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Car Accident Claims Tips & How-To Guides

How Insurance Adjusters Evaluate Claims

Disclaimer: This article is for informational purposes only and is not legal advice. For guidance tailored to your situation, consult a licensed attorney in your state.

After a car accident, one of the first calls you’ll receive is from an insurance adjuster. They may sound friendly, polite, and genuinely concerned about your well-being — but their job is to protect the insurance company, not you.

What you say (or don’t say) during these conversations can directly impact:

  • how much your settlement is

  • whether your medical bills are paid

  • who gets blamed

  • whether your claim is denied

  • how long your case takes

Most people don’t realize they can accidentally hurt their claim with just a few careless words.

This guide explains how insurance adjuster conversations are commonly evaluated and highlights communication patterns that may affect how claims are reviewed.

Read: How to Deal With Adjusters

This guide focuses on commonly observed insurance claim practices and communication patterns to help readers understand how adjuster conversations are typically evaluated.

What People Often Don’t Realize When Speaking to an Insurance Adjuster

Many people assume that once fault is clear, the insurance process becomes straightforward. In reality, even clear-liability claims can stall for weeks or months due to internal reviews, documentation checks, and cost evaluations that are not visible to claimants. This disconnect often leads people to underestimate how much follow-up and organization is required.

Another common misconception is that the first serious conversation with an insurance adjuster reflects the insurer’s final position. In practice, early discussions are often exploratory and do not represent the full value—or limitations—of the claim.

What Actually Happens in Practice

In practice, insurance adjusters often manage dozens of active files at once and prioritize cases based on urgency, documentation completeness, and response behavior. Claims with incomplete records or inconsistent follow-ups may move more slowly, even when the underlying facts are similar.

It is also common for insurers to wait until medical treatment stabilizes before fully evaluating a claim, which can create long periods of limited communication that feel confusing or frustrating to claimants.


The Insurance Adjuster’s Role in the Claims Process


Insurance adjusters are responsible for evaluating claims on behalf of the insurance company. Their role includes gathering information, assessing liability, reviewing documentation, and determining how a claim should be resolved under the policy’s terms.

Because adjusters manage many claims at once and follow internal procedures focused on efficiency and cost control, the way information is communicated during early conversations can influence how a claim is reviewed. Understanding this process helps explain why insurers often prefer concise, documented communication and why early discussions may not reflect a claim’s final evaluation.

They are trained negotiators who follow internal procedures designed to evaluate claims efficiently and control costs.

Knowing how to communicate with them is one of the most important parts of your accident claim.

The National Association of Insurance Commissioners (NAIC) notes that adjusters must follow fair claims handling standards and cannot pressure or mislead claimants during the process.
Source: https://content.naic.org


Rule #1: Stay Calm, Polite, and Neutral

Insurance adjusters document everything — including tone. Emotional or unclear communication can sometimes complicate how conversations are documented and later reviewed.

Common Communication Principles Observed in Claims

  • polite

  • brief

  • factual

  • neutral

Treat the conversation like a professional interaction, not a personal one.


Common Types of Information Adjusters Typically Request

The examples below reflect communication approaches commonly discussed in claim-handling contexts, not required responses.

Adjusters often listen closely for subjective language, such as statements about pain levels or recovery expectations. Even casual phrases can later be compared against medical records or timelines during claim evaluation.

Basic Personal Information — ONLY

You can safely confirm:

✔ Your name
✔ Contact information
✔ Policy number
✔ Date, time, and location of the accident

Stop there.

Do not provide:

  • medical history

  • work history

  • family details

  • financial details

  • personal background

That information is not required and can easily be used to minimize your claim.

According to the Insurance Information Institute (III), adjusters are trained to minimize payouts, which is why claimants should be careful with what they say during early conversations.
Source: https://www.iii.org


Say You Will Cooperate — After Reviewing Everything

The following examples are illustrative of neutral, commonly referenced responses and are provided for educational purposes only.

A safe, neutral statement:

“I will cooperate fully once I have all the information and after I’ve reviewed everything.”

This keeps you cooperative without giving up your rights.


Request Written Communication

This protects you.

Say:

“Please send all questions and requests to me in writing.”

This prevents misunderstandings and creates a documented paper trail.


 Say You Need Time to Evaluate Your Injuries

Never say you “feel fine.”

Instead:

“I’m still receiving medical evaluation, and it’s too early to know the full extent of my injuries.”

This protects you if symptoms appear later — which is extremely common with soft-tissue injuries.

For more information on injury timelines, see:
👉 Understanding Medical Expenses in a Car Accident Claim

Additionally, the CDC notes that many injuries — including concussions — may develop or worsen hours or days after a collision.
Source: https://www.cdc.gov/traumaticbraininjury


Politely Decline a Recorded Statement

Say:

“I do not consent to a recorded statement.”

In many situations, claimants are not required to provide one, depending on the circumstances and policy involved. Adjusters often use recorded statements to reduce claims.

In practice, recorded statements are often requested early in the process, before medical treatment or documentation is complete. Details shared at this stage may later be reinterpreted once the insurer has more information, even if the original statements were made honestly and in good faith.

Many state insurance departments  such as the Texas Department of Insurance (TDI) publish consumer protection guidelines explaining how insurers must communicate with claimants and respond in good faith.
Source: https://www.tdi.texas.gov


Say You Are Gathering Documentation

A simple, safe response:

“I’m still collecting medical records, repair estimates, and other documents.”

This stops the adjuster from pushing for premature answers.


Provide Only Basic Facts About the Accident

You can confirm:

✔ location
✔ vehicles involved
✔ that the accident occurred
✔ that the police were contacted

Do NOT offer personal opinions or long explanations.

A safe statement is:

“The accident happened at [location] on [date]. I was struck by another vehicle. I will share more details after reviewing all documentation.”

A Common Scenario That Catches People Off Guard

For example, after a rear-end collision, a claim may appear simple at first. Initial vehicle damage is documented, medical visits begin, and liability is accepted. However, insurers often delay meaningful valuation until treatment patterns become clearer. If medical care pauses or changes unexpectedly, the claim may be reassessed internally—even when no new information is requested from the claimant.

This behind-the-scenes evaluation process is rarely explained upfront, which is why timelines and expectations often feel unclear to people navigating a claim for the first time.


What is common for claimants to avoid Saying When Talking to an Insurance Adjuster

Many experienced claimants choose to limit conversations to basic facts, avoid discussing fault or recovery expectations, and request written communication to prevent misunderstandings later in the process.

Many claimants avoid saying

The following statements are commonly cited as creating complications during claim review:

❌ “I’m sorry.”
Sounds like admitting fault.

❌ “I’m not hurt.”
Many injuries appear later.

❌ “I think…” / “I guess…”
Never guess — it creates contradictions.

❌ “It was probably my fault.”
Fault must be determined by evidence, not your opinion.

❌ “Yes, you can record this.”
Never agree to recorded statements.

❌ “I don’t have a lawyer.”
This signals vulnerability.

❌ “Sure, I’ll sign whatever you send.”
Some forms release your rights.

❌ “I don’t need more treatment.”
This harms injury claims.

❌ Long explanations
Stick to facts.

❌ Anything about pre-existing injuries
Adjusters use this to deny claims.


How to Protect Yourself During Adjuster Calls

1. Keep Calls Extremely Short

If a question feels uncomfortable, say:

“I’m not comfortable discussing that yet.”

2. Take Notes

Record:

  • date

  • time

  • adjuster name

  • questions asked

  • answers you gave

3. Avoid Discussing Pain Levels

If asked how you feel:

“I’m still undergoing medical evaluation.”

4. Direct Them to Your Lawyer

If you hire one:

“Please speak with my attorney from now on.”

For more guidance see:
👉 Should I Get a Lawyer for a Minor Car Accident?


Why Adjusters Want You to Talk Before You Know Your Rights

Because early in the process you:

  • don’t yet know your medical status

  • don’t know repair costs

  • don’t know future treatment needs

  • don’t know the value of your claim

They often make contact early because key information such as medical outcomes and repair costs has not yet been fully established.


How to Respond to Common Adjuster Questions

Q: “How did the accident happen?”

A:
“The accident is under investigation, and I’m still reviewing details.”

The Legal Information Institute at Cornell Law explains that negligence is a key concept in determining liability, which is why statements to adjusters can affect your claim.
Source: https://www.law.cornell.edu/wex/negligence

Q: “Were you injured?”

A:
“I’m still being evaluated by medical professionals.”

Q: “Can you give a recorded statement?”

A:
“I do not consent to a recorded statement.”

Q: “Can you share your medical history?”

A:
“I’m not discussing medical history at this time.”

Q: “Can you send your medical records?”

A:
“I will provide accident-related records when appropriate.”

Q: “We’d like to offer a quick settlement…”

A:
“I’m not ready to discuss settlement yet.”

For more information:
👉 How to Handle a Lowball Settlement Offer

Many people are surprised to learn that conversations that feel informal at the time can later influence how an insurance claim is evaluated.


When You Should Stop Talking to the Adjuster

Stop communication immediately if they:

  • pressure you

  • blame you

  • deny your injuries

  • misstate facts

  • request irrelevant documents

  • make a suspiciously low offer

  • make you uncomfortable

Or if you hire a lawyer — then all communication should go through them.


Do You Need a Lawyer to Talk to an Adjuster?

Data from the National Highway Traffic Safety Administration (NHTSA) shows that many crash injuries are not immediately obvious, which is another reason to avoid minimizing your symptoms early.

A lawyer is especially helpful if:

  • you are injured

  • fault is disputed

  • the offer is too low

  • the adjuster is aggressive

  • long-term treatment is needed

Most personal injury attorneys work on a contingency basis, meaning you pay nothing unless you win.


Conclusion — How Early Conversations Can Influence a Claim

Talking to an insurance adjuster might seem simple, but the wrong sentence can dramatically weaken your case.

In practice, many claimants focus on sharing only basic facts, avoiding fault discussions, declining recorded statements, and requesting written communication whenever possible. Keeping conversations brief and factual helps reduce misunderstandings early in the process and prevents statements from being misinterpreted later.

Last edited: 12/30/2025 by James Carter

Author

  • James Carter serves as the Lead Legal Editor at Crash Claim Guru. His background includes formal legal education and professional experience related to personal injury claims, insurance evaluation, and accident-related documentation review.

    Over the course of his career, James has worked with matters involving motor vehicle accidents, insurance coverage analysis, and claim evaluation processes. His experience includes exposure to how insurance companies typically review medical records, assess liability, and determine settlement ranges in non-catastrophic injury cases.

    This background allows him to provide editorial oversight that reflects commonly accepted legal principles and real-world insurance practices, without offering legal advice.

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James Carter serves as the Lead Legal Editor at Crash Claim Guru. His background includes formal legal education and professional experience related to personal injury claims, insurance evaluation, and accident-related documentation review.

Over the course of his career, James has worked with matters involving motor vehicle accidents, insurance coverage analysis, and claim evaluation processes. His experience includes exposure to how insurance companies typically review medical records, assess liability, and determine settlement ranges in non-catastrophic injury cases.

This background allows him to provide editorial oversight that reflects commonly accepted legal principles and real-world insurance practices, without offering legal advice.