Adjuster Law: But Your Guy Didn't Die

I have a case that came in not too long ago. Single car wreck. 11:30 p.m., the car’s right tire goes off the edge of the road and the driver over corrects, swerving back and forth trying to get control of the car. The car eventually hits a concrete culvert and flips 3–4 times, finally coming to a rest upside down in a cornfield.

My client is the passenger. He was buckled in and looking for the driver. He came to and was able to drag himself out of the car. Frantically looking for the driver, he finally found him 30–40 feet away from the car in a twisted mass. Dead.

The driver was a friend of his. Someone quite a bit younger, that he had been living with for three months, working with and mentoring in his trade. Dead.

My guy had the initial ER bills, four weeks off work and minimal follow up to that point, because he couldn’t afford the doctor’s bills. I called the insurance company. They had the state minimum policy limits of $25,000 with an additional $25,000 for UIM.

I figured that this was more than enough to get to the $50,000 and called them to check on their feelings. “Oh no…..that’s not nearly enough.” Not enough to get to the $50,000? “No……Not enough to get to the $25,000.”

But this is a very serious fatality case. It was his roommate, friend and co-worker. “Your guy didn’t die. We consider this a soft tissue case and nothing more”.

Wow. It’s breathtaking.

The insurance company is of course Allstate.

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Adjuster Law: Not Enough Damage to the Car

I sent a demand package to an insurance company on a car wreck case with about $26,000 in bills for medical treatment and two herniated disks. The adjuster wanted us to get information on prior medical treatment because of the severity of the claim, they felt there had to be some pre-existing condition. We complied because that was information that we would need to gather if there was a lawsuit anyways. When that didn’t turn up anything, the denied any payment.

The reason? Not enough damage to the car and they didn’t believe that my client could have herniated two disks from that amount of collision.

When I talked to my client his response “Well Dave, there wasn’t too much damage to my car. I was driving a Nissan Titan. The guy who hit me, his car was totalled. It was a crumpled mess that had to be towed away from the scene”.

Of course, the car that was totalled belonged to the adjuster’s insured, so she was well aware of that, but any reason to deny a case.

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My First Experience with Adjuster Law

When I was relatively new as a Plaintiff’s attorney, I received a call from a GEICO adjuster stating that at the beginning of December, that they wanted to take all of their cases and wrap them up for the year’s end. That a super adjuster was coming in from Atlanta and would take care of all the cases at once.

What a great idea, I naively thought. The big day came and I had 5 cases with GEICO at that time. She didn’t even read the demands and medical records:

  • Too Young – I can’t believe that such a young girl has such serious injuries and won’t recover. She’s young, she’ll get better.
  • Too Old – I can’t believe that she’s having such problems from the car wreck. She has to have a ton of pre-existing conditions.
  • Too Much Treatment – It’s clear she’s ‘milking it’.
  • Too Little Treatment – She’s obviously not hurt.

Let’s play this ‘game’ a little more.

  • If a person goes directly to the doctor – She ran to the doctor. Why is she doing that?
  • If a person waits a day, to see how they’re feeling – They must not be hurt. If they were hurt, they’d go immediately to the doctor.

It took me awhile to realize that to a very large degree, the facts don’t matter to the adjuster. They’ll find anything they can to poke. After awhile you learn to document your case and if the adjuster won’t listen, then you just file suit, and move the case forward. The best way to settle a case is to prepare for trial.

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