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How Do insurance Companies Handle Car Accident Claims? | Guy S. DiMartino DC, JD, PA

Guy DiMartino June 6, 2013

Interviewer: What kind of insights do you have when it comes to car accident claims that other lawyers wouldnt know?

Guy S. DiMartino: Because I worked defending car accident claims for insurance companies in the past, I understand how insurance companies work. Insurance companies are very structured. They have rules, regulations and procedures. One of the most important things for an insurance adjuster is to meet her goals. Often, the insurance adjuster doesnt really care about the facts of the case.

They are judged on whether their reporting is timely, on the number of cases that they close, and the average length of time a claim is open. If an adjuster is able to close cases quickly, they are rewarded. If the car accident lawyer understands this concept, he will provide all the information the insurance adjuster needs to evaluate a claim as quickly as possible.

If the clients case is strong then providing the supporting documentation ASAP paves the way for adjuster to set proper loss reserves, which is the amount of money set aside for the particular case, high enough to get the case resolved for a fair amount of money.

The great motivator for insurance adjusters is getting their cases closed

Being a defense lawyer gave me the understanding that the insurance company is in the business of settling claims as fast as possible for the lowest possible amount. As a defense lawyer, I would hear a lot of lawyers say, “Im a great lawyer. I go to trial and I win these cases for the insurance company all the time”, but yet they wonder, “Why theyre not getting a lot of business from the company”, and many times the reason why he wasnt getting a lot of business was the insurance company didnt really care about the result at trial.

The insurance adjuster carried about the attorney having all the reporting in on a timely basis. So, if the lawyer had a pretrial report that was due 45 days before the mediation or a trial report that needed to be done 90 days before the first day of the trial-docket, thats what the adjuster cared about. With this information in hand, an attorney representing a car accident client, has to understand that giving the insurance company all the supporting information before, he or she has to go and get settlement authority is a lot easier than the adjuster having to go back to her bosses asking for more money later on because she didnt have all the information.

Many Property and Casualty Auto-Carriers Use Claims Management Software

Another thing about insurance companies that people have to understand is that many of these companies have strict procedures and structure. Take Allstate for example. Allstate uses a claims management software called Colossus to adjuster car accident claims. The adjuster puts data into the computer program from the medical records, bills and facts of the accident. The computer then sets a settlement range.

The Allstate adjuster doesnt have much room to negotiation, and most of the time, he cannot go outside the range provided by the computer unless there is additional documentation. So, a lawyer can scream and make threats to an Allstate adjuster all they want when they get a silly offer like $4,117.33 but that will not change the number because of the insurance companys structure. With these insurance companies, the best tactic is to file a lawsuit because a different adjuster will get the file for review after the court case is filed.