Insurance Adjuster Tactics That Can Affect a Pennsylvania Injury Claim

After an accident, an insurance adjuster may contact an injured person quickly to gather information, investigate liability and evaluate the claim. An adjuster represents the insurance carrier’s interests. Understanding the process can help an injured person avoid giving incomplete information, signing an overly broad authorization or settling before the claim can be reasonably evaluated.

Early Settlement Offers

An early offer is not automatically unfair, but it can arrive before the medical prognosis, future treatment, wage loss, liens or available insurance coverage are fully understood. Before accepting a final settlement, consider whether the extent of the injuries and losses can be evaluated with reasonable confidence.

Settlement Checks and Releases

Insurance settlements commonly involve a written release. The effect of accepting or negotiating a check depends on the accompanying documents and circumstances, so an injured person should not assume that every payment has the same legal effect. Read the release and settlement terms carefully before accepting a final resolution.

Recorded Statements

An adjuster may ask for a recorded statement about how the accident happened and the injuries involved. Obligations can differ depending on whether the request comes from your own insurer or another party’s liability carrier. Your own policy may impose cooperation duties. Before giving a recorded statement, understand who is requesting it, why it is being requested and what obligations apply.

Broad Medical Authorizations

An insurer may request authorization to obtain medical records. Medical history can be relevant to causation and damages, but the scope of an authorization matters. Review what records, providers and time periods the authorization permits the insurer to obtain.

Requests for Extensive Documentation

Insurers may reasonably need medical records, bills, wage information and other evidence to evaluate a claim. If a request appears unusually broad or unrelated, clarify why the information is being requested before providing sensitive material.

Delay and Filing Deadlines

Negotiations with an insurer generally do not eliminate the need to comply with legal deadlines. Pennsylvania generally applies a two-year limitations period to many negligence-based personal injury actions, but exceptions, other causes of action and special notice requirements can alter the deadline. Claims involving governmental entities can involve additional requirements. Do not rely on ongoing settlement discussions as a substitute for determining the applicable deadline.

What Should You Do When an Adjuster Calls?

• Be accurate and avoid guessing about facts you do not know.
• Keep copies of correspondence and documents you provide.
• Understand whether the adjuster represents your insurer or another party’s insurer.
• Review medical authorizations and releases before signing.
• Do not accept a final settlement until you understand what rights will be released.
• Track applicable filing and notice deadlines independently of negotiations.

Frequently Asked Questions

Is the insurance adjuster my advocate?

No. An adjuster investigates and evaluates claims for the insurance company. That does not mean every adjuster acts improperly, but the adjuster does not serve as the injured person’s attorney or fiduciary.

Do I have to accept the first settlement offer?

No. A settlement is an agreement. Whether an offer is reasonable depends on liability, injuries, damages, coverage and other facts.

Can I keep negotiating while the statute of limitations is approaching?

Negotiations may continue, but an injured person should not allow a filing deadline to expire based on an assumption that negotiations will protect the claim.

Learn More About Pennsylvania Injury Claims

Read ZwickLaw’s verified guides on protecting the value of a personal injury claim, what to do after a Pennsylvania car accident, and full tort versus limited tort. You can also review the firm’s personal injury practice and Matthew R. Zwick’s attorney profile.

Contact ZwickLaw

To discuss a Pennsylvania personal injury claim, call (814) 371-6400, email mrz@zwick-law.com, or use the ZwickLaw contact page.

This article provides general information and is not legal advice. Insurance obligations, deadlines and available claims depend on the policy, facts and applicable law.