Confessions of an Auto Claims Adjuster

Confessions of an Auto Claims Adjuster


When you want to get a little more for your car, you can't be nice. The adjuster knows what he can do, he's done it a hundred times before and he won't hesitate to do it again to close that file. But to you, the individual, it's a brand-new thing. And it's money in your pocket.

After my friends get in a car accident, they come to me to ask how to deal with the claims adjuster. Recently, I helped a friend who had totaled her Mini Cooper and she got $1,500 more than what the insurance company first offered her.

You have to know the business and understand the role of the auto claims adjuster and then you can negotiate effectively on your own behalf. It's not that the insurance companies are trying to cheat their clients. Actually, they want you to be happy. But they are in a hurry, with lots of open cases, and don't have the time or inclination to thoroughly research your case.

The Life of an Auto Claims Adjuster

I spent four years as a claims adjuster for a nationally known insurance company, and my specialty was dealing with total loss claims as well as theft vehicles that weren't recovered. So it was my job to determine the value of the vehicle, present this to the customer and convince them to accept it.

Being a claims adjuster is probably one of the most stressful jobs. I actually lasted longer than most people. If you have a low tolerance for people yelling at you, you won't last long. There were times when my office had bomb threats and even times when I was confronted physically.

My caseload was about 150 open cases. Just think of keeping up to date and knowledgeable about all 150 cases and the high volume of telephone calls that goes with it. In addition, you are meeting people face to face under circumstances which aren't always pleasant.

I also had an extremely high volume of calls, probably 60 calls going out and 50 calls coming in each day. The calls came in so fast that if you picked up the phone there might be someone on the line before it rang. That happened three or four times a day.

How the Claims Process Works

I worked the back end of the claim. I got the file after liability had been settled, so they knew who was at fault. It was my job to decide how much to pay the person for their car or to decide if the vehicle was repairable.

Auto claims adjusters love it when a customer is happy with what they offer. For example, if Mrs. Smith is happy with the amount we give her, she signs the paperwork and we're done. But in most cases, they aren't happy. People get too attached to their cars, and they think the car is worth more than it really is. People might not have gotten a car in four or five years, and they don't realize the car has depreciated considerably. That is where the big disputes come in.

When the customer disputes the claim, the adjuster will explain how they got their figure. Basically, they have prepared what is called an evaluation report that uses two to three similar vehicles ("comparables") as pricing references, but it can use a dozen or more.

Get More Money for Your Car

If you are offered $15,000 and you just tell them you want $18,000, they aren't going to give it to you. You have to come up with a reason for them to give you that much. Every adjuster has a little flexibility, and they know that not everything will go through easily. So they usually have an extra $500 to settle a case.

The best way to get more money out of an auto claims adjuster is to challenge the evaluation report. Take a look at the vehicles they used as comparables. A fair market value is determined by taking the average of the comparable vehicles. The key word there is average — it only takes two vehicles to make an average. So if you have two cars worth $20,000 but the six others are worth $14,000 you can ask your adjuster, "Here are two cars that are just like mine, so can you base your evaluation report on those?"

Another tip is to ask the adjuster to reduce the number of comparables. You can ask him just to use the top five vehicles and that might be enough to bring the price up quite a bit. Believe it or not, a lot of people don't do that. But the smart ones do. When someone did that to me, it made me wonder if they had talked to some other adjuster who had coached them.

If you have a classic car, 90 percent of the time the insurance company will not evaluate your car correctly. Say you have a 1980 Pontiac Trans Am, the old Smokey and the Bandit car. I could see an evaluation report coming back at $4,500. But in all honesty, that car, in pristine condition, is worth about $25,000. If you know that, get ready for a lowball offer and find your own comparable vehicles to get your price to where it deserves to be.

Another thing that consumers don't realize is that in some states, you have the right to hire an independent appraiser. This could be a good move depending on the cost. But if you have a 2004 Camry, there isn't much to be gained if the independent service costs $400.

Be Prepared for Pushback

If a customer challenged me, I had a few lines I would always use. I'd start by saying something like, "I think our appraisal looks good. I'm sorry it doesn't satisfy what you think it's worth." But then, if they still didn't agree, I would say, "Here's what I can do. I can go up another $500 if you are willing to settle." And sometimes that worked.

Just remember, the auto claims adjuster wants to settle your claim. They have a heavy caseload, and they are looking to close 40 cases a month. So there is always about a $500 window where they can settle a claim immediately. If a claimant pushes for more money, it might take longer to get approval while the adjuster gets a signature from their supervisor.

When Your Car Is "Totaled"

If the repairs to your vehicle were less than 50 percent of the car's value, we fixed it. (Note: This percentage varies by state.) But what if the customer had a car that was worth less? If they went to sell it and the buyer found it was in an accident, they would reduce their offer or refuse to buy it. This is called "diminished value" and the insurance company won't pay for this loss of value.

So if you are close to the 50 percent threshold, you can argue with the adjuster to just "total it out." That way, you get a check that you can put toward the purchase of your next car, rather than getting your old car back.

Tell the adjuster, "There might be some hidden damage to the car that you didn't find. It could have damage to the unibody frame or the rails or maybe something is going to go wrong with the air-conditioning. Therefore, can you please total out the car?" Sometimes, this will persuade them since they know you're right.

Avoiding the "Preferred" Repair Shops

You should also be prepared for the auto claims adjuster to try to steer you toward their preferred body shop. We would tell our clients, "We would like to help you get your vehicle repaired and we do have a list of preferred shops that we would like for you to use. They are all certified and do top-of-the-line work."

My recommendation is to ignore this offer and go with the shop you want. If possible, take your car to a shop that specializes in your make of car. If you have a fairly new car, like a 2007 Honda Accord, take it to a Honda body shop. I can tell you right now our preferred shops, once a month, came around and bought us lunch and gave us little gifts to get us to push business their way. If the vehicle was going to be repaired we would push people toward one of our shops.

Looking Back

Being an auto claims adjuster took a toll on me. I'd say it changed my view of human nature. It opened my eyes to the fact that some people are honest but some people are just trying to get as much as they can.

But it's also important to be ready to negotiate and stand up for yourself. I remember I offered this one guy a settlement, and he accepted it right off the bat. He said he was a religious man and respected what I did and assumed I was being honest. It almost made me feel bad. I wanted to say, "Wait! Wait! Don't you want to negotiate?" But being a good claims adjuster, I would never do that. So just remember, it's your car, you paid all those premiums, and you deserve whatever your car is really worth.

Read more articles in the Edmunds Confessions Series.

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  • thanks!! i never knew you could negotiate! as i recently went through a total loss and just accepted the offer!

  • ader ader Posts:

    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_lachnit c_lachnit Posts:

    @Ader: Thanks for sharing your experiences. This Edmunds article, "10 Steps to Buying Auto Insurance" point out how important it is to check on how the insurance compan

  • merlynwzrd merlynwzrd Posts:

    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.

  • More people need to do this !! Worth the read !

  • ldowns911 ldowns911 Posts:

    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.

  • lukemc1212 lukemc1212 Posts:

    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 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.

  • lukemc1212 lukemc1212 Posts:

    Correction *I've never made out great even after filing a total loss claim*.

  • shopowner2 shopowner2 Posts:

    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.

  • chelleche chelleche Posts:

    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.

  • zounds zounds Posts:

    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.

  • rav462 rav462 Posts:

    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.

  • wvangel wvangel Posts:

    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!

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