When you’re involved in an accident or have filed an insurance claim, a call from the adjuster is inevitable. Preparing for these discussions is essential because this conversation could affect your claim.
Car insurance claims are common in Alberta. The General Insurance Statistical Agency (GISA), overseen by provincial regulators, reported that the average legal settlement for auto insurance in Alberta cost over $100,000 in 2023. For Canada, this is an all-time high.
This detailed guide will help you prepare for an adjuster’s call. This includes what to know, how to communicate, what to avoid, and why you need an experienced attorney personal injury to handle your case.
Understanding the Role of the Insurance Adjuster
Before beginning the preparation process, it’s essential to understand who an insurance adjuster is and what their role entails. The insurance company employs adjusters to assess claims made by policyholders.
- Their primary goal is to investigate the claim, determine liability, and estimate compensation.
- Importantly, they work for the company—not for you—and aim to minimize the payout as much as possible to save costs for their employer.
In Alberta, it’s common for adjusters to be involved in claims arising from motor vehicle accidents, property damage, or injury incidents like slip-and-fall accidents. Knowing their motivations allows you to prepare adequately and protect your interests during the conversation.
Adjusters’ Goals
- Assess your claim’s validity and scope.
- Determine the extent of your injuries or damages.
- Minimize the compensation offered by the company.
Step 1: Gather Necessary Information
Preparation begins with ensuring you have all the documentation and information relevant to your claim. This will help you present your case clearly and accurately. It also ensures that you are well-equipped to address any questions they may ask.
Essential Documents to Prepare
| Your Policy | Review your insurance policy thoroughly, particularly the sections related to your coverage limits, deductibles, and exclusions. |
| Claim Details | This includes the claim number, incident date, location, and a concise but accurate summary of what happened. |
| Police Reports | If your claim involves a car accident, obtain a copy of the police report. This gives an objective event account, including faults and violations. |
| Medical Records | Get hospital reports, doctor’s notes, and treatment plans for injury claims. Ensure these documents accurately describe the extent of your injuries and any treatments you’ve received or will need. |
| Photographs and Videos | Examples include photos of vehicle or property damage and visible injuries. Visual evidence can strengthen your case and make it harder for them to downplay the extent of damages. |
| Receipts and Estimates | This will clearly indicate the incident’s monetary impact and serve as a foundation for your compensation demand. |
| Communication Records | Keep track of all communications with your insurer or any third parties, including emails, letters, and phone calls. Reviewing these records is essential to ensure consistency. |
Step 2: Know What You Should and Shouldn’t Say
The adjuster’s job is to ask questions that help them gather information, but how you answer them can significantly affect your case. Knowing which details you should provide and what topics to avoid is critical.
What You Should Say
Factual Details
Stick to the facts of the incident. Provide a concise explanation of what happened, but avoid elaborating unnecessarily. For example, describe the events leading up to the accident, the date and time, and any immediate aftermath (such as seeking medical attention or contacting the police).
Injury and Damage Overview
While you should accurately describe the injuries and damages you’ve sustained, avoid giving too much detail about long-term impacts or speculative damages. Keep your descriptions factual and rely on your medical records and other evidence to support your claims.
Policy Details
Refer to your policy if necessary to explain what you are covered for. If the adjuster questions the legitimacy of your claim, being able to cite policy language can be a powerful defence.
What You Shouldn’t Say
Don’t Admit Fault
One of the most critical things to avoid during your conversation is admitting fault, even if you may have been partially responsible for the incident.
- Alberta operates under a modified comparative fault system, which means your compensation may be reduced if you are found to be partially at fault.
- Let the investigation determine liability rather than offering your own opinion.
Don’t Downplay Your Injuries or Damages
You may feel tempted to downplay the extent of your injuries or damages, especially if you feel better when the adjuster contacts you. However, many injuries—especially soft tissue, spinal cord injury, or internal injuries—can worsen over time. Stick to the medical evidence and avoid statements like “I’m feeling fine now,” which could be used to minimize your situation.
Don’t Provide a Recorded Statement Without Consulting an Attorney
Some adjusters may ask for a recorded statement during the call. You are not obligated to provide this, and doing so without consulting an attorney could harm your case.
- Insurers use recorded statements to find inconsistencies in your story or twist your words to weaken your claim.
- Politely decline this request until you’ve had the chance to review the matter with a lawyer.
Step 3: Understand Common Questions the Adjuster Might Ask
During the call, the adjuster can ask specific questions about the incident and your injuries. Preparing for these questions will help you avoid saying something that could undermine your case.
Common Questions and How to Respond
- Can you describe what happened during the incident?
- Response: Provide a factual, straightforward account of the events leading up to and immediately following the incident. Avoid speculating about causes or admitting fault.
- What injuries did you sustain?
- Response: Stick to the facts outlined in your medical records. Don’t exaggerate or downplay the severity of your injuries. You can say something like, “I’ve been following the treatment plan recommended by my doctor, and my medical records contain a full account of my injuries.”
- Have you received medical treatment?
- Response: Answer truthfully, but avoid giving excessive details. For example, you might say, “Yes, I’ve been seen by a doctor, and I am following their recommended course of treatment.”
- How much damage was done to your vehicle/property?
- Response: Refer to repair estimates or appraisals. Avoid giving your opinions or estimates, which could conflict with official documentation.
- Do you think the other party was at fault?
- Response: Never admit fault or speculate about someone else’s negligence. A safe response could be, “I believe the investigation will determine the cause of the incident.”
Step 4: Know When to Consult a Personal Injury Law Firm
A lawyer specializing in personal injury cases can help protect your rights, ensure that you don’t inadvertently harm your claim, and negotiate with the company on your behalf.
In Edmonton, Alberta personal injury lawyers can guide you through the process, offer advice on handling adjusters, interpret your policy, and represent you if your personal injury case becomes more complex.
Key Indicators You Should Consult Injury Lawyers in Edmonton
- The company pressures you to provide a recorded statement or admit fault.
- As an accident victim, you feel unsure about the legal implications of the questions being asked.
- A settlement offer that feels too low based on your damages or serious injuries.
- Your personal injury claim appears to be unfairly denied or delayed.
Prepare With Edmonton Personal Injury Lawyers Today
Being well-prepared for a legal call is essential to protecting your case. You can confidently approach the conversation by gathering the necessary documents, knowing what to say and avoid, anticipating common questions, and consulting an attorney.
Working with Sidhu Personal Injury Lawyers Calgary can significantly influence the outcome of your claim. Our experienced personal injury lawyer handles the legal process and helps you deal with insurance companies to ensure adequate recompense. Schedule a free consultation today.
Frequently Asked Questions
Can I request to speak with a different adjuster if I feel uncomfortable?
Yes, if you believe the person assigned to your case is unfair or uncomfortable with their approach, you can request to speak with a different adjuster.
- While the company isn’t obligated to fulfill your request, it’s within your rights to voice your concerns.
- Remember that the company employs all adjusters and has similar objectives, so it may be beneficial to seek legal counsel if you need stronger representation.
How long does the insurance adjuster have to decide on my claim?
While no strict law dictates how long an adjuster has to process car accident claims in Alberta, companies are generally expected to act promptly and fairly.
If you feel the process is being unreasonably delayed, you may file a complaint with Alberta’s Superintendent of Insurance or consider legal action. An attorney can also assist in pressuring the insurer to handle your case promptly.
Can I refuse to talk to the adjuster and let my lawyer handle it?
Yes, you can direct all communication through your lawyer if you have legal representation. This is often recommended to avoid saying anything that could harm your claim. Once you’ve retained an attorney, the insurer must contact your lawyer rather than you directly. This ensures that all discussions are handled with the appropriate legal oversight.