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Confessions of an Auto Claims Adjuster

Edmunds.comEdmunds.com Member, Administrator, Moderator Posts: 10,315
edited September 2014 in General

imageConfessions of an Auto Claims Adjuster

Find out the secrets to getting more insurance money from the Auto Claims Adjuster after your car is totaled or stolen.

Read the full story here


Comments

  • tacomabobby_tacomabobby_ Member Posts: 1
    thanks!! i never knew you could negotiate! as i recently went through a total loss and just accepted the offer!
  • aderader Member Posts: 8
    8/3/2011

    Stay away from Progressive Auto Insurance. When I called to speak with a representative and specifically asked her NOT to process my payment with my Visa card information on file, she went ahead and did it anyway. She did not tell me she was processing the payment, she did not give me any sort of authorization number and I specifically said i wanted to make the payment online myself so that I could print out proof of my payment. These people are reckless and irresponsible with their customer's private information and when I called in to address the issue, they showed no remorse. I've canceled my auto insurance with progressive due to the mishandling of the VISA card information which they were not supposed to keep on file - but did anyway. These guys just do whatever they want and help themselves to money out of your bank account. Their customer service reps have an abrasive and arrogant attitude. I shopped around and got a better deal at All State who treated me with the high level of customer service and professionalism that I used to get at Progressive but it now appears they don't care about their customers or privacy of information. They also had the nerve to charge me a $50 cancellation fee after having messed me around so badly... Stay away.
  • c_lachnitc_lachnit Member Posts: 2
    @Ader: Thanks for sharing your experiences. This Edmunds article, "10 Steps to Buying Auto Insurance" http://www.edmunds.com/auto-insurance/10-steps-to-buying-auto-insurance.html point out how important it is to check on how the insurance compan
  • merlynwzrdmerlynwzrd Member Posts: 1
    I don't know who this adjuster worked for, or how long ago he worked in the industry, but there are numerous inaccuracies in his article. As an adjuster with 20+ years experience. I know whereof I speak.

    First, Claims 101: The first and most important lesson an adjuster learns in training is "we pay what we owe". The insurance company owes what it costs for a shop to fix your car, and choosing your own shop, which is something any legitimate adjuster is required to tell you, does not obligate them to pay that shop's price. Specialty shops like the author describes will typically pad the estimate with higher labor rates and unnecessary repairs.

    Second, claims adjusters almost never have direct contact with the so-called preferred shops. Their contracts are negotiated by management, and are usually guaranteed for as long as the person owns the car.

    Third, 50% is much too low a threshold for a total loss. Typically a company will total a car if repairs are 70-80% of the car's value. Also if you think merely suggesting that there MIGHT be hidden damage will convince an adjuster to total your car, think again. The damage described by the author is something any reputable shop would have on the original estimate.

    Fourth, any reputable company will have their own appraiser look at the car and write their own estimate which will be compared with the shop estimate and an agreed price reached with the shop. Also, most companies today use total loss evaluation services, and that evaluation is basesd on a physical inspection of the vehicle. These will include comparable local vehicles, usually as many as 15-20. No one has a right to pick the vehicles to be used as comparables. This is true both for insured individuals (it's written into the policy) and claimants. I have rarely seen the appraisal clause invoked, and very few of those cases were decided in favor of the vehicle owner.

    Finally, going back to the beginning., the adjuster will pay what the company owes. Tactics that the author attributes to the insurance company don't happen if you are dealing with an honest adjuster, which is about 99% of us. These things are counter productive, since they require more time than they save. As for the suggestions made by the author of asking for an extra $500, suggesting there might be hidden damage in an attempt to persuade an adjuster to total the car or asking for only a partial list of comparable vehicles to be used are dishonest and could possibly be insurance fraud. That extra $500, multiplied by just 1 driver a month in each state, amounts to $300,000 a year. That means extra premiums for everyone!

    Adjusters also get audited on their file handling, and I can personally guarantee that an adjuster who let these tactics go on would soon be unemployed. Dealing fairly with people is only in the adjuster's best interests. Taking the extra time to "lowball" a customer actuall hurts their performance; giving in to the tactics suggested by the author hurts their performance as well. The best rule to follow for the adjuster and claimant is to pay (or accept) what is fair - nothing less and nothing more.
  • chaseautobodychaseautobody Member Posts: 1
    More people need to do this !! Worth the read !
  • ldowns911ldowns911 Member Posts: 1
    i have a total loss assesment on my 2008 dodge ram 1500 only 55-60k miles on it. brand new tires. The front end was the only part that was pretty bad. I wanted to see how to figure out what the value I would get for my vehicle how would I figure that out I don't want to be low balls. My truck was about $25k when I bought it.
  • lukemc1212lukemc1212 Member Posts: 2
    Perhaps the 50% vehicle value total changes among states. Also, Insurance companies will "cover" the adjuster appraisal. They are obligated to insure the vehicle for a value determined by the adjuster and the vehicle owner. Pay what we owe? How is this determined? By average cost, average acceptance of claims, importance of claim, how much time it takes to negotiate with a client, how many claims they have to settle, how much money the range of the vehicle is worth, how much insurance profit was gained from the registered vehicle..so on and so forth. I've had adjusters go from low-ball 2,600 to upwards of 4,000 because I told him I would get my vehicle checked out by my mechanic, whom is reputable in town, and hire and independent adjuster recommended by this mechanic if we still could not settle on a price. Further more, if this price was still insignificant I will change my insurance provider.

    Now who has the upper hand? I've never "Made out great" on how much I've paid for insurance up until I actually file a claim and how much money I get back. I've never had any personal injury's to cover for myself or anyone else. In fact, I live in a no-fault accident state where there is an association that handles personal liability and coverage. This, "No-Fault" accident scheme costs over 100 dollars in fees per 6 months, as well as a premium increase of usually 100 dollars per 6 months as well. Now, how often is there a 300k+ dmg for personal injury's for 3+ people? Not often, and I also have to pay to protect uninsured drivers due to this. It is increasingly difficult to justify negligent driving by offering compensation for higher premiums instead of allowing the victim to settle in court if they wish. So yes, if I am injured or injure an uninsured driver and I do not have appropriate coverage, I am looking at a large settlement often involving drowning that driver in a financial burden they can never pay off.

    If I wanted to switch insurance providers where I live, the insurance company would lose more than 1.5k in less than 2 years with these associated fees unless I totaled another vehicle; which then I would be a high risk driver without any sort of compensation to choose from, even with a deductible for under 2 grand a year per vehicle..and do you think I'd be driving a BMW in my 2nd or 3rd accident? If you are just following this, you get the gist without any technical details that your insurance company can afford to keep you, and the insurance adjustment agency worker for insurance companies can afford to pay extra for a damaged vehicle. Nobody wants to make a claim, but when they do they want that claim to represent their pocket expense in full and to see fit in timely manner.
  • lukemc1212lukemc1212 Member Posts: 2
    Correction *I've never made out great even after filing a total loss claim*.
  • shopowner2shopowner2 Member Posts: 1
    Actually the adjuster is spot on. we have been told by several of our customers that their adjusters or wrecker drivers try to influence where they get their vehicles repaired. they even go as far as to say they have to use a preferred shop on their list. most of their preferred shops cant even match the factory paint and will make excuses like the paint is sun damaged and cant be matched. we have been doing this for more years than I care to admit and Im here to tell you we can match any paint and anybody that knows what they are doing can do the same. also it is very seldom that I don't have to ask the insurance company for supplements because they overlooked one repair or another. my advise to people is simply this, don't cash the check until a qualified shop has had a chance to look at your vehicle and make sure your being paid for all the damage.
  • chellechechelleche Member Posts: 1
    merlynwzrd - The insurance company is not always going to be the one to pay up. I have known times where they would want to keep their best interest in mind while working with the customer. They are not in business to not "make" money. THINK ABOUT IT THIS WAY....THEY DON'T WANT TO LOSE EITHER.
  • zoundszounds Member Posts: 2
    Sounds like Merlyn (see above) knows what he's talking about, at least from the stand point of working for a big insurer (I think he works for State Farm because their motto is we pay what we owe).
    I've got about 9 years auto adjusting experience as well as another 9 years or so of investigation experience so I too have handled a lot of total loss negotiations.
    I have a couple of comments;
    Some states (PA for one but probably many others) regulate how insurers have to evaluate total losses. Some say when a car is a total (usually around 70-75% of value to repair) and all of them now require very stringent rules on how the title is branded as a salvage vehicle which means the old days of owner retaining a car with a simple signature on a form are gone thanks in part to the National Motor Vehicle Title System and NHTSA/DOTs involvement in making sure all titles are branded in a uniform way.
    Anyway I digress;
    Your adjustor will follow the rules of the state you live in first then their own internal guidelines. A General Adjustor or experienced Senior Adjustor will have leeway and negotiating authority that a more junior adjustor won't. Some adjustors are perennially in bad moods (it's a lousy job frankly) and some are always happy but all of them will respond to being treated professionally and fairly so do what your mom taught you; BE NICE. If you're nice they'll be nice back. If you're awful to deal with they'll avoid dealing with you and will make no effort to help you (read pay you more).
    It's OK to be sure they get the correct information to evaluate your car by going over the options and condition in detail. This is really important if the car is stolen or totally burned and can't be inspected for options and condition.
    If you try the ol' "all my repair and parts receipts were in the glovebox when it was stolen" route forget getting the benefit of the doubt. Adjustors aren't going to cut you a break just because you were stupid (or worse if they catch you lying). And they won't (and can't) pay you for stuff that every car needs like routine maintenance (I just changed my oil!).
    It's been my experience, especially now in the era of the internet that no one pays more for used cars then insurance companies. No one. Period.
    Try selling a 20 year old Ford Escort with a slipping transmission on the internet for $2500. Think anyone will pay that? Think anyone will pay more than $500? Your insurance company will. They are in the business of paying claims expeditiously and without ruffling feathers of their agents, customers and especially state regulators. So yeah, they'll pay you $2,500 and you should thank them and move on.
    In my experience insurance settlements usually exceed and often FAR exceed what you'd ever get paid in an open market sale.
    Nuff said. Go forther and prosper.
  • rav462rav462 Member Posts: 1
    I created an account on here just so I could comment on this article and give the top comment kudos. The comment from merlynwzrd could not be more accurate: indemnity is focus of every claim in every reputable claims handler's mind. As an adjuster myself, I have seen people retain attorneys in an attempt to leech more than what is due them from the insurance companies and they are usually left with the original offer less attorney fees. Insure with a reputable company and you have nothing to worry about.
  • wvangelwvangel Member Posts: 1
    My car was totaled due to a hail storm, the claim was paid no problem. However, I have called the insurance company to pick up the car on two occassions and it has been over a month and it is still sitting in my driveway. Do I have any rights as far as the ownership of the car?

    If they don't want to take ownership, I will gladly take it and sell it for whatever I can get out of it.

    Thanks!
  • cryssflycryssfly Member Posts: 1
    edited August 2015
    About 5 years ago, my wife had an accident. She was traveling at apx. 30mph fell asleep and ran into a dirt embankment. I was in the hospital with pneumonia, she was on her way to visit me when it happened. The car was a fairly hard to find (especially in excellent condition)Acura RSX Type S 40000 miles and new tires, plus lots of extras. The damage was minimal, apx $3000 in parts, the air bags did NOT deploy, no windows broken, damage was from the radiator forward, and as a veteran auto technician I knew the appraiser was full of IT when e promptly totaled out the car. He refused to see me in the hospital, and by the time I was out and able to deal with it, it was too late. The clown refused to return my calls, he tried to say the engine mount drivers side was pushed back... [non-permissible content removed] I had FARMERS insurance for 20 plus years. They are expensive and now I know NOT HONEST AT ALL. BE AWARE, there are a lot of wolves out there. Now so much time has passed I can only change carriers, Like most mechanics I take great pride in my work (maybe not most) the car was part of our family, and my wife's pride & joy. Being disabled, driving was one of the only thing's she truly enjoyed that she could still do, and that car gave her great joy. BUT insurance companies DO NOT care about any of that. Chances are the car was sold at auction, repaired half a** and given a clean title, jut to be sold again within 90 days, AND on top of that the GAP coverage was voided and we had to pay the difference out of pocket, or buy the car back for ...get this... $8000.00 which was more than the balance on the loan!!! It is one thing to make good money at your job, it's another to rob and destroy to get rich. Had I had the $8000 to buy it back, I would have, now it's gone from us forever.
  • jd123456jd123456 Member Posts: 1
    Hi i recently lied on my auto claim with geico i told them that i was the person operating the vehicle. long story short the claim went to investigation and i ended up telling the truth . will the still pay for my damages ? its worth about 50% of the cars value .

  • mousears7mousears7 Member Posts: 1
    I went up over a curb and collided with a sign which just caused some damage to the driver's right front end on the quarter panel area, the headlight missing, a few other parts, tire is flat and there no damage to the frame, the suspension, hood, anything under the hood, and in addition there was another sign or mailbox or sign on the other side that cause damage to the back passenger side to the quarter panel, missing tail light, a few parts needed, scratches but the car was even still driveable after the accident. No leaking, no steering issues, the tire was going flat but needed to get just down the road because there was no reception or anything, no other cars in the area as it was secluded so couldn't call anyone, was getting dark etc but light enough to see etc. The passenger door partial jammed but still opens part way. Even though it was still driveable, they elected to have it towed since I have towing, and it was towed to a towing yard. Called and reported accident to State Farm. Upon reporting it, the agent who asked all the questions, reported it partially incorrect and it somehow got reported as mostly likely totalled which was an error on his part but didn't know it at the time. The agent gave me a list of repair shops in the area which were a list of their "select service" shops but said I could choose any repair shop I wanted to, I had worked with some of the "select service" shops before with bad experiences and seem to overestimate, have horrible service and take a long time,so I elected to choose a shop highly recommended. Was told that by choosing whatever shop I wanted, they would then have an adjuster come to that shop and do their estimate at that location and do the walk through with their "mechanic" and do their "formula" etc and go from there.as told it was looking like about 5 days before an agent could even get to the repair shop to do estimate. Magically, were there next day at the tow yard doing an estimate! The words he used according to the tow shop were, "well I heard the car was totalled, so here I am and his estimate for $7015.00!!! Was saying I had suspension damage I know but not sure what else as that is all I could get out of State Farm. I was floored as to why they were even there to do an estimate at the tow yard doing an estimate when it was supposed to be done at the repair shop, along with the mechanic. This is a shop that has worked with State Farm in the past many times but NOT one of their select service shops n trying also to say they want to help me and would fix or repair for whatever number they gave them, up to code state farm requires of course but was told they would then be violating State Farm's policies because they aren't a "select service" preferred shop.

    Called to find out why adjuster showed up at tow yard, State Farm told me, yet another mistake was made n someone else made an error again stating someone checked the box stating possible loss which automatically sends an adjuster out n State Farm apologized for this error. Explained this was the 3rd error on their part, first being how it was reported incorrectly, which some one took care of re-asking original questions about accident n said car is considered repairable n NOT a possible loss. Then arranged for the tow. Then someone else was in file n checked box for "possible loss which triggered adjuster out there even though the tow was already set up an all the notes were in the system with how the first error was made n was deemed as REPAIRABLE. So spoke with with supervisor, was told to ignore all of that cux Spoke with another agent she was giving me all figures as my car being Totalled n I explained all issues mentioned above, all errors which caused this mess said, I'm sorry, they are going by what adjuster said n your car is totalled n that is final but never gave me amount what my car is even valued at yet so don't know how they know it's totalled?? But still fighting that anyway.

    I have all of the agents I spoke with, all of notes n actual recordings of the calls as they are legal in my state. The supervisor, said I was to IGNORE the agent who stated my car was considered Totalled as that was again another error by State Farm. He said it is NOT TOTALLED, amount given was an estimate and that my car was NOT TOTALLED, but REPAIRABLE and apologized for this whole mess but said main thing is that my car is NOT TOTALLED and that they needed get to the repair shop n then get the estimate from the repair shop with adjuster since I disagreed amount of adjuster, I have right to dispute that and have the mechanic and adjuster relook at things as things could be missed, some things could've been included in original estimate by adjuster that aren't even wrong, such as them saying the suspension for one, when the mechanic already said there is no suspension damage since n it has gotten towed there, he said the car isn't even that bad n cannot figure out at how they are even coming up with that number at all. They say it's completely repairable and not even close to that amount and refuse to explain it to me.

    When I called State Farm yet again, they refuse to send an adjuster to the repair shop since they already went to the tow yard and did the estimate which was wrong because of someone checking a wrong box, was supposed to be done at the shop, PERIOD, which was how process is supposed to work every agent I have spoken to has told me same thing, n I if I feel there is a discrepancy in estimate, n have a mechanic who also has discrepancy, according to my rights, I am entitled to have them come out n have this looked at since I am disputing the amount, especially based on the amount of the estimate, and in Good Faith, according the law I am entitled to a prompt, fair, claim where where the determination is unclear and if disagree for them to come out and do a re-evaluation, every time I call, the information changes, State Farm has already admitted to making mistakes filing it wrong to begin with.Every time I call State Farm I get different information. Luckily I have the calls recorded, as in the state of Colorado, it's legal to do so. I was just recently assigned a new claims adjuster, who is VERY nasty who refuses to even speak to me. She just says I have reviewed all of the notes. She will not let me speak or go over all of the details. Says again, I see who you've spoken to and have the notes. I tried to tell her that notes do not always contain all of the information, especially details, and I'd like to go through the details with her. She refused to listen to me at all. She was also very nasty to repair shop. She will not allow an adjuster to go there and do what I believe I am entitled so especially since I have a huge discrepancy and I do, I'm entitled by the law, to have substantial justification and a fair assessment and re-evaluation where there is a discrepancy involved.
    First request was denied to have evaluation done but asked for another manager. I'm finding more and more information regarding my rights. If she denies, I'm going to her manager.I just know they are doing me wrong. Have ready many reviews and seen some lawsuits where Start Farm has done this in the past and am gathering as much information as possible. I am have contacted the Colorado Department of Regulatory Affairs Division of Insurance who stated I definitely need to file a claim so it can be investigated and they can get involved as she says to much time as gone by and they need to help me get someone out there. Next is the State Insurance Commission for Colorado.
    Can anyone help me out here? Give me some additional direction on how I can invoke my rights on getting an adjuster to do what they are supposed to if I do not agree with their assessment,the mechanic disagrees as well?? I am looking into possibly involving the media if need be. I have no idea what to do. I need help. I'm desperate!
    Thank you!!
  • carboy21carboy21 Member Posts: 760
    Send them a lawyers notice
  • henry4hirehenry4hire Member Posts: 106
    I read the article and the comments and spoke with a co-worker that used to be an adjuster and I managed to get an extra $750 by telling the adjuster to use a smaller list of cars and keep it very local. The adjuster was totally cool with that and got back to me within an hour with a new estimate. I was happy and he was happy. Done and done.
  • PitherPither Member Posts: 1

    I was hit by driver. We both have progressive insurance. I made the claim through her since she hit me. Ahhh but she lied and said it was the other way around…until I got the video… the adjuster never follows up anyway and even with the proof I am ignored. I’ve always had good service with them until now. Is there an issue since I claimed it under the other driver? They originally had 2 claim numbers but consolidated them. Thank you sooo much.

  • kyfdxkyfdx Moderator Posts: 237,051
    Pither said:

    I was hit by driver. We both have progressive insurance. I made the claim through her since she hit me. Ahhh but she lied and said it was the other way around…until I got the video… the adjuster never follows up anyway and even with the proof I am ignored. I’ve always had good service with them until now. Is there an issue since I claimed it under the other driver? They originally had 2 claim numbers but consolidated them. Thank you sooo much.

    If the other insurance company is not responsive, contact your insurance company for help.

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  • zoundszounds Member Posts: 2
    Pither, you are in the somewhat awkward position of having a claim where you and the adverse party are both represented by the same insurance carrier. Big companies have rules about making sure the handling of the 2 claims is siloed to prevent the adjusters from working together against the interest of their customer(s) but if you cannot get assistance by first asking to speak to your adjuster's supervisor, then you might need to complain to your state Department of Insurance. Usually that can be done with an online questionnaire on the DOI's website and that will definitely get your adjuster's attention! Good luck.
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