Insurance Adjuster Tactics

First-Party Tactics: Your Own Insurer Working Against You

Your own insurance company owes you a duty of good faith under the policy contract. That does not stop adjusters from looking for ways to limit what they pay. Common first-party tactics include disputing whether your injuries fall under the coverage you purchased, arguing that certain treatments were not medically necessary, and delaying payment while requesting additional documentation that adds nothing to the file.

Another frequent move is steering you toward the insurer's preferred medical providers or repair shops. These providers may have financial arrangements with the insurer that incentivize lower treatment costs or conservative damage assessments. You generally have the right to choose your own providers. If your first-party claim is denied or underpaid, many states allow you to file a bad-faith claim against your own insurer — a separate legal action that can produce damages beyond the original policy benefits. Document every interaction with your insurer in writing. Phone conversations should be followed up with an email summarizing what was discussed.

Third-Party Tactics: The Other Driver's Insurer Owes You Nothing

The at-fault driver's insurer has no contractual relationship with you and no duty of good faith toward you. Their sole obligation is to their policyholder. Every dollar they save on your claim is a dollar retained. This creates a fundamentally adversarial dynamic that many claimants do not fully grasp until they are deep into negotiation.

Third-party adjusters use several standard approaches. They call within days of the crash and request a recorded statement before you have consulted a lawyer. They offer a quick settlement before medical treatment is complete, betting that you need cash and will accept a fraction of the claim's true value. They request blanket medical authorizations that give them access to your entire health history, then comb through years of records looking for pre-existing conditions to attribute your current symptoms to. Each of these tactics is legal. Each is designed to minimize your payout. Awareness of the playbook is what prevents it from working.

The Pre-Existing Condition Argument

If your medical records show any prior complaint involving the same body part or symptom you are claiming, the adjuster will argue that your current condition predates the accident. A back injury from five years ago that fully resolved becomes 'a chronic condition' in the adjuster's narrative, even if you were symptom-free for years before the crash.

The legal standard in most jurisdictions is the eggshell plaintiff rule: the at-fault driver takes you as they find you. If you had a previously healed back injury and the crash aggravated it, the driver is responsible for the aggravation. Your attorney counters the pre-existing argument by obtaining detailed medical records showing your condition before and after the accident, along with physician testimony that the crash caused a new injury or worsened a dormant one. The key is documentation. If your doctor confirms the crash caused your current symptoms, the adjuster's attempt to rewrite your medical history faces a factual barrier.

Protecting Yourself During the Claims Process

Do not sign a blanket medical authorization. The insurer is entitled to records related to the injuries you are claiming — not your full medical history. Provide records from the relevant body parts and time periods only, or have your attorney draft a limited authorization.

Keep every communication in writing. If an adjuster calls, take notes on who called, what was said, and the time and date. Follow up with a written summary sent to the adjuster. This creates a paper trail that becomes evidence if the insurer engages in bad-faith practices. Do not accept the first offer without having your attorney evaluate it against the documented damages. And do not let the adjuster create urgency — phrases like 'this offer expires Friday' are pressure tactics, not contractual deadlines. The statute of limitations governs your filing deadline, not the adjuster's arbitrary timeline. Time favors the prepared claimant, not the one who panics.

This site is an independent information resource, not a law firm. Nothing here constitutes legal advice — consult a licensed attorney in your state for guidance on your specific claim.