Legal Question in Personal Injury in New York

Insurance adjuster acts prematuely

I am currently recouperating from surgery due to an auto accident.I hstill have a ways to go and may need cervical surgery.The adjuster for the other driver has already closed the case without even asking if I may need more testing,surgery,etc.Are they trying to force my hand to possibly settle early?


Asked on 8/26/06, 11:14 am

4 Answers from Attorneys

Jason Stern Law Offices of Jason Stern

Re: Insurance adjuster acts prematuely

If you don't have an attorney, NOW is the time to get one. It sounds as if the insurance company is taking advantage of you. I am an experience personal injury attorney who can help you. Please contact me as soon as possible to discuss this matter to preserve your rights.

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Answered on 8/26/06, 11:42 am
Scott Levinson Korybski & Levinson

Re: Insurance adjuster acts prematuely

The insurance company for the other driver would like nothing better than to close this case, however you have every right to proceed further. You don't need to be "forced" to do anything. If you do not yet have an attorney you should retain one and pursue this so that your rights are fully protected. My firm handles these types of cases and I would be happy to discuss this further with you to explain your options.

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Answered on 8/26/06, 12:01 pm

Re: Insurance adjuster acts prematuely

There are things you can do to protect yourself. You can file an arbitration against the carrier or sue them directly. However, an adverse ruling could affect your case against the other driver so make sure you have the same lawyer handle the insurance issues. If you don't already have a lawyer, please feel free to contact me. We have 10 offices and 40 attorneys to fight for you.

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Answered on 8/26/06, 1:05 pm
David Simon Hogan & Rossi

Re: Insurance adjuster acts prematuely

What makes you think the insurance carrier has "closed the case"? If it is simply that the adjuster never asked, then you or your attorney have to tell the adjuster that you will require future medical treatment.

There could be reasons why a case is deemed to be closed by an adjuster, including (1) that s/he didn't know you need more treatment; (2) they had an "independent" medical examination of you by their doctor suggesting you have gotten all the medical treatment you need and/or that injuries are not the result of the accident; (3) the adjuster's investigation suggests the accident is your fault, not the insured, and does not see any potential liability for the insured; (4) the adjuster does not see this as being "serious personal injury" under the insurance law - many "soft tissue" injuries fall into this category - and you may be relegated to a no-fault claim with your own insurance company; (5) maybe s/he is already offering the policy limits. There could be other reasons as well.

Let me suggest some advice and a word of caution. You need expert legal advice, but you also don't want to shoot yourself in the foot by blindly giving up a third of your recovery as legal fees. If you have been made an offer that is close to the insured's policy limits, then you have to analyze whether it is realistic that you would be able to recover any deficiency from the other driver, personally. This is not easy to ascertain.

Let me give an example. Suppose the other driver ran a red light. Liability is solid. The other driver has a $50,000 policy, and the adjuster has offered $50,000. Maybe the other driver has a minimum wage job and no assets. By hiring an attorney on a standard contingency basis, they will get one-third of your recovery. If, at the end of the day, you have a judgment for $100,000, but can only recover the $50,000 from the insurance company, you have really gone backward after deducting legal fees. You really have to have a good sense what your injuries are worth in the jurisdiction and venue where you could possibly bring a lawsuit, and the other driver's circumstances. So if you have an offer on the table, you should try to hire an attorney that will take his or her fee off the excess they recover for you over and above the amount of any offer.

Note that the adjuster will ask you to release your claims against their insured if you decide to take their offer. You need to be advised whether this is a prudent decision given all the facts and circumstances.

Please note I am NOT suggesting to do this alone without an attorney. To the contrary, I think you need expert legal advice.

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Answered on 8/29/06, 1:39 am


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