Here's something we tell every client: insurance companies are not on your side. They are businesses, and their business model depends on paying you as little as possible. Understanding how they evaluate claims is how you protect yourself.
Insurance adjusters typically look at:
- Medical records and bills — They scrutinize every gap in treatment, every missed appointment, and any pre-existing condition they can use to reduce your damages.
- The nature and severity of your injuries — Soft tissue injuries are routinely minimized; catastrophic injuries like TBIs or amputations are harder to dispute but still fiercely contested.
- Lost wages documentation — They want proof from your employer, tax returns, or pay stubs.
- Liability clarity — The cleaner the liability (e.g., rear-end collision, clear fault), the harder it is for them to fight the claim.
- Your social media — Yes, they look. A single post showing you active after claiming debilitating injuries can tank a case.
- Whether you have an attorney — Studies consistently show that represented claimants receive significantly higher settlements than those who go it alone.
