Where do the adjusters get their numbers from?

Question

I have $55,000 in economic loss resulting from an accident on Sept 21, 2012. The adjuster is accepting liability in the case. The negligent driver had $100,000 in coverage. The adjuster isn't willing to pay limits. What is that about? I fractured my pelvis and missed 7 months of work. Seem a bit unfair. Where do the adjusters get their numbers from?

Gary Platt · Answer

The simple answer to this question is, the adjustors get their  numbers  from their own experience, the advise of their lawyers, and from their   knowledge that you have no idea what your case is worth and they can likely get   away with paying much less in damages than fair value because you are not   represented by a lawyer.  Do yourself a favor and hire an attorney to   represent you.  Even after you pay his fee, you will likely still end up in  a  better position.

Georges Shers · Answer

Most adjusters try to base their numbers on the low figure that similar other cases settled for. They discount chiropractic treatment, treatment from anyone that they consider excessive, time off work not justified by a treating physician's letter, and, very sadly, whether you are represented by an attorney. They also look at what liens have been filed, how long they feel you should have been off work, etc. [incidentally, do you have underinsured insurance coverage for yourself that would pay for pat of the difference between the case value and what the other driver's $100,000 limits were]. You may need an attorney to review the economic damages and medical reports and then write a strongly worded letter to the insurance company that either they pay or suit will be filed and they can explain to their insured why they have to be bothered by a lawsuit, whether they are entitled to Cumis counsel, and why they might have to pay any excess judgment.

Willie Stephen Graves · Answer

They have all sorts of software programs and formulas that they use, but the purpose of all of those tools is simple  to minimize the amount they have to pay to get you to go away. As for how to get the best recovery for your case, if you have a lawyer, trust him or her. If you don't, get one.

Loren Lambert · Answer

Where do the adjusters get their numbers from? They offer as little as they think you will accept based upon the risks of them having to pay more if you decline and sue.

Paul Whitfield · Answer

Not enough facts here. What and how is liability established? Amount of property damage? amount of medical bills? What do doctors say about future medicals if any? What is "economic loss" and how is it established? You need a lawyer to help you.

J. Michael End · Answer

The adjuster is just trying to settle the claim as cheaply as he or she can. Your case is clearly a limits case. The adjuster may think that he can settle the claim for less because you do not have a lawyer representing you. I cannot imagine the adjuster would not be willing to pay the $100,000 if you were represented by a lawyer. My advice is to persist in demanding $100,000, or get a lawyer to help you.

Gregory Janks · Answer

Many adjusters see their job as "saving their employer money" by refusing to pay valid claims or to pay full value, when their job is really to assess liability and damages and pay valid claims in a fair amount. Some insurers also see claims as a "waiting game" where they never offer fair or full value and drag the claim out hoping you will settle for a lesser amount just to be done with the matter. They all cry about "frivolous" lawsuits and the "lawsuit explosion", but have created  the problem themselves by not paying valid claims and making you sue  them to try and get fair value. Also adjusters use computer programs, Jury Verdict research, rely on in house stats and a "multiplier" x "specials" as other, seemingly more valid, ways to determine their offer.

Wayne Wimer · Answer

If I was honest about where they get the numbers, I would be kicked off of this forum, so I won't say where.  If it is Allstate, they employed a program named Colossus. Medical procedure codes were input to the program, and then they pressed a button on the key board and presto, here's your number, take it or leave it.  Other insurers probably employ something similar, but they will claim that a computer is not making the decision for them.

Alexander Gilburg · Answer

Instead of pondering obvious questions - adjuster represents insurance company's interests, not yours - hire an attorney as soon as possible. Judging from your statements, your case could be worth substantially more than $100,000.

James Kelaher · Answer

Out of thin air. Send the adjuster all of your medical records and medical bills, and demand they offer the policy limits. Tell the adjuster if they don't offer the policy limits, you will be going to a lawyer who handles bad faith cases for him to file suit, and then there will be no policy limits that should give them a scare.

Michael Hecht · Answer

If the other car was responsible I would agree that that in New York that would be unfair got that type of injury. Sometimes adjusters use a computer program to get their numbers.   If you don't have a lawyer, the adjuster may be trying to settle the case for less than full value.

James Eugene Hasser · Answer

Sometimes they just pull the numbers from the air. Sometimes they have statistics. No two cases are the same, though. You probably should get a personal injury lawyer to help you enhance your claim.

Hamed Yazdanpanah · Answer

We strongly urge you to seek counsel in that for years, personal injury attorneys have been blaming THESE EXACT bad faith tactics by the insurance carriers as a result of their refusal to negotiate with injured parties like you.  Recently CNN's Anderson Cooper conducted an undercover investigation into these tactics and to further illustrate why you will require the aid of an attorney.

Brett Rosenthal · Answer

Adjusters now get their numbers from the claims manager, because most adjusters no longer have a certain amount of authority and have to run all cases up the proverbial flag pole. Keep in mind they also are very mindful of the fact that you are unrepresented and have no knowledge or experience to know what cases are worth and they believe that you won't file suit, but will take the carrot they are dangling. While the $55,000 is indicative of a case that may exceed the $100K policy limits, it is really more dependent on the injuries. However, with a fractured pelvis, even with a great recovery I cannot imagine any scenario where you have that large an economic loss and would assume your medical bills are sizable, but with the new Howell case you only get to recover the amount of medical bills paid, not billed. Regardless, with that injury your claim is worth the policy if it's worth a dollar. If you haven't already would do a policy limit demand and give them a deadline. Then would hire counsel and pursue full value on claim contending the carrier already opened the lid on the policy.

Thomas Edward Gates · Answer

They use similar cases jury verdicts.  They know what the average jury has paid and, as you approach this number they are willing to take their changes in trial.

Gregory Shurman · Answer

The insurance companies want to pay as little as possible, of course.  You should speak with an attorney to force the issue with the insurance company.

John Hone · Answer

If this is a Michigan case, you are confusing the PIP case with the third party case.  Your own insurance company is responsible for the $55,000.00.  You get this regardless of fault.  If your own insurance company will not honor that obligation, you have to sue them within a year the obligation is incurred.  The third party case is for "general" damages: pain and suffering, emotional anguish, etc. The insurance company is not paying you because they don't have to.  You obviously do not have a lawyer, so they will attempt to manipulate you to take less than you deserve.

Erven Nelson · Answer

They use various computer programs which take into account many factors.  You are not required to accept the adjuster's numbers, and can make a counteroffer.

Matthew Kaplan · Answer

The adjusters evaluate risk.  When you are unrepresented, they decided that they do not feel they are at risk to lose the rest of that money.

John Brennan · Answer

You will need an attorney,  Adjusters numbers are based on some facts, but normally what they believe the plaintiff will accept in settlement. You damages would seem to exceed the policy limits.

Ronald A. Steinberg · Answer

They use computer programs.  Otherwise they pull the numbers out of the air.  Get your own lawyer and create your own numbers.  Otherwise, let the jury put the number on the value.

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Where do the adjusters get their numbers from?

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