What Is an Insurance Adjuster in a Personal Injury Claim?

The Short Answer…

An insurance adjuster is a representative of the insurance company responsible for evaluating personal injury claims and determining settlement amounts. Their primary goal is to minimize payouts by investigating accident details, assessing liability, and negotiating settlements on behalf of the insurer.

Key Takeaways

• Insurance adjusters work for the insurance company, not for you. Their goal is to minimize payouts.
• Adjusters investigate claims, assess damages, and negotiate settlements based on company policies—not fairness.
• Common tactics include lowball offers, delays, and disputing liability to reduce payouts.
• Never give a recorded statement without legal advice, as adjusters can use your words against you.
• If your claim is delayed, denied, or undervalued, a personal injury lawyer can help protect your rights and negotiate for fair compensation.

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What Is an Insurance Adjuster?

An insurance adjuster is a professional responsible for evaluating personal injury claims and determining how much an insurance company should pay. Their job is to review accident details, assess damages, act as a point of contact for the insurance company, and negotiate settlements, all while protecting the insurer’s financial interests. 

Adjusters work for insurance companies—not for you. Their goal is to minimize payouts by scrutinizing evidence, questioning injury severity, and looking for reasons to reduce or deny claims. Understanding who they are and how they operate is key to securing fair compensation.

Types of Insurance Adjusters

Company (Staff) Adjusters

These adjusters are full-time employees of the insurance company. They handle claims exclusively for their employer and are trained to settle cases for as little as possible while staying within company policies.

Independent Adjusters

Independent adjusters work as contractors for multiple insurance companies rather than being on a single insurer’s payroll. Although they are technically “independent,” they still represent insurers—not injury victims—and their goal remains the same: limit claim payouts.

Public Adjusters (Less Common in Personal Injury Claims)

Public adjusters work for policyholders rather than insurance companies. They help individuals negotiate with their own insurance providers, usually in property damage claims. In personal injury cases, public adjusters are rarely involved since lawyers typically take on the role of negotiating compensation.

Practical Insight About Insurance Claims Adjusters

Insurance adjusters are evaluated based on how many claims they settle and how quickly they close them. Independent or inexperienced adjusters often have less flexibility in negotiations and may need approval from higher management before making settlement decisions. In many cases, they have limited control over what they can offer.

This is important to keep in mind during settlement negotiations. Remember, you know more about your case than they do—they’re working from a file, but they weren’t there to witness the accident and aren’t experiencing the financial and physical impact firsthand. This perspective can give you an advantage when negotiating for a fair settlement.

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What Does an Insurance Adjuster Do in a Personal Injury Claim?

Once a personal injury claim is filed, an insurance adjuster steps in to investigate and determine how much—if anything—the insurer will pay. Their process includes:

• Investigating accident details – Reviewing statements, photos, and reports to establish what happened.
• Reviewing medical records and evidence – Examining injury reports, police reports, and medical bills to assess the claim’s validity.
• Assessing liability – Determining who was at fault and whether the insurance company is responsible for covering damages (if it is covered in the insurance policy).
• Evaluating damages and injuries – Estimating financial losses, including medical expenses, lost wages, and pain and suffering.
• Negotiating a settlement – Offering a payout that benefits the insurer while aiming to close the case as quickly as possible.

Because adjusters work for the insurance company—not for you—their goal is reducing the insurer’s financial exposure, not ensuring you receive full compensation.

How Insurance Adjusters Determine Settlement Offers

Adjusters don’t offer compensation based on fairness. They rely on data-driven calculations and company policies to minimize payouts. They consider:

• Medical expenses – Bills related to hospital visits, surgeries, therapy, and ongoing care.
• Lost wages – Compensation for missed work and reduced earning capacity.
• Pain and suffering – A subjective estimate based on the severity and impact of injuries.
• Comparative negligence – In Texas, if you’re found more than 50% at fault, you may be barred from receiving compensation under state law.

Insurance companies often use proprietary formulas—such as multipliers or software algorithms—to calculate settlements, frequently undervaluing non-economic damages like pain and suffering. Because of this, initial offers are typically lower than what victims deserve, making settlement negotiation necessary.

Tactics Insurance Adjusters Use to Minimize Your Payout

Insurance adjusters are trained to protect their company’s bottom line, often using strategies to reduce, delay, or deny your claim. These tactics often include lowball settlement offers, disputing liability, downplaying injuries, or pressuring you into recorded statements that can be used against you.

Understanding these strategies can help you avoid common pitfalls and protect the value of your claim. For more information, visit our guide on How Insurance Companies Undermine Injury Claims (And How to Fight Back).

When to Hire a Personal Injury Lawyer to Deal with the Insurance Adjuster

If an insurance adjuster is delaying, undervaluing, or disputing your claim, it may be time to involve a personal injury lawyer. While you may be able to handle minor claims on your own, serious injuries, denied claims, and complex liability disputes often call for legal representation.

An injury attorney can negotiate on your behalf, gather strong evidence, and push back against unfair settlement offers. At Braker White, our team works on a contingency fee basis, meaning there is no cost to getting our professional help unless we win your case for you. If you’re unsure whether you need a lawyer, schedule a free case review with us and we’ll provide an honest evaluation of your situation and our professional recommendation for how to proceed.

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FAQs About Insurance Adjusters