How Does Your Insurance Adjuster Determine Your Settlement Offer?

Personal injury settlements are determined by an insurance adjuster. You may want to find out how the insurance company arrived at a figure before accepting or refusing their offer. 

If you’ve been in an accident and are negotiating insurance compensation, you’ll most likely have to deal with a personal injury claims adjuster. Knowing how the insurance adjuster got the figure they’re offering will help you decide whether to accept or counter a settlement offer. 


Typically, the claims adjuster will request the full facts of the case in the same way an attorney would. They will probe the accident and injuries sustained, along with damages (if any). How does the insurance adjuster carry out these investigations?

They Speak with the Policyholder 

A third-party claim is made when an injured person files a claim against the insurers of the individual they believe caused their accident. In this situation, the insurance adjuster first contacts the company. Then, they’ll read the accident report or any other report to get a full view of the issue. 

They Investigate the Claimant

Insurance companies have a claims database where they keep data on past injury claims. The insurance adjuster will go through this database to see if you’ve made similar claims in the past. They’ll also use Google to see if there is any dirt on you that can strengthen their case. 

They Ask for Documentation Relating to the Claim

The insurance adjuster will get in touch with your attorney to get documents related to your claim. Documents may include medical reports and bills, evidence of property damage, earnings reports, and tax returns. 

The insurance adjuster will analyze the document carefully to find anything they can use to their advantage. They may look for prior injuries, suspicious earnings, and other forms of misconduct. The adjuster will refuse to make any offer till they are satisfied with the provided paperwork. 

They Determine Settlement Value

For the adjuster, deciding how much to pay a claimant comes down to two primary considerations: 

  • Can the claimant win at a trial if the case goes to court?
  • How much is the court like to award in damages?

There are two kinds of damages: Those that can be clearly calculated (Lost earnings, medical bills) and those that cannot be calculated (pain, distress, and suffering). 

The insurance adjuster may reduce the medical bills claim in situations where healthcare providers rather than doctors and hospitals provided care. 

They Evaluate Incalculable Damages 

Determining pain or suffering is often the most challenging part of negotiations. However, there are now formulas and software that bring some degree of precision to these sorts of claims. 

The Adjuster Comes with a First Offer

The insurance adjuster offers a part of what they believe the case is worth. They may decide to offer 45% of the case value. There are no regulations regarding first settlement offers, so the figure varies among adjusters. 

Insurance adjusters are at liberty to adjust their first offer based on the circumstances and the individual with whom they are negotiating. If a claimant is not represented by legal counsel, the insurance adjuster will likely come with a low offer. However, a plaintiff accompanied by an attorney is most probably going to get a decent first offer. 

If you’ve been injured or sustained damages in an accident and seeking compensation, it is in your interest to enlist the services of an attorney. Valiant Advocates have a network of experienced attorneys ready to help with your claim. We will instantly search and connect you to a personal injury attorney in your local area, who will reach out to you and discuss your case details. 

Call us now: (800) 910-6668. It’s time to get what you deserve. 


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