Factors Adjusters Examine When Evaluating Claims

After you file a personal injury claim, your Lakeland personal injury lawyer will send your medical records to the insurance adjuster to document and support your claim for bodily injury. In order to determine how much to offer you on your claim, an insurance claims adjuster will carefully consider the following factors.

Correlation Between Accident, Injury And Medical Records

Claims adjusters thoroughly analyze medical records. In particular, they will look for:

  • References to any pre-existing ailments or injuries to the same body part
  • Any indication of alcohol or drug use
  • Any facts that stray from the version of events that you reported to the adjuster
  • Medical reports verifying the period of disability
  • Medical reports confirming any claim of permanent disability or disfigurement
  • Comments regarding previous claims or injuries

For example, a claimant reported that she hurt her neck when she slipped off a massage table. She sued the manufacturer of the table, alleging that it was faulty and therefore caused her injury. The claimant’s lawyer sent her medical records to the claims adjuster. However, the records did not refer to the claimant falling off a massage table. Instead, they reflected that she had previously slipped and fallen on ice when skating on a pond. The adjuster likely lost trust in the claimant’s credibility after that.

Relationship Between Injury And Medical Expenses

When evaluating claims, claims adjusters focus intently on the relationship between the injuries that are reported to have been suffered and the degree of medical expenses that have allegedly been incurred. Through experience, adjusters develop intuitions about when medical bills are greatly out of sync with the claimed injuries. For example, claimants often “build up” medical bills regarding soft tissue injuries, which means they excessively exaggerate the medical costs in order to drive up the adjuster’s purported settlement evaluation of the case.

For the best advice about your particular personal injury case, contact the dedicated and experienced Lakeland personal injury lawyers at Smith, Feddeler & Smith, P.A., at 863-336-6927. You can also send an email. The initial consultation is free of charge.