(Photo: Daniel Hayduk - Castanet)
Facts your adjuster won't reveal
May 14, 2011 / 5:00 am
If you are injured in an accident, one of the first people you will have to deal with is your friendly neighbourhood insurance adjuster (insert “It’s a Beautiful Day in Your Neighborhood” background music here). However, no matter how friendly they appear, you need to know that they are not your friend.
The following are 10 important facts that your adjuster won’t tell you:
They have a conflict of interest - If you have been injured in a car accident involving another BC driver, it is impossible for the adjuster to act in your best interest. This is because ICBC is also the insurer for the vehicle that hit you and they are required to defend that driver. If they have to act in the best interest of the driver that hit you, they cannot act in your best interest as well. This is a conflict of interest.
Your limitation period is about to expire – No matter how much negotiating you do with the insurance adjuster or how many internal appeals you do (note: this is a huge problem with disability insurance claims), if your claim is not filed with the Court (Note: not the insurance company, the Court) before the expiry of the limitation period, your claim will be statute-barred, which means the insurance company no longer has to pay you a dime.
Settling your case before you have fully recovered is a bad idea – Until you have fully recovered from your injuries, neither you or the adjuster can calculate what your claim is really worth. The amount of money you are entitled to depends on several factors, including how long you are injured for. If you do not know how long it will be before you will get better or even if you will get better, you cannot get a fair settlement for your case.
The insurance company may not be entitled to see your entire medical file – When you first meet with the insurance adjuster they will ask you to sign a bunch of authorization forms. Most people don’t pay close attention to what they are signing, which may include a request for your last 7 years of medical records. A lot of this information is not relevant and they will use what they find in your history against you. For more information on why giving a blanket authorization to insurance companies is a bad idea, see my previous article titled “What’s in Your Medical Records.”
Even though your collision is considered an LVI (Low Velocity Impact) you may still be entitled to damages – ICBC has a policy not to pay damages for personal injury claims on collisions that are categorized as LVI. However, this is ICBC policy and not the law. If you were injured in the accident, you can still pursue damages through Court.
You should take the following steps to prove the other party is liable and you are not – The insurance company is not going to tell you how to prove that their insured (the other driver, store, manufacturer, professional, etc.) is at fault. Also, they may not tell you that they think you are at fault or that they do not think their insured (the other party) is at fault until it is too late for you to gather critical evidence that would have been available within a short time from the accident. You should never assume that an insurance company accepts that the other party is at fault.
They pay their specialists hundreds of thousands of dollars a year and they are not likely going to find anything wrong with you – Insurance companies have specialists (doctors, occupational therapists, etc) that they hire on a routine basis because these specialists are more likely to provide them with the kind of reports that allow them to justify their decision to terminate benefits and make low settlement offers. It is important to counter these reports with reports from your own specialists. If you are being asked by an insurance company to see a specialist, it is a good idea to seek legal advice before the appointment to find out if you have to go and how you should prepare for the appointment.
Hiring a lawyer is a good idea – Insurance companies do not want you to hire a lawyer because it will cost them more money. In many cases, if you do not hire a lawyer, the insurance company will take advantage of your lack of knowledge about what your claim is worth and how to go about proving the true value of your claim.
Hiring a lawyer will result in you receiving more money - Since insurance companies don’t want you to hire a lawyer, they will tell you things like “hiring a lawyer will cost you a lot of money and you will get less in the end.” What they won’t tell you is that they will actually deduct a significant percentage off the top of the settlement figure they arrive at (based on their estimate of fair) before making an offer to you, to account for the legal fees that you would have paid, if you had hired a lawyer. In other words, there is no savings to you by not hiring a lawyer, only the insurance company.
Hiring a lawyer will provide you peace of mind – In addition to knowing what is a fair settlement, hiring a lawyer will allow you to get on with life and focus on your recovery instead of having to deal with an insurance company and worrying about whether you should sign something, if you have given them too much information or if the offer they have presented is fair. If you make a mistake settling your own case, unfortunately there is no one to blame and suing yourself is not an option. If you hire a lawyer and the lawyer makes a mistake (such as missing the limitation period), suing the lawyer is an option, which provides you with an extra layer of protection.
In summary, it is important to remember that the adjuster assigned to your file works for an insurance company. The adjuster’s job is to settle your claim as quickly and economically as possible. So, no matter how much the adjuster tells you that you will be treated fairly, it’s a business, which means at the end of the day, they will only tell you what they want you to know.
*Important Note: The information contained in this column should not be treated by readers as legal advice and should not be relied on without detailed legal counsel being sought.
Read more INJURYwise articles
- Minor accident - minor injury? May 4
- ICBC says I don’t need a lawyer Mar 3
- ICBC ought to include a warning Feb 3
- Run over by a reindeer Dec 22
- The skeleton in your closet Oct 5
- The good lawsuit Aug 1
- CYA for hosting BYOB Jun 28
- Is it medical malpractice? May 25
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