Insurance adjuster won't budge on a settlement amount

Question

Insurance adjuster won't budge on a settlement amount.

When the adjuster was talking numbers she asked me what I wanted. I told her what I wanted after the medicals were paid and she admitted that she made a mistake and told her boss that was the total amount I was asking for. Now she won't negotiate nearly to what I am asking for saying her boss already has my starting number and I have to work my way even lower. Can we start over since she made the mistake?

Answer 1

I suggest you go into arbitration right away.  If arbitration doesnt work, then it will have to work in court.  To be honest, I believe that it was not a mistake. ...They purposely do this to make you helpless...so that you can just accept what is given...Dont fall for it...and an arbitrator will work in the middle....not taking sides...if the arbitrator was bought out by them, then going to court should clear up all problems.....To tell you that they wont budge on a settlement amount because that was what you said is absurd...who knows if you actually said $5 dollars?  Nobody knows that....her boss only heard it from her.....you could say $5 dollars...and she in turn went and said $2 dollars...I know how they work....I used to scam them for doing it to me...

Answer 2

I'd speak to her supervisor directly. It sounds like she just doesn't want to admit to her supervisor that she made a mistake. I'm a little unclear on the situation. But if she agreed to your amount verbally and came back to you with a different number, then she has committed "waiver and estoppal"  By law, once we agree to coverage, we have to abide by it. If she doesn't, you can site bad faith with the state's department of insurance. As an insurance adjuster myself, I can tell you that we can always negotiate (at any stage) so long as the reason for the adjustment can be justified.  

Answer 3

Report this to the state insurance commissioner. They may have a record of Insurance non-payments for this company. Write a letter with a copy to the insurance company.

Answer 4

If there was no meeting of the minds - then there is no valid settlement. You were thinking you wanted X + meds. She was thinking you wanted X.  You were talking apples - she was talking oranges.

Therefore, there is no meeting of the minds. It is not a valid settlement and could not be enforced in a court of law.

And it's doubtful that waiver and estoppel  would apply here.

She will not pay what you are asking for because she does not believe that is what your claim is worth.  Just because you asked for it - does not mean she will pay it. You could ask for $20,000 for a bruise and there is no way an adjuster would pay you that.

A negotiation process is just that......negotiation. That means you make a demand, she counters, you counter, she counter.....back and forth.

So, lower your demand and make a counter offer.

Answer 5

Nope.  And you won't get more than the policy limit, either.

But you CAN shut down negotiations, flat out.  If it's your policy, you can request arbitration.  If it's the other guy's policy, you can file a lawsuit.  

So.  YOu don't say what kind of insurance, you don't say if it's yours or the other guys, you don't say what the limit is, you don't say what the damages are, etc.  Maybe your agent, who might have some of these answers, might be a better resource for you for an answer.