Claims Adjusters and Their Duties
When you or a loved one are involved in an accident, it is a reasonable first step to make a claim to your insurance company. After making a claim, your insurance company will assign a claims adjuster to the policyholder’s case, free of any charge. A claims adjuster essentially decides whether an insurance company is responsible for paying a claim. They are typically tasked with investigating claims; going to view the property damage, verify the claim is not fraudulent, ensure the claim is covered by the insurance company, discuss with legal counsel, decide the amount the insurance company should pay, and eventually settle the claim. If an adjuster decides the claim will be settled, they also are responsible for negotiating the claim and authorizing payments.
Adjusters, though employees of the insurance company, do have ethical requirements to policyholders. Some of the ethical standards required of company adjusters includes the following, which can be found in the Florida Administrative Code and Florida Administrative Register rule 69B-220.201: an adjuster shall treat all claimants equally, shall handle every claim with honesty and integrity, shall make unbiased and truthful reports, shall report any misconduct by fellow adjusters, hall exercise extraordinary care when dealing with elderly clients, shall scrupulously avoid any suggestion calculated to induce a witness to suppress or deviate from the truth, shall not advise a claimant to refrain from seeking legal advice, nor advise against the retention of counsel, shall not attempt to negotiate with or obtain any statement from a claimant or witness at a time that the claimant or witness is in shock or serious mental or emotional distress, and shall not knowingly fail to advise a claimant of the claimant’s claim rights in accordance with the terms and conditions of the contract and of the applicable laws of this state. This means that an adjuster has the ethical duty to work in the interest of the facts of the claim, rather than for the benefit of the company or policyholder.
How can Moody Law help you with an insurance claim? An attorney works for the benefit of the policyholder, with the goal of maximizing the clients’ possible settlement under his or her insurance policy. There can be value in hiring an attorney, especially if you feel as if the adjuster provided by your insurance company is lacking. A lawyer may be able to help you sue your insurance company for denying you the full value of your claim under your policy’s coverage. However, in any case, a lawyer can help advocate for you, and negotiate coverage and payment for your claim with the insurance on your behalf. As studies have shown, in many cases, hiring a lawyer can on average increase the value of a claim by more than what a claimant would get if they handled the claim themselves. Please contact Moody Law at (863) 733-9090 or at thefirm@moodylaw.com for a free consultation regarding your claim.