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Houston Auto Accident Attorney
Vehicle Claims Adjusters & Deception in the Insurance Industry
Insurance companies are supposed to protect you when unimaginable things happen (such as auto accidents, hurricane damage or homeowner liability). When you have a claim one of the first things you do is contact your insurance company policy. The first thing an insurance company does is to assign a claims adjuster to your case. Adjusters make the decisions on whether your claim is covered under the policy of insurance, whether to believe you, how much they should pay and how much they think they can pay based on the person making the claim, for example, the age, sex, education and past experience with claims. Of course this is unfair and it’s wrong that a claims adjuster would cheat a senior citizen or a young single mom, but they do.

Regardless of the experience, education, age, sex and any other factor, anyone with an auto accident claim should contact an auto accident lawyer immediately after having an a car wreck or any other insurance claim.

You should remember that insurance companies are an industry whose profits depend on not having to pay out on policies. There has been very little research on how these adjusters make their decisions. One study done in 2003 published in the Journal of Risk and Insurance examined claims adjuster practices and found inequities in the way that claims adjusters make their decisions. Sometimes these inequities are driven by a desire to avoid paying out on a claim. Other times, they are based on stereotypes surrounding gender and age. Like any negotiation claims adjustment discussions are highly influenced by how the adjuster views himself or herself, and how he or she views the claimant. This is a primary reason to consult an auto accident attorney after an accident.

Gender bias is one of the more common tactics of claims adjusters, whether the adjuster is male or female. The avoidance of risk or chance taking plays a great role in how successful a negotiator can be. People who do not like taking on risk are less likely to have a successful negotiation. This is because the emotional and psychic cost to a risk-averse negotiator is usually greater than the financial sum they will receive at the end of it. Simply put, they don’t want to deal with the headache of arguing with their insurance company. Negotiators who are willing to take on more risk are usually rewarded at the end of the negotiations with a greater financial payout. To these people, there is less emotional

cost to negotiating and therefore a larger check at the culmination of the process is worth the risk. Generally, women are perceived as more risk-averse negotiators. Men are seen as typically more aggressive and willing to take on more risk for the possibility of a large pay out at the end of the negotiation. However, men also need to contact a personal injury lawyer after an accident primarily because of the disparity of knowledge between a consumer and an experienced claims adjuster.

The elderly are another group of claimants who are seen as weak negotiators. Studies show that claimants above the age of 65 show a greater risk aversion than others. The elderly often have a more physically or emotionally fragile situation than younger claimants, making the cost of negotiation inherently higher and more taxing. When elderly claimants are involved in a vehicular accident situation with a younger claimant, claims adjusters assign more risk to the claimant who is over 65. The family of an elderly person should talk with them and help them find a reputable personal injury lawyer to handle a sometimes complicated settlement practice.

Claims adjusters, arguably are like all human beings, are influenced by perceptions and views that are not necessarily in their conscious thought process. Because these perceptions are never formally recognized in any company policies or procedures, they are very difficult to trace. Yet they can have a largely disparate impact on the daily lives of Americans. The same set of circumstances can lead to different payout results depending on the gender, age, or geographic location of the insured. It is imperative that consumers are aware of these discrepancies when negotiating with their insurance company, and are able to competently negotiate with full knowledge of all the subtle factors involved.

Insurance companies have set procedures and policies by which claims adjusters must abide when negotiating with claimants. However, in an effort to close files, resolve contentious negotiations, and save money for the company, adjusters develop unwritten rules of thumb that they use to make decisions. For example, a common rule of thumb when negotiating a vehicle accident is to assign fault to the driver of a car that rear ended another car. It is assumed that the car in the back of the crash could have avoided it somehow. Claims adjusters rarely investigate whether the car in the front stopped too soon and caused the accident. Rules like this are usually enforced when the cost of negotiating is more than the amount of money at stake. With this kind of economic incentive, these rules become part of the culture of the claims adjustment, but are never officially adopted as standards or policies by the company.

State laws can also affect the way that claims adjusters are biased in a negotiation. In the United States, there are three different models for negligence when allocating fault. The first is the “50 percent comparative negligence rule.” According to this rule, in order for a plaintiff to collect damages against a defendant, the plaintiff should be no more than 50% at fault in the incident. The second is the “49 percent comparative negligence rule.” States that use this rule legislate that a plaintiff can only recover damages if he or she is less at fault than the defendant. That is, the plaintiff bears no more than 49% of the fault in the incident. Finally, some states use the “pure comparative negligence rule.”
States that use this rule assign a percentage of fault to each party involved in the incident, and claims are paid out accordingly. For example, if a plaintiff were 60% at fault in a car accident, in a comparative negligence state, he or she would be entitled to 40% of the damages.

Research has shown that insurance companies charge higher rates in states that use the pure comparative negligence rule. In these states, the insured defendants are also assigned a greater percentage of the fault. These statistics are driven by a rule of thumb used by claims adjusters. When an adjuster in a pure comparative negligence rule state negotiates a claim, the best way to avoid a significant payout is to assign as much fault to the claimant as he or she can. In a state that follows the 49% or 50% comparative negligence rules, the claims adjusters do not have to analyze and assign fault in as much detail to avoid paying out on the insurance policy. Therefore, these insurance adjusters typically assign less fault to the claimant once they are sure that the insurance company will have to pay out on the policy because the threshold for fault has been met.

All of this is to say, that settlement of auto accident claims is more complicated than you think. You should at least phone a lawyer and ask questions before you decide not to hire an attorney. Remember that auto accident attorneys do not charge for a telephone call or office visit and do not charge by the hour. They are only paid when they settle your claim based on an agreed percentage, usually one-third. Attorneys pay for all expenses (which can be significant) and they are reclaimed when the case is settled. Only expenses that help win your case and get you a fair settlement are authorized.

Contact a reputable auto accident attorney like those at Ogletree Abbott, 713-223-1234 today to visit with us over the phone about your situation.


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No attorney´s fees unless you recover. Client Advances, court costs, litigation expenses, and medical are paid from your share of the recovery. If there is no recovery, you will not be responsible for any court costs or litigation expenses except for unpaid medical bills. Results obtained depend on the facts of each case. Past performance is no guarantee of future results. We only consider employment in another state in association with co-counsel licensed in that state. Licensed to practice law in Texas only. Not licensed in any other state. References to laws are limited to federal and State of Texas law. Some cases may be referred. Not certified by the Texas Board of Legal Specialization.
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