The Insurance Adjuster’s Role In Your Personal Injury Case

Car wrecks, slip and fall accidents, and numerous other personal injury incidents unfortunately happen daily. The circumstances of each of these events are as unique as the people who are involved in them. However, for every accident or wreck that results in an insurance claim, one thing is certain: an insurance adjuster is involved.

Once you file an insurance claim, you can expect an adjuster to contact you shortly thereafter. Adjusters may not explain their role in your claim or only offer a vague overview of their duties. 

Understanding the adjuster’s role in your personal injury case can keep you from making costly errors. Here’s what you need to know.

An Insurance Adjuster Works for the Insurance Company

It’s important to keep in mind that the insurance adjuster works for the insurance company, not you. It does not matter how friendly the adjuster is or if they are from your insurance company. The adjuster does not owe you any obligation other than to perform their job in accordance with the insurance company’s instructions and the law.

The insurance adjuster’s primary responsibility is to investigate the facts of your claim and determine the insurance company’s liability. In other words, the adjuster’s role is to look at what happened and decide whether the insurance company is responsible for paying your claim. If so, the adjuster’s investigation helps inform the insurer how much they should pay.

Your adjuster will fulfill this role by speaking with you and others involved in the accident. They may also review police reports, photographs, and medical records. They may also personally inspect certain items of evidentiary value, such as your damaged car, following a car accident.

The Adjuster’s Job Is to Save the Insurance Company Money

Adjusters are not interested in fairly evaluating your claim and ensuring you get paid what is fair. Instead, your adjuster will look for opportunities to undervalue your claim or reasons why the insurer need not pay your claim at all. Some common tactics that adjusters employ to accomplish this include:

Declaring the Loss Not Covered by the Policy

If the policy does not cover your specific loss, the adjuster may deny the claim without paying any benefit to you. For example, suppose that an uninsured motorist struck you. If you do not have coverage for this specific type of loss, the adjuster may deny the claim as not being covered.

Undervaluing Your Damages

Although the adjuster may consider bills and invoices when determining the extent of your loss, do not expect them to do so. In fact, the adjuster is more likely to use a model or resource that does not consider your actual losses at all when calculating the amount to offer as a settlement. 

Overestimating Your Degree of Fault

In California, any amount of fault attributable to you can be used to reduce the value of your claim. For example, suppose that you incur $25,000 in damages but are 20% responsible for causing the accident or your injuries. In this case, you would only receive $20,000 on your claim.

How to Deal With the Insurance Adjuster in Your Case

In light of the adjuster’s loyalties and objectives, it’s crucial not to consider the insurance adjuster an ally in your personal injury case. Instead, you will want to make sure that you take the following actions to deal with the adjuster:

  • Retain an experienced personal injury lawyer who can negotiate on your behalf
  • Avoid providing the adjuster with any recorded statement without an attorney 
  • Refrain from admitting to any wrongdoing or fault in your accident
  • Avoid minimizing your injuries by stating that you are “fine” or “feel okay”

Adjusters recognize that litigation is often not in the interests of their companies and will typically try to settle your case as quickly as possible. Leverage this interest by insisting that you will need to receive fair compensation before you will settle your claim.

The Adjuster: A Necessary Party in Your Personal Injury Case

While you cannot receive payment on your insurance claim without an insurance adjuster, this does not mean the two of you are working toward the same goal. Keeping the priorities and objectives of the adjuster in mind when dealing with them will help you in obtaining the compensation you deserve for your claim.

Fortunately, a personal injury lawyer can navigate the claims process for you and deal with the insurance adjuster on your behalf.


Since 1992, our personal injury attorneys at the Pines Salomon Injury Lawyers, LLP. have been fighting for the people of San Diego. Now, when those injured in automobile accidents – including cartruck, and motorcycle accidents – need financial help, or for the families that need to know that the loss of a loved one could have been prevented, there is a personal injury law firm in San Diego that is on their side. If you or a family member has been injured, call the lawyers at Pines Salomon Injury Lawyers, LLP. There’s never been a better time than right now to speak to a personal injury attorney—FREE of charge. Call us at 858-551-2090 or request a free consultation online today!