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How to
Negotiate a Settlement for Auto Accident Injury Claims
Sample Dialogue with Claims
Adjuster
To help you understand how to negotiate a
settlement for auto accident injury claims, we've included a sample
dialogue between an injured person (handling their own claim) and the
insurance claims adjuster. The "Notes" section explains important
strategies and tips for insurance negotiations.
The following dialogue between the adjuster and an
injured party (Mr. Jonathan Pierce), demonstrates the typical
negotiation process for an auto accident claim.
Although case specific, this dialogue represents the form and
substance
of most successful personal injury negotiations. Using it as a
guideline will help you keep on track as your claim unfolds and
hopefully draws to a successful conclusion.
The most effective personal
injury negotiations are those in which the
injured party is
able to turn the tables on the adjuster and have him answer questions
rather than ask them.
Going on the offensive is important. Controlling the dialogue makes
sure its focus remains on you and your claim.
The Dialogue
begins...
ADJUSTER:
“I’ve reviewed the bills and I’m having a hard time getting the second
MRI
and CAT scan approved. We can’t see any reason for them.”
INJURED:
“Well Sir,
if you would take a look at the entries in my chart on December 6th,
8th, and 9th of 2010 you will see the first MRI and CAT scan identified
the origin of my pain from those areas I described to the doctor."
"Subsequent to the first MRI and CAT scan I developed separate pain and
discomfort from an entirely different area of my back. That's an area
the doctor apparently didn’t see on the first MRI and CAT scans."
"Whether the doctor should have been able to identify all areas of
injury to my back after the first MRI and CAT scans is irrelevant to
me. I didn’t order the additional tests, he did. If you want to subrogate
against him later,
that’s fine, but for now you will need to
pay for the tests."
---
ADJUSTER:
“Alright. I’ve reviewed the reasons for the additional MRI and CAT
scans. I don’t know what this doctor was thinking, but after looking at
the entries on your chart I will go ahead and pay for the additional
MRI and CAT scan."
"About your claim Mr. Pierce... I’ve taken a hard look at this and I
can’t come close to what you’re asking. That is not even close to my
authority.”
Notes:
Your original demand
was five times the amount of the claim.
INJURED:
“Well tell me what you’re authority is so I can tell you if we are even
close.”
Notes:
The adjuster will evade the subject, not wanting to show his
hand. If he does, he knows you will ask for $1.00
less than his authority. And if his authority is just too low, you will
then confirm you really are still miles apart on the
amount. Knowing his authority puts you in a better bargaining
position and
saves you the otherwise wasted time of offers and counter offers. But
don’t hold your breath. The adjuster isn’t ready just yet to divulge
his authority.
--
SIDEBAR --
Some people think adjusters will offer less to a non-lawyer than a
lawyer. That is not true!
Getting to this point in the negotiation took skills comparable to
those of a competent personal
injury attorney. By now the adjuster has
developed a
begrudging respect for you. You've figured out how to negotiate a
settlement and how the game is played,
and he knows it.
Some people also think that if you're representing yourself the
adjuster
won’t take you seriously because he knows you are not a lawyer, or that
he
won’t give your claim fair consideration because you don’t have that
one piece of leverage attorneys have...
The leverage of course is the
ability to file a proper lawsuit and pursue it through depositions,
interrogatories and all other pre-trial and trial matters. That's why
adjusters exist in this world.
Adjusters are
here to try and
settle a claim for less than it would cost if a lawsuit was filed.
Experienced adjusters know there are non-attorney injured parties
who will represent themselves throughout the negotiations and when the
time comes and the adjuster says, “this
is my final offer,” those same injured people will
fold and take the offer.
They fold because they don’t want to
hire an attorney
and because they've already spent the settlement
proceeds. They want their money now, regardless of
the fairness of the settlement amount.
The same experienced adjusters know there are also non-attorney injured
parties who represent themselves until the adjuster says, “this is
my final offer,” and if the final offer isn’t appropriate
they will go
ahead and hire an attorney to represent them at that time.
Adjusters know that even though they spent countless hours
negotiating with this non-attorney injured party, that person won’t
hesitate to hire an attorney if the final settlement offer is not
fair. If that happens the adjuster knows he would have wasted
all
that time, with the case ultimately winding up in the insurance
company's legal department.
-- END SIDEBAR --
ADJUSTER:
“I don’t see anything in the file supporting your demand. I
have
already fully repaired your car and have agreed to pay all of the Hard
Costs. I also said I will go ahead and pay the additional five
thousand dollars for the extra MRI and CAT scans.”
INJURED:
“I don’t
know if you have ever been in a serious automobile collision. If you
have you might have some empathy. You should understand what it is like
to feel
totally helpless knowing you are about to be crushed to death
between two thousand pounds of steel and a concrete wall. In those
split seconds I prayed as I thought of my children and my wife.”
“I saw myself sliding across lanes of traffic knowing at any second I
was probably going to die. And then I hit the concrete wall.”
“I still wake up nights in a cold sweat. In my nightmares I see myself
in the driver’s seat hurtling toward the concrete wall. I wake up in my
bed grabbing at air trying to pry myself out of my car right before it
hits the wall.”
---
ADJUSTER:
“I have no doubt what happened that day affected you. After looking
over the case again I feel comfortable raising my offer to
($XX,XXX.XX).”
Notes:
The adjuster now brings the settlement offer up to 1½ times the amount
of the claim.
INJURED:
“I think that offer is way too low. I’ll think about it over the
weekend and get back to you early next week”.
Notes:
The insurance adjuster wants to settle the case. Telling him the offer
was too low, and then saying you'll get back with him early next
week is a clear sign he is not going to buy you off quickly and cheaply.
You should return
his call on Tuesday - not Monday. Patience can be a virtue
in car accident negotiations. The adjuster is starting to realize you
are not folding anytime soon.
Adjusters do treat many non-attorney injured parties with the same
respect they would an attorney. Adjusters realize there may
come a point when the settlement offer won’t be enough. The next thing
to happen will be a letter on the adjuster’s desk from an attorney who
has just been retained to represent the same injured party he's been
negotiating with for the last four months!
INJURED:
(Tuesday of next week) “I gave your offer
a good deal of thought and
must tell you it is substantially lower than I can accept.”
---
ADJUSTER:
“Well, how much would you accept?”
INJURED:
“In the
spirit of compromise and to move this case along I will reduce my
demand to ($XX,XXX.XX)."
Notes:
Your current offer is four times the amount of the claim.
---
ADJUSTER:
“I don’t have authority for anything near that.”
INJURED:
“Well this case certainly merits your obtaining it.”
---
ADJUSTER:
“I don’t see anything this week that is any different from last week.”
INJURED:
“I can’t
seem to understand why you continued to insure this guy. I mean his
driver’s license had already been suspended for a recent DWI. He had a
previous one year driver’s license suspension because of the number of
moving violations he's had (tickets for speeding, etc.). It’s only
a matter of time before he kills someone. He almost killed me.”
“After our conversation this past Friday I contacted the State Board of
Insurance. I was shocked to see you guys were still insuring this
guy. It seems to me your insured was not the only negligent
party. To me the insurance company itself could easily become
a
defendant in a lawsuit."
"You guys continue to facilitate and enable this
guy. If you had cancelled his policy after even his second suspension
he might not have been on the road that day and I might not have had to
suffer for so long.”
Notes:
This is not the kind of comment in which you are threatening to sue...
It's close, but not quite there.
---
ADJUSTER:
"Look, I’ll tell you right now my limit is $XX,XXX.XX. It
looks
like we aren’t even close. I have been doing this for sixteen
years and I can tell you I don’t remember a case
settling for anything
close to what you are asking."
Notes:
Words like "right now" are important. The adjuster is not saying he
can’t get more money. Instead he is saying he doesn’t have authority to
pay any more right now. This
is the first time he has
told you his limits. He's taking one last shot at you hoping you will
accept his authority just because he's shown it to you. The
implication being he is “opening his heart to you” saying “alright you
win. I’m giving you all I have. You win.”
Don’t be fooled into thinking the adjuster is giving you a form of
ultimatum. He's not, though he is at a break point. He probably did
give you his authority, adjusters aren't supposed to lie about such
things. He just doesn’t want to go to his supervisor and ask
for more authority. The supervisor is the one who initially authorized
the limits. The supervisor did so because he knows from experience what
a claim should be worth.
So when the adjuster comes back to his supervisor and says "I need more
money" (authority) he is impliedly saying the
supervisor’s initial evaluation of the claim was wrong. (To make
matters
worse, the adjuster hasn’t told his
supervisor he's dealing with a non-attorney.)
INJURED:
“I don’t
know why your offer continues to be so minimal. While
recovering
I did some research into this State's court records. It’s amazing
what you can find on the internet. Do you know what the average jury
verdicts for cases similar have been? Some are 6
and 7 times
costs. There were some lower and some higher."
"The highest verdicts were
those in which the insured had a prior record of license suspensions
and arrests. The juries in those cases must have been pretty
upset with someone.”
---
ADJUSTER:
“But we are not talking about jury verdicts. First they take years to
get to trial, and then if we lose the case it is usually appealed. That
means you might not see any money for years.”
INJURED:
“I want to
settle this case, but the settlement must be fair. You know
your
paltry offer is not fair. Although I am not considering hiring
a
lawyer right now, I am starting to wonder if I may have to.
Notes:
At this point in the negotiation there seems to be a stalemate. That's
normal. Now is the time to turn it up a notch.
---
ADJUSTER:
"You don’t want to hire an attorney.
You know they are going to take
one third (1/3) of any settlement, and to be honest, I’m not
prepared to offer any more money just because an attorney becomes
involved."
Notes:
The adjuster is now concerned because for the first time the issue of
an attorney has come up. Although you were smart enough not to
say you hired an attorney, you have at least let him know you are
considering doing so. The adjuster is not panicking, but he
is
anxiously starting to give serious consideration to all the time and
effort he has already invested in this claim.
And now, after all this
time he realizes he is very close to losing this negotiation to the
legal
department. That's something he wants to avoid. He is paid to
settle cases and not knock them around for a while just to finally turn
them over to the legal department.
INJURED:
“You know
if my driver’s license had been previously suspended and I continued to
drive
recklessly, ultimately sending an innocent person into a
concrete
wall, I would be in serious trouble. If my case couldn’t settle
and a jury verdict was rendered against me for $30,000.00 I would be
personally and financially
devastated. The adverse effect on my family and me would be so
very terrible.”
“But if a jury verdict for $30,000.00 was
rendered against your insured, (and by implication his insurance
company) the insured and the insurance company would just shrug
it off as if nothing happened – just a cost of doing
business. Thirty thousand. A verdict like that would be less
than a hiccup to them. They probably spend twice as much
on their annual golf tournament.”
“It is not right nor fair that you continue to insult my integrity with
your offer.”
Notes:
An experienced adjuster knows the “hiccup” comparison is often used
successfully by experienced and skilled attorneys in personal injury
car accident trials.
INJURED:
“I have
learned a great deal while working on my claim. After reading some of
the court transcripts of the attorneys’ jury arguments I understand why
car accident verdicts are so high."
Notes:
As part of their argument skilled personal injury
attorneys will bring
up things like
the selfishness of the insurance company. They will tell a jury that
insurance companies actually calculate a certain number of jury
verdicts into their bottom line. And of course they adjust
their customer’s premiums to make up for the high jury verdicts...
“just
the cost of doing business.”
Attorneys will tell the jurors to wonder how many other reckless
drivers the insurance company, insatiable for more premiums, continues
to insure; making the jurors wonder if their loved ones will get home
safely. Attorneys have been known to say things like:
"Someone has to stop these
multi-million dollar insurance companies from
continuing to reward dangerous drivers by keeping them insured,
and by implication, on the road. The only way to get their attention is
with a million dollar
verdict. Any amount smaller surely won’t get their
attention.
Maybe that
amount might put the insurance company on the same level as
the injured party. A few more million dollar judgments should go a long
way toward keeping these dangerous drivers off our roads, our loved
ones safe, and hopefully
make them think twice about insuring reckless and dangerous drivers.”
After hearing your remarks the adjuster has decided it is definitely
time to settle this claim. You are obviously starting to give
serious thought to handing this claim over to an
attorney. Reading those court transcripts may have just pushed
this case over
the line.
---
ADJUSTER:
(FINALLY!)
“I have been able to get authority to settle for ($XX,XXX.XX). This
offer is only good for twenty four (24) hours."
Notes:
The offer is three times the hard costs of the case. Take it!
At this point you should be quite proud. You've learned how to
negotiate a settlement and used almost every valuable tool available.
Your
introduction of evidence against the insured included
items even some attorneys might not have introduced. Your able and well
organized presentation of the case is admirable.
You successfully introduced negotiation tools such as:
- The insured’s driving record
- The insured’s criminal record
- Similar jury verdicts
- An understanding of the comparison effect of
jury verdicts on the common man versus the insurance company
Well done!
If you want to learn more about
how to negotiate a settlement, read a few pages on Negotiation Strategy here.
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