Insurance Adjuster

After an accident, one of the first people you may hear from is an insurance adjuster. An insurance adjuster investigates claims, reviews evidence, evaluates damages, and helps the insurance company determine whether to accept a claim and how much compensation it may offer. While adjusters play an important role in the claims process, they generally work on behalf of the insurance company, not the injured person.

At Conboy Law, we help injured people throughout Illinois understand the claims process and protect their rights when dealing with insurance companies.

What Does an Insurance Adjuster Do?

An insurance adjuster's job is to investigate an accident and gather the information the insurance company needs to evaluate a claim. Depending on the circumstances, the adjuster may communicate with the parties involved, inspect property damage, review medical records, interview witnesses, and analyze other available evidence.

Their responsibilities commonly include:

• Reviewing accident reports and photographs
• Speaking with drivers, witnesses, and other involved parties
• Evaluating vehicle damage and repair estimates
• Reviewing medical records and bills
• Assessing liability
• Calculating the value of a claim
• Negotiating settlement offers

Although adjusters investigate claims, they generally do not make the final legal determination regarding fault or liability. Their findings are used by the insurance company when evaluating the claim. 

Who Does an Insurance Adjuster Work For?

One of the biggest misconceptions after an accident is that every insurance adjuster is neutral. In reality, the adjuster's responsibilities depend on who hired them.

Company Adjusters

A company adjuster is employed directly by an insurance company and investigates claims on behalf of that insurer. Their role is to evaluate claims under the company's policies and procedures.

Independent Adjusters

Independent adjusters are not employees of a single insurance company. Instead, they are hired on a contract basis to investigate claims for one or more insurers. Although they work independently, they still represent the insurance company that hired them for your claim.

Public Adjusters

A public adjuster is different. Rather than working for an insurance company, a licensed public adjuster represents the policyholder in certain first-party insurance claims, most commonly involving property damage. Illinois law requires public adjusters to act in the best interests of their clients and establishes professional standards governing their conduct. 

If you were injured because of someone else's negligence, the insurance adjuster contacting you after the accident is usually working for the at-fault party's insurance company. Their responsibility is to evaluate the claim on behalf of that insurer rather than provide legal advice or advocate for your interests.

What Happens After an Insurance Adjuster Contacts You?

It is common for an insurance adjuster to contact you shortly after an accident. Understanding what typically happens during the claims process can help you know what to expect.

Initial Phone Call

The adjuster may ask basic questions about when and where the accident occurred, who was involved, and whether anyone was injured. They may also explain how the claims process works and request additional information.

Request for a Recorded Statement

In some cases, the adjuster may ask if you are willing to provide a recorded statement about the accident. Whether you should do so depends on the circumstances, including whether the adjuster represents your own insurance company or the other driver's insurer. Before agreeing to a recorded statement, many accident victims choose to speak with an attorney to better understand how their statements could affect their claim. 

Request for Medical Information

If you are seeking compensation for injuries, the adjuster may request information regarding your medical treatment, healthcare providers, and related expenses. Medical documentation often plays an important role in evaluating injury claims.

Property Damage Inspection

When vehicles or other property are damaged, the adjuster may inspect the damage personally or review photographs, repair estimates, or appraisal reports before evaluating that portion of the claim.

Settlement Discussions

Once the adjuster has gathered sufficient information, they may begin discussing a possible settlement. Depending on the circumstances, additional documentation, negotiations, or investigation may still be necessary before the claim is resolved.

What Information Should You Share With an Insurance Adjuster?

Cooperating with the claims process does not mean you should speculate or guess when answering questions. Providing accurate information while avoiding assumptions can help prevent misunderstandings later.

Generally, it is appropriate to provide basic factual information such as:

• Your name and contact information
• The date and location of the accident
• The vehicles involved
• Your insurance information, when appropriate
• Information regarding property damage or medical treatment that you know to be accurate

Avoid guessing about issues such as fault, the extent of your injuries, or facts you do not yet know. If you are uncertain about a question, it is generally better to explain that you do not know or that the investigation is ongoing rather than speculate.

Should You Give a Recorded Statement?

Whether you should provide a recorded statement depends in part on which insurance company is requesting it.

If the request comes from the other driver's insurance company, Illinois law generally does not require you to provide a recorded statement. Many personal injury attorneys recommend speaking with legal counsel before agreeing to such a request because statements made early in the claims process may later become part of the insurer's evaluation of your claim. 

If the request comes from your own insurance company, your policy may include cooperation requirements that affect your obligations. Because every insurance policy is different, reviewing your policy and obtaining legal advice when necessary can help you understand your responsibilities.

An insurance adjuster's questions may seem routine, but your answers can affect how your claim is evaluated. If you have been injured in an Illinois accident, understanding the claims process before making important decisions can help protect your rights.

How Insurance Adjusters Evaluate Claims

Insurance adjusters consider many different factors when evaluating a personal injury claim. Their goal is to determine whether the insurance company is responsible for paying the claim and, if so, what they believe the claim is worth based on the available information.

Liability

Before discussing compensation, the adjuster will investigate how the accident occurred and whether the insured party may be legally responsible. This often includes reviewing police reports, witness statements, photographs, video footage, and other available evidence.

Medical Records

Medical documentation helps the adjuster understand the nature of your injuries, the treatment you received, and whether those injuries appear consistent with the accident. Records from physicians, hospitals, therapists, and other healthcare providers often play an important role in evaluating the claim.

Lost Income

If your injuries prevented you from working, the adjuster may review employment records, wage statements, or other documentation to verify lost income and determine whether compensation for those losses may be appropriate.

Property Damage

Vehicle repair estimates, photographs, and appraisals help establish the extent of the property damage. Although property damage alone does not determine the value of an injury claim, it often forms part of the overall evaluation.

Future Damages

When serious injuries require ongoing medical care or may affect future earning capacity, additional documentation may be needed to evaluate those potential losses. Depending on the circumstances, expert opinions may also become relevant.

Common Insurance Adjuster Tactics

Insurance adjusters handle claims every day and often follow established procedures designed to investigate and resolve cases efficiently. Understanding these practices can help you better prepare for the claims process.

Offering an Early Settlement

In some cases, an adjuster may make a settlement offer before the full extent of an injury is known. Before accepting any settlement, it is important to understand whether future medical treatment or other losses have been fully considered.

Requesting Broad Medical Authorizations

An adjuster may ask you to sign forms authorizing access to your medical records. Before signing any authorization, you should understand what information is being requested and whether the request is appropriately limited to issues relevant to your claim.

Questioning the Severity of Injuries

If the available medical records do not clearly document your injuries or treatment, the adjuster may ask additional questions or request further documentation before evaluating the claim.

Disputing Liability

Insurance companies may investigate whether another party contributed to the accident or whether liability remains disputed. Under 735 ILCS 5/2-1116 in Illinois, the facts surrounding the accident can affect whether compensation is available under the state's modified comparative negligence law.

Taking Additional Time to Investigate

Some claims require additional investigation because of disputed facts, serious injuries, or complex liability issues. While delays are not uncommon in more complicated cases, understanding the reason for additional investigation can help you better evaluate the status of your claim.

Insurance adjusters evaluate claims based on the information available to them. Providing complete documentation and understanding the claims process can help ensure your case is presented as accurately as possible. If you have questions about an Illinois injury claim, Conboy Law can help you understand your legal options.

What If the Insurance Company Denies Your Claim?

A claim denial does not necessarily mean your case is over. Depending on the reason for the denial, additional evidence or legal action may still be available.

Possible next steps include:

• Reviewing the reason for the denial
• Providing additional documentation or evidence
• Correcting inaccurate information
• Continuing settlement negotiations
• Filing a lawsuit when appropriate under Illinois law

An experienced personal injury attorney can evaluate the denial, explain your options, and determine the most appropriate course of action.

How an Attorney Can Help During the Claims Process

Insurance claims can become more complicated when liability is disputed, injuries are serious, or settlement negotiations stall. Having an attorney involved allows you to better understand your legal rights while ensuring the insurance company receives the information necessary to evaluate your claim.

At Conboy Law, we help clients throughout Illinois by:

• Communicating directly with insurance companies
• Gathering and preserving important evidence
• Reviewing medical records and other documentation
• Calculating the full extent of damages
• Negotiating settlement offers
• Filing a lawsuit when necessary to protect our clients' rights

Our goal is to allow you to focus on your recovery while we handle the legal process.

Frequently Asked Questions (FAQs)

Contact Conboy Law for Help With Your Insurance Claim

Dealing with an insurance adjuster can feel overwhelming, especially while recovering from an injury. Whether you have questions about a recorded statement, a settlement offer, or a denied claim, experienced legal guidance can help you make informed decisions.

At Conboy Law, we represent injury victims throughout Illinois and are committed to protecting our clients' rights during every stage of the insurance claims process. Contact our law firm today at 312-726-9000 for a free consultation to discuss your case and learn how we can help you pursue the compensation you deserve.