Formerly Known as Casares Law, LLC Learn More

What to Do If You Disagree With The Car Insurance Adjuster

Written by: Dale G Casares Portrait Dale Casares
Red Toy Car On Top Of Some Documents And Coins

When you file a claim with your car insurer, a car insurance adjuster is tasked with evaluating the damage, determining fault, and estimating the costs of repair or replacement. This crucial step dictates how much the insurance company will pay out for your claim.

Dealing with the insurance company is never fun, especially if you feel they’re not holding up their end of the agreement in your policy. If you find yourself disagreeing with the adjuster’s conclusions, it’s important to know that you’re not at a dead end; you have the right to challenge their findings and negotiate a settlement that feels fair to you.

After all types of car accidents, it is essential to approach this situation armed with correct information and clear documentation to support your case. A car insurance adjuster’s responsibilities might include inspecting the vehicle, reviewing police reports, and interviewing any involved parties to assess the claim.

However, their initial offer is not final and can often be the start of a negotiation process. Accepting the first offer is often a mistake. Your understanding of this role will enhance your ability to effectively engage in discussions and reach an amicable agreement.

Ensure you gather all necessary documents, such as repair estimates, photographs of the damage, and any other evidence that can substantiate your stance. Presenting this information clearly and logically can help assert your position, legally proving fault. Remember, negotiation is a common practice in the insurance claims process, and you are entitled to seek a satisfactory resolution when the adjuster’s assessment does not align with your expectations.

Man Holding His Head Next To A Damaged Car

Role and Responsibilities of a Car Insurance Adjuster

In the aftermath of filing a claim, you’ll interact with a car insurance adjuster whose role is crucial to the process. They assess damage, evaluate costs, and make pivotal decisions regarding your payout.

Determining Claim Value

When you file a claim, the adjuster is responsible for determining the value of your claim based on the policy coverage and damage incurred. They’ll inspect your vehicle, review the accident report, and may also assess any bodily injuries claimed. To accurately evaluate the claim they will:

  • Collect evidence: This includes photos of the damage and the accident scene.
  • Evaluate repair costs: Adjusters often use professional estimates from mechanics.
  • Consider medical expenses: If injuries are involved, adjusters will review medical reports and expenses.

Negotiation and Settlement Process

Your adjuster is also tasked with negotiating the settlement. They will offer a settlement amount that you can accept, reject, or counter.

  • Initial offer: Usually adjusters start with a lower offer to leave room for negotiation.
  • Your response: You have the right to counter with evidence like repair estimates.
  • Final agreement: The process continues until both parties reach an agreement that’s fair and within policy limits.

Man On The Phone Reading A Piece Of Paper Next To A Broken Car

Common Reasons for Disagreements With Car Insurance Adjusters

When dealing with car insurance adjusters, disagreements can arise due to a variety of factors. Recognizing common scenarios where these conflicts occur can help you address them effectively.

Assessment Differences

You may find that the adjuster’s valuation of damages differs from your expectations or assessments done by independent parties. This could manifest in:

  • #1 An underestimation of your vehicle’s damages or repair costs
  • #2 A discrepancy in determining whether your car is a total loss
  • #3 Differences in the evaluation of medical expenses related to the accident

Policy Interpretation Conflicts

Disputes may also occur over how policy terms and benefits apply to your specific situation. These conflicts might involve:

  • Coverage limits: What the policy covers in terms of repair costs, replacement parts, or medical bills may be in contention
  • Fault determination: The percentage of fault the adjuster assigns to you can greatly affect your settlement
  • Deductibles and premiums: How these financial aspects affect the overall payout might differ between your understanding and the adjuster’s stance

Steps to Take When You Disagree With a Car Insurance Adjuster’s Decision

When you disagree with a car insurance adjuster, it is crucial to communicate your stance effectively. Clear and persuasive discourse ensures that your evidentiary backing is understood and considered.

Clarify Your Position

To clarify your position, start by creating a comprehensive list of points that support your disagreement. This should include gathering photographs of the damage, repair quotes, and any relevant medical records if injuries were involved.

Prepare a written document that articulates why you believe the adjuster’s assessment is incorrect, referencing specific evidence. This will help you present a structured argument and prevent any misunderstanding about your perspective.

Question the Adjuster’s Evaluation

When questioning the adjuster’s evaluation, approach the dialogue with respect. Politely ask how the adjuster arrived at their valuation, requesting a breakdown of their assessment. Go through their evaluation and address each point, contrasting it with your evidence. Remember to listen carefully to the adjuster’s explanations. This will not only show your due diligence but also help you understand their position and prepare a more informed rebuttal.

Request a Reevaluation

Compile comprehensive documentation including photographs of the accident scene, medical reports, and repair estimates to support your claim. You may then want to consult another insurance professional to gain an alternative assessment which might favor your perspective on the claim.

File a Formal Complaint

Initiate your grievance through the insurer’s formal complaints process, which is typically outlined in your policy documentation. You may also want to consult an attorney. For persistent disputes, legal advice may be necessary to explore your rights and the viability of litigating the decision.

Exploring Dispute Resolution Options

When you disagree with a car insurance adjuster’s decision, it’s important to know your rights and what steps you can take to challenge the assessment. These options can range from invoking an appraisal clause to seeking mediation and arbitration.

Appraisal Clause

Your insurance policy may include an appraisal clause which provides a method to resolve disputes about the value of your vehicle or the amount of your claim. To utilize this:

  1. Review your policy to confirm the existence of the clause.
  2. Notify your insurer in writing that you wish to trigger the clause.
  3. Each party (you and the insurer) will select a competent appraiser.
  4. The two appraisers will choose a neutral third-party professional if they cannot agree.
  5. If either party disagrees with the outcome, they can often pursue further legal action.

Remember, the appraisal process can incur additional costs, which are usually split between you and the insurance company.

Mediation and Arbitration

If direct negotiation doesn’t resolve the disagreement, mediation and arbitration are alternative ways to settle disputes without going to court.

Mediation involves a neutral third party who helps both you and your insurer reach a mutually acceptable resolution. The mediator does not make a decision but instead facilitates discussion to resolve the dispute.

Steps for Mediation:

  1. Suggest mediation to the insurer as a voluntary process.
  2. Hire a qualified mediator, sometimes provided by the court system or an independent service.
  3. Prepare to outline your perspective and evidence in a structured setting.

Arbitration is more formal and can be binding or non-binding. An arbitrator hears both sides and then issues a decision.

Steps for Arbitration:

  1. Agree with the insurer to arbitrate the dispute.
  2. Select a neutral arbitrator with experience in insurance matters.
  3. Present your case, including evidence and any expert testimony.

Both mediation and arbitration can be faster and less expensive than court proceedings, but if arbitration is binding, you may be limited in your ability to appeal the decision.

Legal Considerations

When challenging a car insurance adjuster’s decision, it’s crucial to approach the issue with an informed understanding of legal aspects. This involves recognizing your contractual rights under the insurance policy and adhering to the specific timeframes established by law.

Understanding Your Policy

The first step in disputing a car insurance adjuster’s assessment is to thoroughly review your insurance policy. This document outlines your coverage limits, deductibles, and the insurer’s process for settling claims. Key provisions to look for include:

  • Coverage Details: Specifics about what types of damages or losses are covered
  • Exclusions: Conditions or situations not covered by your policy
  • Duties After Loss: Steps you are required to take after an incident, which could affect your claim

Knowing these details empowers you to argue based on contractual obligations, not just personal beliefs about what is fair or unfair.

Statute of Limitations

A critical time constraint to be aware of is the statute of limitations, a law that sets the maximum time after an event within which legal proceedings may be initiated. The statute of limitations for insurance disputes varies depending on the specific nature of the dispute.

Generally, though, issues related to insurance policies have a statute of limitations of three years in Colorado. Should you decide to take legal action against the insurer for a dispute, it is essential to initiate it within these timeframes; otherwise, you risk forfeiting your right to sue.

Insurance Agent And His Client Going Over Documents

Seeking Legal Representation After a Car Insurance Claim Denial

When you’re at odds with an insurance adjuster’s decision, seeking legal representation can be a strategic move to ensure your interests are robustly defended.

Consult an Attorney

When should you consult an attorney?

  • Your claim is significant or complex.
  • The adjuster has made a low offer that doesn’t cover your losses.
  • Negotiations with the insurance company have stalled.
  • You suspect the insurer is acting in bad faith.

How to proceed:

To begin, research attorneys experienced in insurance disputes. Ask for a free consultation to discuss your case. Prepare documentation, such as evidence of the damage and repair estimates as well as the claim denial letter, to present to the lawyer.

The Benefits of Legal Advice From Mountain States Injury Law

  • Expertise: Attorneys specializing in insurance law can navigate the complexities of your claim more efficiently.
  • Negotiation: Lawyers have negotiation skills and experience that can match or surpass those of insurance adjusters.
  • Protection: A legal professional will protect your rights and advocate for a fair settlement.
  • Resolution: If necessary, an attorney can escalate the matter to court to secure the compensation you deserve.

If you feel your insurance company isn’t paying out what you need and deserve, you should hire a lawyer. By doing so, your claim leverage is enhanced with knowledgeable support at your side. For those in the Castle Rock area, these lawyers are at Mountain States Injury Law.

Reach Out to Mountain States Injury Law for a Free Consultation

If you get a claim denial or inadequate coverage for your claim, you need legal counsel as soon as possible. We’re here to ensure you get the proper compensation you deserve.

Contact a car accident lawyer today and we’ll discuss your car insurance claim in full detail, as well as look deeper into your auto insurance policy, help you through the claims process, and even appeal the insurance company’s decision.

You don’t need to deal with a denied claim on your own. Contact us for the legal representation you need to ensure your personal injury damages are covered fairly and legally.

Leave a Comment

Your email address will not be published. Required fields are marked *

Dale G. Casares Attorney

Dale G. Casares

Colorado, Idaho, and Montana
Personal Injury Attorney

Meet Dale Talk to a Lawyer

Free Consultation

We won’t charge a fee until your claim is settled.

Best Law Firms 2023 Best Lawyers. Lawyer of the Year Million Dollar Advocates Forum