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The Insurance Adjuster’s Playbook Revealed: Understanding Who You’re Really Dealing With

Why Your Insurance Claim Might Be Getting Stalled (And How to Fix It)

After an accident, understanding how insurance adjusters operate can make the difference between a fair settlement and being taken advantage of. Here’s what you need to know about the people handling your claim:

The Authority Problem: Why They Keep Saying “No”

Most insurance adjusters, especially newer ones, have very limited authority to approve settlements:

  • New adjusters might only be able to approve up to $3,000 without permission
  • Mid-level adjusters might have authority up to $20,000-$30,000
  • Even senior adjusters must get approval for larger settlements

What this means for you: When an adjuster says “that’s the best I can do,” they’re often telling the truth – but that doesn’t mean it’s the best the company can do.

The “Manager Shopping” Strategy

When your claim exceeds an adjuster’s authority limit, they need to get approval from their manager. Here’s what happens behind the scenes:

  • Some managers easily approve reasonable requests
  • Others make adjusters “justify” every dollar over their limit
  • The adjuster you’re dealing with has to play office politics to get your claim approved

Action tip: If an adjuster says they need to “check with their manager,” be patient but persistent. Ask when you can expect to hear back and follow up if you don’t.

The Real Decision-Makers

For serious injury claims or wrongful death cases, your file may be sent to:

  • A home office examiner
  • A vice president
  • A special claims committee

These higher-level decision-makers have authority for settlements of $200,000 or more.

What to do: If your injuries are severe, make it clear that you understand the claim will need higher approval. And, if it is not obvious, call me.  Even after my fee is taken out, you will end up with 3-4x more money.  This is not a “made up” statistic – it is a fact that insurance studies have proven over and over. 

The “Blame Management” Tactic

Many adjusters use what’s called the “agency principle” – they build a friendly relationship with you, then blame their “unreasonable” managers when they can’t meet your demands.

They might say things like: “I would love to give you an extra $5,000, and I think you deserve it, but my manager just won’t budge.”

The truth: This is often a negotiation tactic, not reality. Don’t let sympathy for your adjuster lower your expectations for a fair settlement.

Bottom Line

Insurance companies create these complicated authority systems on purpose – they make it harder for you to get fair compensation. By understanding how the system works, you can navigate it more effectively and negotiate from a position of strength.

Remember: Persistence and patience are your most powerful tools when dealing with insurance adjusters.

Remember even more:  you are not an attorney and you cannot “threaten” them – you might say you’re going to get an attorney – they don’t believe you…. ONLY an attorney can file a lawsuit – then, the insurance companies will start offering reasonable compensation. I file lawsuits, I go to court.  You shouldn’t try to negotiate even a modest injury claim by yourself.

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This firm provided some great information that I think almost anyone who has been in an accident could benefit from. You still may need a lawyer like Paul to handle some of the specifics.