Insurance Adjusters

It is bad enough getting hurt in a car accident from a negligent driver.  If you are lucky enough to come home from the hospital and take phone calls, you will find some new best friends – adjusters from insurance companies covering different losses from your car accident.  

Knowing why these adjusters are calling, and their differing roles, can help you get the benefits you need, while preserving your interests in a personal injury action.   Here are the most common adjusters that you may encounter after your car accident. 

The No-Fault Adjuster

New York state no-fault coverage provides medical care and a percentage of lost wages for injuries suffered in a covered car accident in New York.  Usually, the no-fault carrier for the car that you are driving or riding in provides no-fault coverage.   Its adjuster will communicate with you about your injuries, medical treatment, lost wages, and billing or documentation.  It is in your interest to return these phone calls and provide the information requested, and to timely fill out the necessary documents.   

Video: Why you should consider getting New York OBEL and APIP extra no-fault benefits


The SUM Adjuster

New York SUM/UIM coverage (“SUM”) is insurance coverage that you buy from your automobile insurance carrier that may cover certain of your losses if the negligent driver is underinsured or uninsured. If you are not represented by an attorney, you are likely to get calls from the SUM carrier adjuster seeking to take a statement, and asking for medical records and authorizations.   The SUM carrier is potentially at odds with you over the value of your injuries, and whether it should pay you from its policy.  Therefore, we direct the SUM carrier for our clients to only deal with us.    

Video: What is New York SUM coverage and why is it so important that you have it before a car crash?


The Property Damage (PD) Adjuster

Hopefully, you have New York collision coverage on your automobile.  If so, generally you will submit your car damage claim to your automobile insurance company under such coverage.  It will assign a property damage (PD) adjuster.   You will communicate with the PD adjuster about having your car inspected for repair or to be declared a total loss. The PD adjuster may also contact you about any rental car coverage, handling the existing debt on the car if it is a total loss, where and how the car will be repaired or inspected, and the timing of same.     

The Negligent Driver’s Bodily Injury (BI) Adjuster

This is the adjuster for the automobile liability insurance company that covers the negligent driver that hit you.  It is the insurance carrier that will pay for your injuries and loss for which the negligent driver in legally responsible, up to the level of that policy. In multi-car accident cases, there may be multiple BI carriers, and therefore multiple BI adjusters.  In our view, these adjusters usually do not act in your best interests.  They protect their insured driver and the assets of the insurance company for which they work.  Their job is to pay as little as possible for any personal injuries or other damages that you have suffered.   The BI adjuster will attempt to get a written or recorded statement from you.  We do not believe that these statements help anyone but the negligent driver’s liability insurance company. Therefore, once we represent an injured person, we immediately stop all contact between the BI adjuster and our client. 

The Workers Compensation Adjuster

If you suffer injury in car accident while you are working, workers compensation should cover that injury.  In such case, the workers compensation carrier adjuster will communicate with you about your medical bills, lost wages, approvals for medical treatment, and medical examinations.  This is like the role of the no-fault adjuster, although there are differences.   

The Private Investigator

Drivers working for large corporations sometimes hit and hurt our clients in car accidents.  These corporations are extremely sophisticated — and quick to act.   In one of our cases, a private investigator from the driver’s corporate employer arrived at a crash site within 40 minutes of the crash.  He also attempted to see our injured client in her hospital room on the same evening as the crash.  We stop that contact immediately.  Usually, the private investigator is seeking information to use against our client.  

We suggest that you compile a list of all the adjusters involved with your car accident.  Keep your list handy so you will know who you are talking to and can respond accordingly.    If you have questions about this or other car accident related issues, contact me at 518-489-1098 x17 or check out the FAQs and blog posts on this website.  

by Patrick J. Higgins
Last updated on - Originally published on

Posted in: Personal Injury Law