Most insurance adjusters want to resolve a personal injury claim simply and without unnecessary time and energy. But there are always a few adjusters—because of personality, negotiating style, or company policy—who are willing to bluff or stall well past the time all relevant documents have been examined and all arguments have been made on both sides.
These adjusters will often make an extremely low initial offer and then stick to it without providing any justification. They hope that their tactics will intimidate you, or just frustrate you into accepting a settlement much lower than what your injury claim is worth.
So what are your options when personal injury settlement negotiations are at an impasse or have broken off completely?
You may be able to move an adjuster off a stubbornly held position just by regularly—every week or ten days—calling or writing to ask when the adjuster will make a fair and reasonable settlement offer. By reaffirming that you will be both patient and persistent and will not fold up your claim, you may get the adjuster to come up with a fair settlement offer. Learn more about responding to a too-low personal injury settlement offer.
Adjusters do not like lawsuits. When a personal injury lawsuit is filed, that means lawyers will soon get involved, costs will go up, and the claim file may be taken away from the adjuster and given to an insurance company lawyer or claims manager, which may mean a blemish on the adjuster’s work record. Also, a lawsuit can get the insured person upset, which can mean lost business for the insurance company. Since a claims adjuster wants to avoid all this, you might be able to loosen the insurance company’s purse strings by suggesting that if a fair offer is not made by a certain date, you will be forced to file a lawsuit and to hire a personal injury lawyer to handle the claim for you.
No Lawsuit If Arbitration Mandatory. Although the threat of a lawsuit sometimes can be an effective way to nudge an adjuster toward a settlement, it works only if a lawsuit is actually a possibility. Most uninsured motorist coverages and some no-fault car insurance policies require that unsettled claims be submitted to arbitration. The insured is not allowed to file suit. So make sure you have the legal right to back up your threat before you make it. (Get details on arbitration of car accident claims.)
Although most personal injury lawyers are paid on a contingency fee basis (meaning they take a percentage of your settlement), some are willing to consult with you on an hourly basis while you continue to handle your claim yourself. If you and a claims adjuster are at an impasse, particularly if there is some legal question about liability over which you and the adjuster disagree, you might want to meet for an hour or so with a lawyer who specializes in personal injury cases.
Bring all your papers, documents, notes, and correspondence. After a brief review, the lawyer might be able to point out some particular fact, rule, or tactic you can use in your next contact with the adjuster. The lawyer may also be able to help you file a lawsuit to protect your rights within the deadline set by your state’s statute of limitations.
Injecting some new idea or legal theory into the negotiations can sometimes get an adjuster to make a serious settlement offer. You may even want to let the adjuster know that you have consulted an attorney and that if a fair settlement offer is not made, you will be forced to let the attorney take over your claim.
If you decide to consult with a lawyer on an hourly basis, make sure you know ahead of time how much the lawyer will charge per hour, and be sure to set a limit, in writing, on the number of hours you want the lawyer to spend reviewing your claim. Learn more about what to ask before hiring a personal injury lawyer.
If you are unable to settle your claim with the adjuster assigned to it, there are other people within the insurance company from whom you might get a more reasonable offer. The adjuster has an immediate supervisor, and there is also usually an overall claims manager within the claims department. If you have reached an impasse, or if the adjuster fails to act promptly on your claim, politely suggest that the difficulties might be overcome if you both got another opinion. Ask to speak with the claims supervisor. Merely asking the adjuster to bring the supervisor into the picture may jar the adjuster into changing the settlement offer.
If the adjuster promises to contact the supervisor for a review of the file, allow some time for that. The adjuster may come back with a better settlement offer. But if the adjuster is going to discuss the matter with the supervisor, agree on a specific date by which the adjuster will report back to you on the results.
If the adjuster does not agree to speak with the supervisor, ask for the supervisor’s name. Call or write to the supervisor, mention the number of contacts you have had with the adjuster, and explain that the adjuster has yet to make a reasonable settlement offer and has failed to give you satisfactory reasons for the low offer. If the adjuster has delayed or used improper settlement tactics, mention that too. Then ask that the supervisor review the file and either handle the matter personally or refer it to a new adjuster.
If you cannot get a reasonable settlement offer from the supervisor, ask for a written statement of the reasons for the insurance company’s settlement position. This statement may be helpful to you in any further steps you take, like contacting the claims manager, who is the boss of the adjusters and supervisors. Get the name of the claims manager from the supervisor and repeat the process with the manager, describing the problem you have had with the adjuster and the supervisor. To avoid further hassles with a persistent claimant, the claims manager might authorize an increase in the settlement offer.
An insurance company (your own, and the other party’s, to a lesser extent) has an obligation to negotiate in good faith when resolving a claim, and when an adjuster fails to meet this obligation, it can be very costly for the company. So, bringing up the prospect of “bad faith” will certainly get the carrier’s attention. Learn more about insurers and “bad faith” in injury cases.
For a step-by-step guide to the injury claim negotiation process, get How to Win Your Personal Injury Claim, by Joseph L. Matthews (Nolo).