I frequently get calls where a prospective client tells me something the insurance adjuster for the other side said to them. And people are often confused and misunderstand.
So I’m going to clarify a few terms and phrases so you better understand what the adjuster is telling you.
First off, some background about insurance companies and how they handle claims. They are in a business. They want to make money. They do that by collecting premiums from their insured and paying out less in claims. The adjuster’s job is to settle claims for as little as possible.
“The claim will be closed on X date.” This is a sneaky thing some adjusters will tell people. The adjuster wants to create a sense of urgency to get you to settle soon and for a small amount so they say they will close the claim unless you respond by a certain date. But it doesn’t mean anything. In California, there are different deadlines (statutes of limitations) of when you must have settled or sue the wrongdoer. If an adjuster closes a claim because you didn’t respond, they will just re-open the claim once you contact them. There is no legal effect to opening, closing, or re-opening a claim. You just need to settle or sue before the statute of limitations. So don’t let the adjuster create a false sense of urgency and rush you into a bad decision.
“This is our full and final offer.” Sometimes adjusters will send a settlement offer and state it is a full and final offer. Some people interpret that as being the end of the discussion and that they must accept the offer. But that’s not the message they are conveying. In most personal injury matters, the insurance company won’t pay anything until a claim is settled. When it’s settled they pay the settlement amount. “Full and final” means you can’t settle and then ask for more money because your condition is worse than you thought. And you can’t take that money and ask the insurance company to pay your future medical care. “Full and final” means that’s the money you get and you’re responsible for paying any liens, bills and future care out of it. It does not mean you have to accept the offer. Usually an adjuster will make an offer for less than their full settlement authority and you or your lawyer can continue negotiating a higher amount.
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