Dealing with Insurance Adjusters After an Accident

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June 23, 2025

TL;DR If you’ve been injured in Washington, your health insurance or benefits may claim a portion of your personal injury settlement. Here’s how reimbursement works depending on the type of coverage:

Private Health Insurance: Can request repayment for medical bills they covered. Often negotiable.
ERISA Plans (Employer-Sponsored): Strong reimbursement rights, especially if self-funded. Harder to reduce.
Medicare: Must be repaid, but the amount can often be negotiated.
Medicaid (Apple Health): Requires repayment, but state law caps how much can be taken.
VA/Tricare (Military Benefits): Can seek reimbursement; reductions may be possible with legal help.

Understanding these rules is key to protecting your recovery. This post explains what to expect and why working with an experienced attorney can help you keep more of your settlement.

After an accident, you may find yourself dealing with various types of insurance adjusters, each with a distinct role. Understanding these roles is critical to avoiding common pitfalls that could weaken your claim or result in less compensation than you deserve. Knowing who you’re speaking with and how they operate can help you navigate the claims process more effectively. While they might seem friendly and helpful, it’s important to remember that their primary goal is to protect the financial interests of their employer—the insurance company. This means minimizing payouts whenever possible.

Types of Insurance Adjusters and Their Roles

Each type of insurance adjuster plays a distinct role in the claims process, but their interactions collectively impact how your claim is resolved. By understanding these roles, you can better anticipate challenges and ensure your rights are protected throughout the process.

There are three main types of insurance adjusters you may encounter: property damage adjusters, personal injury protection (PIP) adjusters, and liability adjusters. Each handles a different aspect of your claim and has unique priorities.

Property Damage Adjusters

Property damage adjusters often set the tone for early claim interactions, as they are usually the first adjusters you encounter after an accident. They handle claims related to physical damage to vehicles or other property involved in the accident. They assess the extent of the damage and determine repair or replacement costs.

When working with property damage adjusters, keep the following in mind:

Obtain Multiple Repair Estimates: This ensures the compensation offered is fair and aligns with market rates.
Document Everything: Take clear photos of the damage and gather receipts for any repairs or maintenance performed before the accident.
Watch for Lowball Offers: Some adjusters may underestimate repair costs to save the insurer money. Don’t hesitate to challenge these offers.

Personal Injury Protection (PIP) Adjusters

PIP adjusters work for your own insurance company and handle claims related to your medical expenses and lost wages under your policy’s PIP coverage. Their role is especially important for addressing your immediate concerns, such as covering urgent medical costs and helping you manage financial challenges early in your recovery.

Here’s how to navigate PIP adjusters:

Provide Medical Documentation: Submit accurate and detailed records, including bills, treatment plans, and receipts for out-of-pocket expenses.
Be Precise About Wage Loss: If you’re claiming lost wages, provide pay stubs or a letter from your employer to substantiate your claim.
Be Cautious: Although they work for your insurer, PIP adjusters may still scrutinize claims closely to limit payouts.

Liability Adjusters

Liability adjusters work for the at-fault party’s insurance company, with the primary goal of protecting their company’s financial interests by minimizing payouts. Their responsibilities include assessing fault, negotiating settlements, and reducing the company’s exposure for bodily injury claims. Given their priorities, it’s crucial to have legal counsel manage communications to protect your rights and ensure your claim is valued fairly.

When dealing with liability adjusters, remember:

Do Not Talk to Them Directly: Avoid engaging in detailed conversations with liability adjusters. Anything you say can be used against you later to dispute your claim or minimize its value.
Do Not Provide Medical Records: Never send medical records or bills to liability adjusters. These should only be shared, if necessary, at the end of your treatment and through your attorney.
Be Wary of Quick Settlement Offers: These offers are often lower than what you may be entitled to and may not cover long-term medical costs or pain and suffering.
Refer Them to Your Attorney: Liability adjusters aim to protect their insured and company, not you. Having an attorney handle communications can prevent you from making statements that could harm your claim.

Tactics Insurance Adjusters Use

Regardless of their specific role, insurance adjusters may employ various tactics to reduce the value of your claim. For example, an adjuster may contact you within days of the accident and ask for a recorded statement, framing it as a routine part of the process. However, any inconsistencies in your statement could later be used to challenge your credibility. This underscores the importance of consulting an attorney before providing any recordings. Common strategies adjusters use include:

Requesting a Recorded Statement: Adjusters may ask for a recorded statement shortly after the accident. Decline this request and consult an attorney before agreeing to any recordings.
Disputing Liability: Even in seemingly clear cases, adjusters may argue that you were partially or fully at fault to reduce the payout.
Minimizing Injuries: They may question the severity of your injuries or the necessity of certain treatments.
Offering Low Settlements: Quick settlement offers may seem tempting but often fail to account for future medical expenses, lost wages, and non-economic damages like pain and suffering.

Your Responsibilities When Dealing with Adjusters

Your approach should differ based on the adjuster’s role:

With Your Own Insurance Company: You must cooperate in good faith. Provide accurate information and meet reasonable requests, such as sharing damage photos or medical bills. However, be cautious about admitting fault or speculating about the accident.
With the Other Party’s Insurance Company: You have no obligation to provide detailed information or a recorded statement. Stick to the basics and let your attorney manage communications whenever possible.

When to Consult an Attorney

Navigating the claims process can be challenging, especially when you’re recovering from injuries. Consulting a personal injury attorney can help you avoid pitfalls and secure the compensation you deserve. An attorney can:

Handle Communications: Once represented, adjusters must communicate directly with your attorney.
Negotiate on Your Behalf: Attorneys are skilled in assessing the true value of claims and pushing for fair settlements.
Protect Your Rights: Whether addressing disputes over liability or rejecting unfair settlement offers, your attorney’s primary goal is to advocate for you.

Final Thoughts

Dealing with insurance adjusters requires a clear understanding of their roles and objectives. While you must cooperate with your own insurer, be cautious in communications with the other party’s adjuster. Avoid speaking with liability adjusters directly, and never send them medical records or bills until the appropriate time. Partnering with a trusted attorney ensures your claim is handled properly while you focus on your health and well-being.

At Scott & Scott, PLLC, we believe our clients should have one job: to heal. We handle everything else—from managing communications with adjusters to securing fair compensation. Contact us today for a free consultation and let us take care of the details, so you can focus on moving forward.