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Workers Comp Claim Adjuster: Discussion Do’s, Don’ts and Never Evers

Have you been involved in an accident at work and want compensation from your employer? If you have, the person you’re going to be discussing your claim with is an insurance or claim adjuster.

An insurance adjuster works for the insurance company hired by your employer to provide worker’s compensation. They may use the title claim adjuster, claims specialist, or claims analyst among others. But they all do the same job – which is evaluating your claim to determine whether to pay or deny it.

They may call you to ask for the information they need to process the claim. They can also send a letter or email with questions for you to answer. It’s crucial for you to know the queries they are likely to ask and how to answer them.

Here is a guide on how to deal with a claims specialist and their questions so that you don’t compromise your worker’s compensation claim:

Know That an Adjuster Isn’t on Your Side

The first and most important thing to note is that a claim adjuster is not on your side, even if they appear to be very friendly. An adjustor works for an insurance company that is in business and wants to make profits. Their end goal is to minimize the amount of money they pay you as much as possible.

An adjuster may not be a bad person, but their objective doesn’t play to your advantage. Their job is to pay you the lowest amount of money or even deny your claim to save the insurance company cash. So, be very cautious when dealing with them and giving them information that may jeopardize your claim.

If you consult a Georgia personal injury lawyer before talking to an insurance adjuster, you may have a better hand at the negotiations. The attorney will analyze the facts of your case and guide you on what to answer and avoid answering during a discussion with an adjuster.

Here are several do’s and don’ts when speaking with a claim adjuster to ensure you don’t jeopardize your chances of getting compensated:

Do’s

The first discussions about your accident and compensation claim may be difficult, but you need to remain calm through the process. It’s possible to hear from several insurance companies and adjusters, so make sure that the facts you give don’t contradict each other.

Here are a few things that you should do when the adjuster calls you up:

Note Down the Details of the Adjuster

The first step you should take before discussing anything with the insurance adjuster is to write down their information. Ask for their full name, name of the insurance company they work for, address, contacts, and name of their business if they’re an independent claim adjuster.

Give the Adjuster Limited Details of Your Personal Information

The adjuster will ask you for some personal information like your full name, address, and contacts. It’s okay to give them that. But don’t go as far as to provide them with details about your work, income, or personal family information.

Take Notes of the Conversation

Have a book and pen ready to scribble down details of the conversation between you and the adjuster. It’s imperative that you do this in case the adjuster says something else later on, and you’re not sure if that’s true or false. Note the questions they ask you and if possible the replies you give.

Be Polite

Even if you’re angry about the accident and the circumstances surrounding its occurrence, don’t pour out your anger on the claim adjuster. It will not help in winning your claim. Most adjusters have come across fuming claimants, and it doesn’t always end well.

But remember to keep in mind that an adjuster isn’t on your side. Being nice has its perks. The adjuster may expedite your compensation claim just because you’re friendly to them.

Ask them Questions

Don’t let the conversation be one-way. Also, ask questions like whether the adjuster is aware of any witnesses and if they can send you a copy of your employer’s first accident report. If you have not yet seen a doctor, ask for a list of the insurance company’s recommended physicians.

It’s good to know what questions you can ask a claim adjuster. An Atlanta workers compensation lawyer can help you draft several questions.

Describe Your Injuries Inclusively

When the adjuster asks about your injuries, describe them in an overly inclusive manner. You must ensure that every part that’s injured will be covered. If you fail to mention any area, the adjuster will be very happy not to pay for it.

For example, your leg could be hurting in the knee and ankle areas only during your conversation with the adjuster. But a week later, the pain spreads to your pelvic bone. In such a case, you should tell the adjuster that the injury is on your whole limb instead of giving specifics.

Tell the adjuster that you will provide them with a detailed and conclusive medical report once the doctors have done a full check-up on you.

Don’ts

As you speak to the claims adjuster, avoid doing the following. They could affect your chances of getting compensated:

Don’t Give Details of the Accident to the Adjuster

When discussing your claim with an adjuster from the worker’s compensation insurance company, politely refuse to give the details of the accident. They may try to engage you in such a conversation without you knowing. Just give them the general information about the accident like where, when, and nature of the occurrence.

Tell them that you’re still investigating the matter and will provide better details at the right time.

Don’t Agree to an Audio Tape or Document Signing

You don’t have to provide a recorded statement to the adjuster. If the claim adjuster sends you forms to sign, only do so after your Georgia personal injury lawyer has reviewed them.

The most common document that an adjuster will send you in Atlanta is the medical authorization form. This allows them to obtain your medical records. You’re obligated by the Georgia workers’ compensation laws to give some type of medical authorization to an insurance company if you’re making a claim and they request it.

What to Say to a Claim Adjuster!

When a claim adjuster calls you up for a little discussion about your worker’s compensation claim, worry not! Above are all the do’s and don’ts that will ensure you don’t jeopardize your chances of getting paid.

Contact us today for professional legal counsel on your compensation claim!

Seth Bader is an Auto accident, Workers Compensation and Personal Injury Attorney who practices in Atlanta, Rome, Savannah, Norcross, Carrollton, Georgia. He graduated from Florida State University College of Law, and has been practicing law for 14 years. Seth Bader believes in fighting for the injured. Learn more about his experience by clicking here.

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