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The Adjuster Is Not Neutral, and He Is Very Good at His Job

Insurance Agent Inspecting Car After Accident
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The call usually comes within a day or two. The voice is pleasant. He's sorry about what happened. He wants to get this taken care of for you, and he just needs to ask a few questions and get a recorded statement so he can move things along. Everything about that conversation is designed to feel like help. It isn't help for you, just for the insurance company. It's the first move in a claim file that has already been opened, assigned a reserve, and evaluated by somebody whose performance is measured on what these files cost.

None of that makes the adjuster a bad person. He's doing the job he was hired to do competently, and he does it every day. The mismatch is that you've never done this before and he's done it ten thousand times. And make no mistake. His job is to save money for the insurance company. He is not trying to make sure you receive fair and reasonable compensation for your harms and damages.

What's already happened before he calls

By the time you hear from anyone, the trucking company's side has usually:

  • Been notified within hours, often from the scene by the driver himself
  • Sent an investigator to the crash site, sometimes before the road reopened, and often times a expert accident reconstructionist.
  • Photographed everything and taken measurements
  • Downloaded or preserved the tractor's engine control module data
  • Talked to its driver and gotten his account while it was fresh
  • Talked to witnesses
  • Opened a file, set a reserve, and started evaluating exposure

Meanwhile you're in a hospital, or you're planning a funeral. That's the position from which the "few questions" get asked.

The recorded statement

Be careful here and understand what it's actually for. A recorded statement is taken early, before you know the extent of your injuries, before all the imaging is back, before anyone knows whether the disc herniation is going to need surgery. Then it becomes a fixed document that gets used to cross-examine you two years later when the picture is completely different.

The questions that cause trouble aren't hostile. They're friendly and open.

"How are you feeling?" — In this country the reflex answer is "I'm okay" or "doing all right." My favorite that I hear so much is “I’m fine,” even when the injured person has serious damages. You'll say it to be polite. It will be read back to a jury.

"Had you had any problems with your back before?" Everybody over forty has tweaked their back at some point. An honest yes, without context, becomes the foundation for a pre-existing condition defense.

"What happened?" You're describing an event you experienced for about two seconds under extreme stress, and you're doing it on medication. Any imprecision becomes an inconsistency later.

"Do you have any idea how fast you were going?" A guess, offered helpfully, becomes your testimony.

You are generally not required to give a recorded statement to the other side's insurance company. Your own policy may require cooperation with your own insurer, which is a different thing. Before you agree to either, it is worth understanding which is which.

What the file is worth is decided by things you can't see

Adjusters evaluate claims against internal criteria such as the strength of liability, the medical documentation, the treatment history, the venue, and increasingly software that scores the file.

Some of what moves that number is unfair and you should know about it anyway:

Gaps in treatment. Eleven weeks without seeing a doctor gets scored as "not really hurt," regardless of the reason.

Delay in seeking care. Waiting four days to go to the ER is treated the same way, even though people in shock frequently do exactly that.

Inconsistency between what you told different providers. The ER intake sheet, the orthopedist's history, the physical therapist's notes. They get compared.

Social media. All of it, and it will be looked at. At Coxwell & Associates, PLLC, we strongly encourage people to stay off of social media and definitely do not discuss your injuries.

Prior claims. They have databases, and they'll run you.

The number the company has to carry, and why it's often not enough

Here's something most people don't know until they need it. Federal law requires an interstate for-hire motor carrier hauling ordinary, non-hazardous freight to maintain only $750,000 in public liability coverage. That's 49 C.F.R. § 387.9. The figure has not been increased since 1980.

Carriers hauling oil or most hazardous materials must carry $1 million. Carriers hauling bulk hazardous substances, explosives, poison-gas materials, or highway-route-controlled radioactives must carry $5 million, and for those commodities the $5 million floor applies even to vehicles under 10,001 pounds. But a lot of what runs I-20 and I-55 is generally freight at the $750,000 minimum.

In a case involving permanent injury, a lifetime of care, or a death, $750,000 doesn't reach it. Which means the questions that actually determine what an injured family recovers are: does this carrier have excess coverage above the federal floor, are there additional responsible parties with their own coverage, and what uninsured and underinsured motorist coverage exists on the injured person's side.

Mississippi law helps on that last one. Under Miss. Code Ann. § 83-11-101, UM coverage is part of every auto policy unless the named insured rejected it in writing on a form approved by the Department of Insurance. No valid signed rejection means the coverage is there. And under Miller v. Allstate Ins. Co., 631 So. 2d 789 (Miss. 1994), a named insured and resident relatives can stack UM coverage across policies regardless of which vehicle they were riding in. Finding every policy in a household is frequently worth more than anything else that happens in the case.

When the defense lawyer shows up

Once suit is filed, the adjuster steps back, and a defense firm takes over, and the tone changes.

Defense counsel in trucking cases are generally excellent. They know the Federal Motor Carrier Safety Regulations cold, they have accident reconstructionist experts and biomechanical engineers they've worked with for years, and they will take the case apart methodically.

What they will do:

  • Depose you at length about your entire medical history, going back decades
  • Retain experts to challenge causation by saying that the forces involved couldn't have produced your injury
  • Retain a billing expert to attack the reasonableness of the charges, which under Jackson v. Brumfield, 458 So. 2d 736 (Miss. 1984) is what it actually takes to rebut the § 41-9-119 presumption
  • Send you to a defense medical examination
  • Subpoena every medical provider you've ever seen
  • Argue comparative fault, because in Mississippi every percentage they can assign to you comes off the top

None of that is improper. It's competent lawyering, and the answer to it is preparation rather than outrage.

Comparative fault, and why it's not the end

Some people stop asking questions because they think they were partly to blame.

Mississippi follows pure comparative negligence. Miss. Code Ann. § 11-7-15 says contributory negligence "shall not bar a recovery, but damages shall be diminished by the jury in proportion to the amount of negligence attributable to the person injured."

There is no cutoff percentage anywhere in that statute. Somebody found substantially at fault still recovers, reduced by their share.

The related point is Miss. Code Ann. § 85-5-7(2), which makes liability "several only, and not joint and several," with each tortfeasor liable "only for the amount of damages allocated to him in direct proportion to his percentage of fault." That's why identifying every responsible party matters so much, meaning a defendant nobody named is a share nobody collects.

Working with Coxwell & Associates

Being strong with an insurance company is not about being loud. Adjusters deal with loud all day, and it doesn't move a reserve. What moves a file is being ready. It means the preservation letter went out in the first week and the electronic data got captured. It means the medical record is complete and reconciled, with the gaps explained in writing at the time they happened rather than reconstructed later. It means witnesses were interviewed while they still remembered. It means the coverage has been inventoried down to the last UM policy. And it means the case is built as though it's going to be tried, because a file that is obviously ready for trial gets evaluated differently than one that isn't.

We also handle the communications. Once we're retained, the adjuster calls us instead of calling you in your hospital room. Clients don't give recorded statements to the other side's insurer without preparation, and usually not at all. I've been doing this in Mississippi for a long time. Over 45 years. The insurance company is not going to pay more than it thinks it has to. The only question that matters is: Did your attorney do the best job to make the company pay you fair and reasonable damages for your harms and losses?

Sources


This article is provided for general informational purposes only and does not constitute legal advice, nor does it create an attorney-client relationship. Every case turns on its own facts. Statistics cited are drawn from the public sources listed and reflect the data years indicated; figures are updated periodically by the issuing agencies. If you have questions about a specific situation, consult a licensed attorney. Coxwell & Associates, PLLC, 500 North State Street, Jackson, Mississippi 39201. Free background information available upon request.

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