intervention of an attorney.
Note that the statement or anything that you sign with the adjuster can be held against you as you continue with your claim. Therefore, watch out when giving a recorded statement. Therefore, consider the following when giving your statement.
- Never go to a rant, complain or discuss anything that might lessen the amount you intend to claim
- Stick to the facts and avoid talking about issues about your personal life, such as divorce. Giving information about your problems can make the adjuster think that they are the source of your distraction that led to the accident. Also, it can indicate that you are trying to settle the claims since you need some money urgently.
- Do not allow the adjuster to throw you off track and get you to make judgment outside the facts. Decline any attempts made by the adjuster meant to interrupt you from giving the correct proceedings of your accident.
- Record your statement along with the one recorded by the adjuster. In this way, you will easily refer to it when preparing for the claim or if the one provided by the adjuster does not reflect your true statement.
- Remain polite with your discussion. The adjuster might be annoying at some times based on the questions that he or she poses to you. Therefore, you must beware of any potential indicators that suggest that you are unreasonable or ill-tempered.
- Do not talk about the severity of your injuries despite how compelling it might be. Designate your conversation only to the areas that have been affected in your body and avoid being too specific. If the adjuster asks about the doctor who is helping you, decline from such questions since it is not the information that they need.
As you submit your medical release forms, note that the adjuster will try to get copies of your medical records dating back to five or ten years. This is meant to check for pre existing injuries that he or she can use to limit your claim. It is essential to involve your attorney so that the adjuster can focus only on medical records that are directly related to your accident injuries.
There are a couple of questions that the adjuster will pose during the first contact. Generally, the adjuster will pose the questions in the following order:
Current Location of Your Car
The adjuster needs to know about the location of your vehicle to confirm that there is no storage accruing from the tow shop. If the vehicle is in a tow shop, the adjuster will contact the shop to authorize its release and move it to a body shop of their preference. It is recommended to release your vehicle rather than fight with the insurance company if you want everything to go accordingly.
The Extent of the Damage
The adjuster will try to determine whether your vehicle had any damages and identify the location of the damages. Speak in the simplest terms possible such as damage on the passenger's side, driver's side, or the back. Whether the car was severely damaged, ensure that they know about it. Also, if the damage was minor, you should notify them as well.
The Proceedings of the Accident
As provided earlier, the adjuster might tempt you to give a statement, which is not a good idea to respond to it. However, you should respond to their questions with clarity when you are not shaken. Request the adjuster to allow you to settle for a few days before you talk to them.
Whether Anyone Was Hurt
It is vital to let the adjuster know whether you incurred any damages to determine whether your insurance has an option to cover their medical costs. You should inform them what you know, and if you are unsure about the injuries suffered by anyone else, tell them about it as well.
Confirm your Conversation With Your Adjuster
You should request the adjuster to submit a letter confirming the conversation that you had with him or her during the first contact to prove whether it is right. Following the confirmation letter, the insurance company will probably send a Reservation of Rights letter. The letter confirms that you have not accepted liability of the accident or injuries even though you might have agreed to discuss the claim with them.
Continue Communicating with the Adjuster
You need to keep in touch with the adjuster and update them with your progress as you continue receiving your treatment. Avoid discussing any settlement offer presented by the adjuster until you are fully healed, and after your doctors have released you from the treatment.
In most cases, the first settlement offer presented by the adjuster is usually a low offer since it does not cover for your pain and suffering. The insurance adjuster will only decide on the offer after completing an assessment of the damages. Note that the insurance company is usually skeptical of issues such as soft tissue injuries and may try to avoid including them in the first settlement offer.
Once you receive a settlement offer, wait a few days, and write a rejection letter. Also, remain proactive by contacting the adjuster until you get a reply to your demands.
The insurance will keep on sending more paper, so you should organize the paperwork to ensure that everything is on your fingerprint when negotiating for a settlement. Also, keep sending copies of your medical bills, statements of lost wages, and out- of – pocket expenses to show that everything you are doing is in good faith.
Handling Car Repairs
Most insurance companies suggest the claimant's car be taken to their preferred repair shop. However, you should not accept their choice if the shop is not trustworthy. Ask them to take it to a repair shop that you can trust, which they should agree on if it has reasonable charges that are acceptable to the insurance company.
Beware of the kind of spare parts that they will be used in repairing your care. The insurance adjuster can authorize the vehicle to be fitted with after-market parts instead of OEMs unless you speak out. OEM ( Original Equipment Manufacturer) are parts that are originally made for the specific car. They are quite expensive and warrantied to ensure that they are quality like original parts. On the other hand, after-market parts represent parts that are not produced by the car manufacturer. They sell at a lower price compared with OEMs and are not as good as them.
Ask the insurance company at fault to cover the expenses for hiring a car as yours is in the repair shop. The adjuster can decide to pay directly or ask the agency to write and keep receipts that will be reimbursed later on. Unless you want to pay out-of-pocket, the adjuster has the responsibility of catering for your rental expenses, so this should not be a problem for you at all.
Negotiate Your Car Accident with The Insurance Adjuster
A successful injury claim should prove that you were hurt, and the injuries were a result of someone else's fault. That's why it is crucial to start collecting evidence such as police reports, pictures, and medical reports once you are hurt and during your recovery. Even so, there are a few considerations to make, as provided below.
Show that Your Were Hurt
It is hard to prove that you were hurt only by showing stiffness and pain. You need to present medical bills and records that connect your injuries to the accident. Ensure that you get the medical records after the emergency medical care to prevent the insurance company from pouncing on any chance that they can use to disapprove your claim. Once you are ready for the claim, you can request copies of your injuries and medical records from every medical practitioner involved in your treatment.
Prove That Someone Else is at Fault of Your Injuries
A second-party insurance company cannot pay for your injuries unless they prove that the person that they insure takes the actual blame for the injuries you are suffering from. You can use evidence such as pictures, videos, and eye witness statements to prove that the other person takes the blame for your injuries. If the insurance company agrees that their policyholder was at fault, they will end up paying your losses.
Settlement for Your Compensation Claim
There is no precise method that the insurance company uses when settling a compensation claim. However, there are particular factors that the company can consider to make the settlement reasonable and fair. Here are the factors used in settling the different types of damages incurred.
Settlement for Your Damaged Vehicle
Settling for your damaged vehicle involves the costs of repair and replacements made. For instance, if you want to replace the bumper, your compensation will be based on whether to repair or replace it, depending on the extent of the damage. If the cost of replacing an extensively damaged bumper exceeds the car value, the company might decide to pay up for your vehicle. Please note that this kind of replacement might not be enough to buy a new car since the company considers the depreciation value of your vehicle.
Settlement for Your Injuries
Negotiations for your injuries are done separately from your property damage. Your compensation depends on the documentation of wage loss, medical bills, and the extent of your injuries, as documented in the report.
Settling Your Pain and Suffering
This is an addition to your medical bills that accommodate both past and future discomfort that result from your injuries. You must reach a point where there is no further improvement or treatment expected from you before you proceed to claim for your pain and suffering.
Some of the factors that determine your pain and suffering compensation include:
- Scaring that led to permanent disfigurement
- Possibility of future treatment
- Extensive burns
- Spinal cord injuries
It is recommendable to consult your injury attorney to avoid leaving out a crucial settlement option for your future medical care. Please note that the settlement is received once, and any compensation that is left out will be waived out once the settlement is completed.
How to Deal with a Roadblock During Negotiation
If you find yourself in a roadblock and cannot manage to settle your claim as expected, there are other options that you can explore. Some of these options include:
Speaking to the Insurance Adjuster Supervisor
Remain polite and explain the stalemate that you have reached upon with the adjuster assigned to you and check if they can assign a fresh one by the adjuster. You should be prepared for a push back if needed and move through your claim and explain that it is for both your interests to solve the issue at hand.
Notify the State Department of Insurance
This is essential when the negotiations are unjustly delayed after different offers have been submitted to you. Take copies of any document that you have and clearly outline the reason for your complaint as you call or write to the state department.
Hire an Attorney
Speaking with a personal injury attorney would be a remarkable step towards a successful settlement. The attorney will help you negotiate through the most detailed aspect of your claim and help in quickening your settlement as well. Once you have decided to engage an attorney, you should cease communicating with the insurance adjuster and refer any communications or contacts to your attorney.
Find a Las Vegas Personal Injury Attorney Law Firm Near Me
Dealing with an insurance adjuster can be hectic. It requires a lot of follow up and documentation, which can be hard as you suffer from the agony of your car accident injuries. However, choosing an attorney could be a remarkable remedy for a quick and fair settlement. We at Las Vegas Personal Injury Attorney Law Firm have the experience and resources that you need to ensure that you get fair compensation in the shortest time possible. Contact us at 702-996-1224 and talk to one of our attorneys.