Once an insurance claim is reported, the company will assign an adjuster to the file. This adjuster will be the primary contact person throughout the life of the claim, and he or she will determine who is at fault for an accident and what will be paid. The vast majority of liability adjusters are hired by the insurance company, and their liability determination is generally the final word in an investigation.
What do Liability Adjusters do?
Some types of car accidents are clear liability. If you rear-end someone or hit their parked car, you will automatically be held responsible for the damage that you cause. Most accidents are not this clear cut. Intersection accidents, sideswipes, backing accidents and other types of collisions all require a licensed adjuster to review the accident and determine who should be held liable for the damage.
Numerous factors are involved in determining liability. Each driver will provide a recorded statement about what happened. The adjuster may need to order a police report or witness statements if available to complete the investigation. The location of the accident, the description of what occurred, the actions each person took and the damages on each vehicle will all play a role in determining who is at fault for an accident.
Liability does not necessarily follow the same rules as police departments use when assigning fault on a police report. Just because someone receives a ticket does not always mean they will be at fault for an accident, and failure to receive a ticket does not mean that they are clear of liability. A police officer may determine that some accidents are no one’s fault, but the insurance company must assign liability to someone as a way to bring the claim to closure.
What Liability Means
Different states handle liability determination differently, so an adjuster must be licensed for any state they choose to work in. In some areas, if a driver is 51% or more at fault, they pay for the entirety of the other person’s damage; in other states, the at-fault driver only pays for a portion of the claim based on their liability. For example, if you are 75% responsible for the accident, your insurance will only pay 75% of the other person’s repairs.
Generally, liability determines whose insurance will pay for an accident. A not-at-fault driver may have their deductible reimbursed or waived, and they have the option of pursuing the claim directly through the third party so that their insurance is not involved. On the other hand, an at-fault driver’s rates may increase as a result of the accident that they cause, and insurance companies may even cancel the policy if the situation is severe.
Because liability is so crucial, insurance companies take liability investigations very seriously. Each company will employ numerous adjusters whose full-time job is assessing liability and communicating these findings to customers. In addition to liability adjusters, insurance companies will also employ an assortment of injury adjusters and damage inspectors. Although all of these workers are licensed and may be called adjusters, they do not play a role in determining liability.
Can I Hire My Own Adjuster?
It is possible to hire an independent or “outside” adjuster for some things. For example, an independent damage adjuster may provide an estimate of damage to a vehicle or other property. Independent liability adjusters are quite rare, however, and the liability decision of the company’s own adjuster is usually the final say in an investigation.
Sometimes the adjusters from two different insurance companies will disagree with each other. This is especially likely to happen when there is no police report or witness testimony and the drivers provide conflicting statements. In these cases, it may become one driver’s word against the other driver’s, and the insurance companies may not reach an agreement.
When this occurs, a third party is recruited to provide arbitration. This is usually the only time an outside adjuster will ever play a role in determining liability. Whatever the arbiter decides will be the binding decision for the insurance company, and settlement will be paid accordingly.
This usually happens after the subrogation process, meaning that the claim may have already been settled and the insurance company is trying to recover the cost of the claim. Many times the insured will not be aware of the liability dispute until the process is over. Other times, the liability dispute may come up earlier in the claims process, and the adjuster will walk you through the next steps at that point.