Claims Adjuster

Claims Adjuster

lllawnchair

Tallahassee, FL

Female, 27

I worked at an insurance company, in claims, from March of 2011 to August 2013. (I'm now back in grad school) I've got experience determining liability (or fault) in 7 states in the southeast US, as well as injury (Personal Injury Protection or PIP) claims in Florida.

**Disclaimer!** I am NOT qualified to give legal advice, so don't ask!

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41 Questions

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Last Answer on September 24, 2013

Best Rated

Is "whiplash" an actual provable injury, or just something that people claim in lawsuits?

Asked by Denise over 11 years ago

Hi Denise,

Whiplash is a common (non-medical) term describing a range of injuries to the neck caused by sudden movement. It's not a diagnostic code as far as I know; usually the diagnosis is described as a 'cervical sprain/strain' or something like that. It's a common injury in rear-end accidents. For example, let's say you were sitting in traffic and a vehicle hit you in the back. Due to physics (or some other fancy science-y phenomenon.... my worst subject in school, can you tell?) you will always travel in the direction of the impact. That, in conjunction with a head rest that is not properly positioned behind your head, may cause your head to jerk back suddenly, and then forward again, thus causing a sudden, extreme movement of your neck, which can cause injury.

Hope this answers your question Denise!

This is regarding Florida No fault PIP coverage, I live in PA and just received Florida adjuster license. I am paying the $10,000 limit and need an exhaust letter to send with it. Do you know where I can find this and other FLorida PIP letters?

Asked by DEB over 11 years ago

Hi DEB, honestly I always used company written letters. I rarely crafted my own letters. Most companies have an in-house counsel that drafts our letters for us. Sorry!

I was involved in a minor accident using my husband's parents' car, under which he is covered. We also have another car under separate auto policy. The claims adjuster of my father-in-law's policy is asking me for my other auto policy number. Why?

Asked by Tina over 11 years ago

Hi Tina,

Most likely it's a required procedure on the part of the claims adjuster. You have it right that, as you were driving a car owned by your father-in-law, his insurance would be primary. For a minor accident (if it was determined that you were at fault), his coverage should be fine. However, there can be exceptions, including the following: Lets say that for whatever reason, your father-in-law's policy wasn't active on the date of loss. At that point the other person's insurance could pursue your insurance (since you were driving) for damages.

Although, most likely it is just a procedural thing: if a claims adjuster finds out that someone was driving your car that isn't listed on the policy, they tend to get more information to let our underwriters (our risk assessors) know, in case they need to adjust your premium. If you were a one time driver, it usually doesn't change anything on your father-in-law's policy. After all, you are generally allowed to let someone borrow your car (although I believe on some non-standard policies you aren't, but that's something you can confirm by looking at your own policy documents: most policies are standard; aka you can let someone borrow your car once and a while) However, if you began driving his car regularly, they may need to add you to his policy as a listed driver. 

Hope this answers your questions!

How often does your company get sued, and do you know how often they settle out of court?

Asked by Borat over 11 years ago

Honestly Borat, I just don't have access to that kind of info.  Those kinds of claims are handled by a special, highly experienced, unit, and they usually don't send company-wide emails about a suit's progress.

I can't say for sure, but I would guess that in most cases like that, both parties would rather settle out of court: it's just less expensive and time consuming.

Do claims adjusters go to the actual scene of an accident, or is it only the police who do that?

Asked by MissPink over 11 years ago

Hi MissPink!

To my knowledge, the first responders to an auto accident are always the police and/or medics. Claims adjusters rarely go to the actual scene of an accident. We may request photos if they are available, or utilize a bird's eye view of the area, if liability is in question. After all, when I handled non-injury auto claims, I worked in 7 states of the southeast, all from the (mild) comfort of my little cubicle!

I was rear ended by a drunk driver he was driving his girlfriend's car I was compensated from her insurance however he didn't have insurance so it fell under my uninsured motorist coverage my insurance wants to meet with me to discuss my injuries why

Asked by sal about 11 years ago

 

I have a 3rd party claim and adjuster sent me (under my name) a full & final check based on initial estimate. What happens if body shop finds more damages? Adjuster knew the shop where the car will be repaired and rental car is even set-up by them.

Asked by ALEXIS almost 11 years ago