10 Reasons Why You Should Not Talk To Your "Friendly" Insurance Adjuster

(An Example of Sally's Slip-&-Fall Case)

Many legitimate injury cases are ruined when insurance adjusters take the injured victim's recorded statement before they consult an attorney. Why not speak to an insurance adjuster without your attorney present? What bad could come of it? Here is a typical example that we see in our practice all too often.

Sally Smith fell and broke her wrist at a department store. The fracture is so bad she needs surgery. As a result, she has $25,000.00 in medical bills, and she also lost her job as a typist because it is now painful for Sally to type. The "friendly" insurance adjuster from the department store's insurance company comes to visit Sally at her home.The adjuster says that he only wants to help, and that he just needs to tape record Sally's story because it will be easier for him than taking notes; "It's just a formality," he says. When he asks her what she slipped on, Sally says, "I don't know." Not having consulted an attorney yet, Sally has not thought carefully about the liability issues in her case. She may not even realize that she has the burden of proving that the department store is at fault before their insurance company has to pay a dime for her medical bills.

The adjuster smiles as he leaves, and tells Sally that he has to finish his investigation and write up his report before they determine whether the insurance company can help her. A week later, Sally gets a letter telling her that the department store's insurance company will not pay her a penny for her injuries or medical bills because there is "no liability" on the part of the department store. Not surprisingly, Sally now can't find a lawyer to take her case, primarily because of her tape-recorded admission that she doesn't know what she slipped on.

Sally Smith's three seemingly harmless words, "I don't know", destroyed her case. When you fall on someone's property, you have the legal burden of proving what caused you to fall. If you cannot prove it, you lose your case. Since Sally, in this example, has already been tape recorded saying that she has no idea what caused her to fall, she effectively has no case. Maybe it is true. Maybe she really doesn't know what she slipped on. On the other hand, maybe she just hasn't really thought about it. When she fell and broke her wrist, she was concentrating on getting emergency medical help. She was in pain. The last thing on her mind was identifying what she slipped on. If only Sally had sat down with an attorney or loved-one first to discuss her case carefully, she may have remembered what she slipped on. But now the insurance company has it on the record saying that she has no idea, and she cannot take back what she said.

An experienced lawyer will thoroughly question a client about every aspect of the case.For example, maybe Sally Smith was not sure what caused her to fall, but she did notice that she had water on her dress as she was getting up off of the floor in pain. Perhaps she looked up and saw water dripping down from an air conditioning vent directly over the isle-way where she fell. An experienced personal injury lawyer, such as the attorneys at Kimsey & DeBari, P.A., will take the facts down, investigate all potential theories of liability, and arrive at a conclusion as to the actual cause of the incident and the responsible party. Perhaps the water dripping from the air conditioner that ended up on Sally's dress was actually the cause of Sally's fall. The attorney's intensive investigation may show by reviewing maintenance and repair records and interviewing employees that the department store was well aware of the dripping air conditioner duct, but did not take reasonable steps to fix the problem, thereby creating the dangerous condition of water on the floor in the middle of the aisle where Sally slipped and fell. Without an attorney and legal team to investigate an incident such as this, an injured victim may not be properly prepared to give a recorded statement that does justice to all of the relevant facts involved in the situation. On the other hand, if a slip-and-fall victim has time to consult a qualified attorney and to reflect upon the incident, he or she will be more prepared to confidently recite the true facts of the case as they happened.

There are many other reasons to never speak to an adjuster without first consulting an attorney. Some examples include:

The insurance adjuster is not your friend. Insurance adjusters are qualified specialists whose job is to pay as little of the insurance company's money to you as possible on claims. Insurance adjusters may seem very friendly, but their friendly appearance is often misleading or disingenuous. They do not have your best interest in mind. They are trained to be friendly in order to get you to cooperate with their investigation, and then to use all of your statements against you.
Insurance adjusters are skilled talkers. Insurance adjusters are experienced at asking questions designed to get you to say things that will hurt your case, possibly without even realizing it. Adjusters may also ask you questions that are misleading or ambiguous. Your attorney will object to these questions or instruct you not to answer.
Giving a recorded statement without your attorney present can result in devastating results. (See the example of Sally Smith above).
Insurance adjusters are snoops. Allowing an adjuster into your home gives them an opportunity to look at private matters that are none of their business.They will observe you, your actions and your surroundings trying to find things to use against you later in the claim.
Insurance adjusters carry dangerous documents. Insurance adjusters may try to get you to sign a form that will allow them to get all of your medical records directly from your doctors and all of your employment records directly from your employer."Just a formality," they will tell you. Unless they are from your own insurance company, they have entirely no right to this material. Once you sign a medical or information release form, they can get almost any of your personal records of any kind, including medical, psychiatric, marriage counseling, psychological, school and employment records. Without the proper restraints that a qualified attorney acting on your behalf will place upon them, these snoops can gain access to records covering all of the most private information from your entire life, not just from your accident! These records may contain information that you do not wish to make public, but once the insurance company has it, you may lose control over the confidential nature of the information. If there is anything embarrassing in these records, the insurance company will likely use it against you in any way possible.
Quick Settlements. Adjusters may try to get you to accept a quick settlement in an effort to minimize the amount of money that the insurance company will have to pay on your claim. A typical scam is for the adjuster to offer to settle for the amount of your current medical bills as full settlement of all of your damages. This type of settlement does not even account for your lost wages, your pain, suffering, your loss of capacity for the enjoyment of your life due to your injuries, much less for your future medical bills, which could be significant. Once you sing a release with the insurance company, your potential claim and lawsuit are likely over. Do not ever sign a release or other document from an insurance adjuster without first reading it carefully and having it reviewed by your qualified, experienced, personal injury attorney who is acting exclusively in your best interest. This includes partial releases (see below).
Tricky Partial Release Forms. The adjuster may try to get you to sign a release of certain claims available under certain insurance policies. For example, in the case of an automobile accident, you may be asked to sign a property damage release in exchange for a check for the damage to your car. The adjuster may assure you that you are not releasing your injury claim by signing the property damage release. What the adjuster will not tell you is that there may be other consequences to signing the release. It may contain provisions that may hurt your injury claim. Additionally, there may be tactical reasons not to sign the property damage release, for example, to preserve a claim for bad faith. Never sign any release without having it reviewed by an attorney first.
Adjusters may try to persuade you to not hire an attorney. Why? They will buddy up to you and make you think that an attorney will only make things more difficult. Be very suspicious of anyone who tells you not to get an attorney. Since most experienced injury attorneys who practice in this area offer free initial consultations, not getting this valuable free advice could be one of the worst decisions of your life. Study after study has shown that people who do not hire an attorney to handle their injury claim routinely end up with far less in settlement money than those who do, even after payment of any attorney fees. As sophisticated as you may be, without the threat of a well-known injury attorney behind you, the insurance company will not take you seriously and will only offer a nominal settlement.
Adjusters are generally under no duty to explain your rights to you. Under most circumstances, any insurance adjuster, agent, appraiser, or other insurance representative who may speak to you does not have your best interest in mind. The insurance representative often holds the interests of the insurance company above that of your interests. Reputable injury attorneys with experience in insurance law who limit their practice to representation of injured victims will give you an unbiased explanation of your rights. This may be even more true where your attorney works under a contingent fee agreement (on a percentage basis) because the attorney or law firm will also have the obvious motivations of having a vested interest in the outcome of your case. The attorneys at Kimsey & DeBari, P.A. never represent insurance companies and offer initial case evaluation to injured individuals free of charge.
Adjusters are generally under no obligation to explain the insurance coverage to you. There are many different types of insurance coverage. Most insurance policies have multiple types of coverage. Even if the insurance adjuster wanted to explain the types of benefits available to you under the policy, the fact is that many insurance adjusters do not understand all.