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Who Decides What The Insurance Company Will Pay?

Usually, an adjuster makes this decision.

An adjuster is a person – usually an employee, sometimes an independent contractor – who is responsible for managing and studying the lawsuit, and deciding how much to offer to settle it.

The adjuster may handle hundreds of files, and have dozens of lawyers reporting to him. If a lawsuit has been filed, he communicates through a lawyer; if not, he communicates directly with you or your lawyer.

Usually, the adjuster is allowed to decide how much the company will pay, up to a certain limit. The limit is called his “authority”.

The authority given to adjusters varies from company to company. The adjuster can settle the case for any amount less than his authority – it may be $5,000.00, $10,000.00, or $50,000.00.

If the adjuster decides that the case is worth more than his authority, he asks a superior for permission to pay more. Sometimes the decision goes up several levels, to a vice president, the President of the company, or even the owner of the company.

The process varies from one company to the next. State Farm, for years, would have meetings of claims committees: an adjuster would present his cases to a committee of other adjusters and supervisors, and they would talk about the lawsuit until they agreed on its worth.

In other companies, a higher level employee – a claims supervisor, or an examiner – may decide how much to pay.

Sometimes, the company gives its lawyer the authority to settle the case. This is more likely when the lawsuit is going to mediated, and the adjuster is based far away.

The trick is knowing who makes the decisions – or who talks to the person who makes the decisions – and how to reach them. For instance, adjusters don’t have a “right” to attend your deposition – but I know lawyers who invite them to attend depositions when they think they have a good lawsuit.

It may make sense just to have the adjuster come to my office before filing the lawsuit, so he or she can meet with you, observe your injury, and get their own impression of you.

I have been a lawyer over 30 years. I am pretty good at communicating; but it’s important to know who you are really talking to, and what is likely to move them. If you have any questions about what adjusters do and how they make their decisions, talk with an experienced Cincinnati Injury Attorney. Call me, William Strubbe, at 513-621-4775.

Because all situations are different, and because there may be other facts pertaining to your case that I don’t know about, you should not rely on this answer for legal advice. I am not your attorney, and no lawyer client relationship has been formed.

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