This NEW Trick Often Gets Adjusters to Pay Big

I'm going to give you the ultimate guide in dealing with insurance claim adjusters. We're gonna look at some of my past settlements and I'm gonna show you strategies that I used in dealing with adjusters to get the largest payout in the shortest amount of time possible. You can use these same tips in dealing with insurance adjusters to settle your case in the shortest period of time for the largest amount possible. I'm Florida personal injury attorney, Justin Ziegler. The first tip in dealing with insurance claim adjusters is to not be intimidated. In other words, don't be scared or nervous. Some adjusters have strong personalities, and some of them even may wanna try to intimidate you into taking less money than you deserve. Let me give you an example of an insurance adjuster who tried to intimidate me. My client, Ryan, was driving Clearwater, Florida. Another car was heading in the oncoming direction. The other car made a left-hand turn, and Ryan crashed into him. As a result of the impact, Ryan suffered a broken leg bone right beneath the kneecap, and he was taken by ambulance to the hospital and underwent surgery. The at-fault driver had $100,000 in bodily injury coverage and Allstate paid me that $100,000 within eight days of the accident. Even though my client was not in his own car at the time of the crash, because he was in a vehicle, he was in a rental vehicle, he was entitled to underinsured motorist insurance coverage that he had on his policy. Even though my client had a broken leg bone in surgery, his underinsured motorist insurer Travelers did not make an offer. I pressed the insurance adjuster to make an offer and she finally made an offer of $150,000. Since my client was working at the time of the crash, he had a worker's compensation claim. His worker's compensation insurer paid most of his medical bills. In Florida, if you don't sue within the first year, your worker's compensation insurer then has the right to bring suit from the time period of the first year after the accident through the second year. I told my client Ryan it was in his best interest to both sue The at-fault driver and his underinsured motorist insurance company, Travelers. Ryan took my advice and I filed a lawsuit against both. After I filed the lawsuit against Travelers' underinsured motorist insurance company, I got a call from a new adjuster. And the new adjuster told me this. She said, I'm now the new adjuster in the case and you know what that means, right? That means I get to reevaluate the entire case. I believe that the new adjuster Sheila was trying to intimidate me by implying that she may offer less than the previous adjuster offered in Ryan's case. The good news is, from my past experience, rarely do insurance companies decrease the offer if they change adjuster or just throughout the case. Now that being said, on rare occasion, I have had insurance companies take money off the table, but that is not the norm. My response to the new adjuster, Sheila, was re-evaluate the case and put some more money on it. I was basically showing her that I wasn't afraid and that I thought that she should re-evaluate the case and offer what the case was worth. Ultimately, after I sued, Sheila offered $200,000, which brought the entire case settlement to $300,000, and my client was very happy with the result. The moral of the story is to not be intimidated by insurance adjusters. While most adjusters are sweet, there are some that can be pretty aggressive and just have stronger personalities. At the end of the day, at this case, I ended up liking Sheila and we got along well. However, some adjusters are tougher than others. In Ryan's case, after my attorney's fees and costs and paying back his workers' compensation lien and out-of-pocket medical He received a check for all medical bills, $187,371 in his pocket. That's 62% of the entire $300,000 settlement. The tip number two when dealing with insurance adjusters is to accept that some adjusters may have a limited settlement authority or decision-making authority. What do I mean by that? Let's look at a case of mine where Frank was shopping in a supermarket. He was actually on crutches at the time he was shopping because he had prior Achilles tendon. Surgery. The tendon in the back of his leg between the back of the knee and his ankle had torn and he was recovering from a surgery. Unfortunately while he was on crutches in the supermarket he claimed that he slipped and fell on some dirty water on the floor and that reopened the wound and it led to two surgeries. After Frank slipped and fell he hired me. I made a claim with the supermarket and the claims administrator for the supermarket Assigned an adjuster to the case who actually sent me a copy of the store video and said, we did nothing wrong, so we're denying liability. Now, I don't know what was going on behind the scenes at this particular claims administrator's office. However, there's a chance that the adjuster felt that they should pay for Frank's injury. However, there is the possibility that perhaps the supervisor denied the individual's request. If you're dealing with a self-insured entity, like the supermarket was in this case up to a certain amount, even if the claims adjuster wants to put money on your case and settle it, there's always a chance that their client, who in this case was the supermarket, may not want to settle it. Or perhaps the adjuster wants to make a fair offer and they write up the case for settlement authority and then their supervisor rejects that amount. So the key is just understanding that it may not be the adjuster's fault. They may want to settle, but they may not be able to secure authority from the supervisor. And in some cases you have to sue. In this case, we filed a lawsuit against the supermarket. We went through discovery. That's when my client answered questions under oath. The supermarket answered questions under oath. I took a couple of depositions. They deposed my client and took his testimony under oath and we settled the case at mediation for $300,000. Tip number three when dealing with insurance adjusters and insurance companies It's to not be insulted by the first offer. You should expect the first offer to be much lower than the fair value of the case. This is particularly true if you're dealing with an insurance company that's really cheap like Progressive. State Farm, Allstate, and many others. Let me give you an example of a first offer that was a low ball. My client Ray was an Uber driver driving in Miami, Florida, heading straight down the street when a vehicle was coming in the oncoming direction and made a left-hand turn and Ray crashed into him. Although Ray did not take an ambulance to the hospital, he later went to the hospital that same day. He ended up having a fracture in one of the laminas of his vertebrae. and spent six days in the hospital. The doctors wanted to make sure that the vertebrae was stable. Fortunately, Ray did not need surgery to his spine. As I say in many of my videos, surgery greatly increases the full value of a personal injury case. In fact, surgery increases the full value of a personal injury case more than any factor. In Ray's case, the insurance adjuster for the Vans Insurance Company Made an opening offer of $150,000. Now, rather than me getting offended at their offer, given at the time Ray had a $99,000 hospital bill and some other bills, I did not get offended. I know that this is part of the negotiation process. Ultimately, through several negotiations, counter offers and offers back and forth, I settled Ray's case for $260,000. In Ray's case, after my attorney's fees cost and paying back his Medicaid lien and out-of-pocket medical bills, he received a check for $167,982. Now, that does not include interest on a loan that he took. So rather than me getting offended at the adjuster and wasting time being angry at her, I developed a decent relationship with the adjuster and we were able to settle his case for $260,000. The better use of your time, instead of getting angry at the adjuster, is to ask yourself, have I given the insurance company all available evidence that helps my case? It's going to be much more productive and ultimately increase your chances of getting a bigger settlement if you spend time thinking about whether you've given the adjuster all the evidence that supports the full value of your case. In other words, did you request the 911 call? Have you given the adjuster every single medical bill and record? That's the paramedic record, the hospital record, the hospital bill, the paramedic bill, the 911 call, any witness statements. You should give the adjuster photos of your injuries, before and after photos showing how your lifestyle was before the accident versus how it is now. If you were a runner or basketball player and played a lot of sports before the accident, Send the adjuster those photos and then send the adjuster photos showing yourself in a wheelchair or on crutches or using a cane or with a C collar on your neck. Show the adjuster how your life has changed from before and after the accident. The real money in pain and suffering is when your life has been permanently or significantly affected by the accident. Now Ray's case is just one of the many examples where the final settlement was $100,000 or more over the initial offer. I also represented a gentleman who was in a motorcycle accident and the adjuster told me that he had reserved or set aside $100,000 to pay the case. We ultimately settled for $445,000. My client had a broken leg bone right beneath the kneecap. and a broken finger and he had surgery to both of those and he also had a rotator cuff tear. Tip number four is to not believe what the adjuster says. I cannot stress this enough. You and the adjuster have opposing interests. For every dollar the adjuster saves the insurance company, that means you're getting the last dollar in your pocket. For every dollar that the adjuster pays you, the insurance company is parting with an extra dollar, so they're losing out. So, no matter how nice the adjuster seems, you cannot believe them. Not believing them doesn't mean that they're a bad person, it just means that this is part of the negotiation process. The adjuster's loyalty is to their employer. The employer is the one that essentially is supporting the adjuster and his or her family. Let me give you an example of why you should never believe what the adjuster says. My client, Angela, slipped and fell in a bathtub near Orlando, Florida, and she fractured the bone right beneath her shoulder, the humerus. She ultimately had surgery, and she had a plate and screws put in there, and ultimately she had a second surgery to have those removed. Now, my theory in this case was that the floor of the bathtub was unreasonably slippery. The way that an injured person gets a settlement or wins at trial in a bathtub case... Is there's typically an issue with the grab bar, either there was no grab bar, the grab bar was in the wrong position, the grab bar wasn't the right size, there wasn't a grab bar in the area when you were exiting the shower, something like that. So it's no secret that bathtub slip and fall cases are some of the hardest cases out there. So the adjuster offered $12,500 and in an email she said, I'm making this offer. Based on your client's fault and remote liability, meaning it would be very, very difficult for my client to prove that the hotel or resort was at fault. I had two options in this case. One was to believe the adjuster that my client was at fault, and it was a long shot in proving that the resort was at fault. Or two, I could continue to build my client's case. My paralegal and I went online, we went to Google Maps and TripAdvisor and other sites and found that people had complained about the bathrooms at the same hotel that my client was injured at. We essentially struck a little bit of gold. Now, that doesn't always happen in every case, but we were fortunate that... There were reviews online. The hotel responded to some of the complaints about issues with the bathtub before the incident, so I sent these to the adjuster. The hotel eventually increased its offer to $60,000, and then we eventually settled at $250,000. Fortunately, my client had a very small health insurance lien, and because she had an attorney, the health insurance company had to reduce the payback amount that we had to pay them back from the settlement significantly. That's a major advantage to hiring an attorney. In many personal injury cases, if I would have listened to the insurance adjuster in this case and believed her, my client would have received a fraction, a small, small percentage of the entire $250,000 settlement. You can see a copy of the $250,000 settlement check here. In Angela's case, after my attorney's fees and costs and paying back her health insurance company, she received a check for $157,353, which is about 62 and two thirds percent of the $250,000 settlement. Tip number five when dealing with insurance adjusters is do not expect them to go above and beyond and help you find additional insurance coverage. Let me give you an example. My client who will call Mary was driving a car when another car went through the red light and Mary T-boned the other driver. Mary broke her wrist and had to have a plate and screws put in her wrist. The driver that Mary ended up crashing into was insured by USAA Insurance Company. Pursuant to Florida's insurance disclosure law, I sent a letter to USAA Insurance Company and they responded under oath. By saying that they're insured, had a $100,000 bodily injury liability policy. Now I know that a broken wrist with a metal plate and screws put in it and medical bills and some back pain is worth much more than $100,000 in terms of the fair value of the case. So I knew we needed to look for additional insurance money. It was only after I sent the letter requesting that the at-fault driver complete the affidavit What she was doing at the time of the crash and if there was any other insurance available was when USAA told me that she was working at the time of the crash and there may be additional insurance coverage. It turned out that the at-fault driver's employer had a million dollar policy with Old Dominion Insurance Company and they paid us $100,000 to settle. That's on top of the $100,000 from USAA. Bringing the total settlement to $200,000. Now, had I never pressed the at-fault driver on what she was doing at the time of the crash, I would have never learned about this additional insurance coverage. You have to press them and ask them to complete an affidavit under oath or take a deposition or file suit to get their testimony under oath if necessary. There's also times when an at-fault driver may have limited insurance coverage. However, if they're not driving their own vehicle, Then perhaps their resident relative, someone that they live with who's related to them, may have insurance that may cover them, even though they're not driving their relative's car. Tip number six is to ask the adjuster insurance company to preserve evidence. Technically, the request to preserve evidence should go to their insured, meaning the responsible party whose negligence you believe caused your injury. For example, in an auto crash, you want to ask the at-fault driver to preserve their car. This is so you can download the event data recorder, which will capture the speed prior to the accident, whether the at-fault driver stepped on the brake prior to the accident, and some other important issues as well. In a slip-and-fall or trip-and-fall, you want to send a letter to the hotel or premises asking them to preserve the entire area so that they don't... Modify it or change it. You wanna then get an expert out there if necessary to take measurements of a change of elevation. For example, if you were to trip and fall on a step that shouldn't have been there or a little change in elevation. In some of these cases, you need an expert to get your case to trial. Without an expert, you lose. So in one case, my client slipped and fell in a bathtub in a hotel in Pensacola, Florida. It was actually at a Marriott. And I sent a letter to the Marriott asking them to preserve the bathtub and any grab bar and the entire incident scene. Although the adjuster may have no duty to preserve it, they typically reach out to their insured and ask them to preserve it. And it shows the adjuster that you know what you're doing in a personal injury case, that you're not your average Joe, that you're going above and beyond, and that you're just not going to be pushed around. And in my slip and fall case, we ended up getting an expert to go to the bathtub and measure the coefficient of friction. That's the slip resistance of the bottom of the tub. He thought that there was an issue with it. And ultimately, Ultimately, we settled that case with Travelers Insurance for $197,000. $7,500 and my client was extremely happy. Cases can literally be won and lost by sending out the preservation of evidence letter to the responsible party. Get the letter out soon. Make sure that it contains all the information that needs to be preserved. In a slip and fall or trip and fall case, ask the defendant to preserve hours of video prior to the incident. You want to see if the substance was on the floor for a long time. Or if other people had tripped and fallen or slipped and fallen prior to you. This is because in trip and fall and slip and fall cases, you need to show that the owner knew or should have known that there was an issue with whatever you tripped on or slipped on prior to you getting hurt. Tip number seven when dealing with insurance claim adjusters is if there's anything that they say to you that you don't understand, ask them about it. Let me give you an example. In one case, my client Tiffany was volunteering at a school that was located in a strip mall. There was construction going on in the parking lot. Tiffany exited one of the doors and she claimed that she tripped on some caution tape that was hanging from one of the barricades where the construction was going on and it was going to some other object. She fell down. Paramedics came to the scene and they transported her to the hospital where she had foot surgery. Now here you can see one of the only pictures that we had in the case. It was taken by another volunteer who was working at the school. Unfortunately you can see the picture does not show what was wrong. You can see some of the rubble that is apparently what was left over after they had removed some of the exterior tile floor. But the problem with this picture is you can't see the caution tape that my client claimed that she tripped over. My client claimed she only had one way to walk so even though caution tape would be pretty obvious to anyone for seeing it, my client claimed that was her only way to exit and what was she to have done? She had no other way but to walk over the tape and then she tripped and fell. As in many trip and fall cases and fall down cases, the defense, the insurance company had a totally different side. They said construction workers said They told my client not to walk there, and that there were other areas she could have walked in. Unfortunately, there was no surveillance in this claim. And my client didn't have any photos showing what was wrong. In any fall down case or any personal injury case where you're injured, always take photos of whatever you believe is wrong. But don't just stop at the photos. Take measurements. In any trip and fall case, take measurements of the height difference that you believe caused your injury. Use a ruler, use a deck of cards, use stack of pennies if that's what you have. But you want to get the height documented. Every personal injury case has hurdles in it. Your goal is to minimize the hurdles. The less things you have to overcome, the higher chance you get a payout and in a shorter amount of time. In this case, the mall was insured by Markel Insurance Company, and they eventually, through a lot of negotiation, offered $100,000 to settle. Markel Insurance Company assigned a defense attorney to the case. He said, I may have a couple more bucks to offer. I thought to myself, what does a couple more bucks mean? Does it mean $2? Does it mean 20 bucks? Does it mean 2,000? Does it mean 20,000? What does it mean? Ultimately, we settled Tiffany's case for $120,000. The lesson here is if an insurance adjuster says a statement like, I have a few more bucks to offer. If you're unsure what it means, That means ask them straight up, say, What does a couple more bucks mean? Some of them will tell you. They still may be lying or misleading when they tell you what it means, but at least you know more than just assuming what it means. After my attorney's fees, costs, and paying back out-of-pocket medical bills and a loan that Tiffany took, She received $45,879 in her pocket. Now that does not include the interest on a loan that she took to pay for her medical treatment. And Tiffany's total settlement was about 3.5 times the final out-of-pocket medical bills that we had to pay back. So the out-of-pocket medical bills that we had to pay back were $33,722. And if you multiply that times three and a half, you get the $120,000 settlement. Like most Personal injury cases where someone has surgery, most of the settlement was for pain and suffering. About 72% of the entire settlement was for pain and suffering. So I estimate that the insurance company was paying about $86,278 for pain and suffering and the rest was for her out-of-pocket medical bills. Another time where you should ask the adjuster what something means is when they tell you that they have your case evaluated, for example, in the low five figures. That could mean 10 thousand, 20 thousand, 30 thousand $10,000, $20,000, $30,000, $40,000, $50,000. Ask them, what does low five figures mean? Some of them are going to be more forthcoming with information than others, and they'll tell you, low five figures means $10,000 or $20,000. Now, again, they still might be lying. However, at least you have something that you can put in the notes. Perhaps confirm this with them in writing and you're in a better position than just assuming what you think low five figures means. Tip number eight when dealing with insurance adjusters is if they offer what's called pre-suit mediation, you should accept it. Pre-suit mediation is a process where the insurance company shows up and the injured person shows up. If they have an attorney, they bring their attorney with them. And the third party that does not have the power to make a decision in the case But the third party known as a mediator tries to get both parties to settle. Pre-suit mediation is most common before a lawsuit if there's a lot of people injured and there's a low insurance policy limits. For example, it may be more likely to happen if you're dealing with a rideshare vehicle and the driver had not yet accepted a ride and you're dealing with a $50,000 policy per person or $100,000 per accident. And you have three or four people who are injured, let's say one or two has a herniated disc or something like that, there's a chance the rideshare insurance companies may wanna mediate that pre-suit. The same thing as if you're dealing not with a ride insurance company and you're dealing with a car insurance company with a low insurance policy limit and there's multiple people injured. Typically, if you're being offered pre-suit mediation, that means that the insurance company wants to pay to settle your case. There are some attorneys who think that pre-suit mediation with some defendants Supermarkets, stores, and other defendants is a waste of time. I tend to disagree with that. I think the most important thing is before pre-suit mediation, ask the insurance adjuster or insurance company if they will pay for the mediator's cost. Mediators can be expensive. They can cost easily $300 an hour, $400 an hour, $500 an hour or more. That's typically split between the parties. But before pre-suit mediation, ask the insurance company to pay. Now, if you're dealing with a high insurance limit, And you're still getting medical treatment, you likely should not agree to pre-suit mediation because your case grows as you continue to treat, assuming your treatment's related to the accident. You don't want to go to pre-suit mediation before you even know what the full value of your case is. However, if you've completed your treatment or if you're dealing with a low insurance policy, I don't see any harm in going to pre-suit mediation. In times like today, you can go to pre-suit mediation via Zoom if the insurance company will agree to that so you don't even have to leave your house. You can go there, you don't even have to say a word. You could tell the mediator that you don't want to say anything, you just want to hear what the other side has to say. You can let them make an offer and if you're that dissatisfied with their first offer, you can just walk out and leave and there's no harm done. But I'm of the general school of thought where it's always better having money on the table than no money on the table. For whatever reason, some adjusters feel that cases are more likely to get settled at pre-suit mediation than negotiating by email or over the phone. GEICO in some cases is one insurance company that I've seen that likes pre-suit mediation even if the case may not be worth the insurance limits. In certain cases, typically with larger injuries, GEICO likes to pre-suit mediate the case. Typically, I'll agree to go to pre-suit mediation with GEICO. I always confirm that they pay the mediator's fees prior to going to mediation. Although typically, I will not agree to mediate a case with GEICO before a lawsuit if my client's still treating and there's a high insurance limit. I represented Richie who was injured when he was driving a police cruiser and another car failed to stop at a stop sign and crashed and hit Richie. And Richie had surgery to the fifth metacarpal in his hand. That's one of the hand bones. Here I accepted pre-suit mediation because my client had completed his medical treatment. Ultimately, at mediation, we settled the case for $125,000 and I got GEICO to pay for the mediator. Knowing how to deal with insurance claim adjusters is just one part of a personal injury case. To learn how to maximize your case in the shortest amount of time possible, watch this video here.