Insurance Adjuster

Dealing with an insurance adjuster starts with one question: Which company does this person work for? The answer shapes what you owe the caller, what you should share, and what ends up in the adjuster's notes about your injury. Those calls often come between medical appointments, while you are still learning how serious the damage is.

At MooreJustice Accident & Injury Lawyers, we deal with no-fault carriers, liability insurers, and their adjusters on behalf of seriously injured New Yorkers. A careless answer in the first few calls can follow a claim for months, so it helps to understand each adjuster's role before you talk. If an adjuster has already contacted you, call our team at (917) 809-7014 before the next conversation.

Who an Insurance Adjuster Really Works For

An insurance adjuster, sometimes called a claims adjuster, is the person an insurance company assigns to investigate a claim and determine how much, if anything, the company should pay. The occupational profile from the U.S. Bureau of Labor Statistics describes adjusters interviewing the people involved and witnesses, reviewing police reports, and gathering written or recorded statements. The same profile says that their goal is to save the company as much money as possible.

That goal does not make adjusters dishonest, but it means the friendly voice on the phone is not on your side. Your answers, treatment gaps, and guesses about fault can all land in the adjuster's report. We treat every adjuster as a professional working for the opposing side.

The Adjusters You May Hear From After a Serious Injury

After a serious injury in New York, you may hear from several adjusters at once. Each one answers to a different company.

Your Own No-Fault Adjuster

After a car crash, your first claim usually goes to a no-fault insurer, generally the company covering the vehicle you occupied or, for a pedestrian, the vehicle that struck you. Guidance from the state Department of Financial Services (DFS) quotes the regulation requiring written notice within 30 days of the accident, unless you provide written proof of a clear and reasonable justification. The same guidance lists 45 days to submit health care bills and 90 days to file lost wage claims.

Your no-fault adjuster can also request medical exams with doctors the insurer selects or approves. An opinion from the state insurance regulator's Office of General Counsel explains that attending a requested exam is a condition of coverage when the insurer has a reasonable basis for the request. We prepare clients and explain what to expect at an insurer's medical exam.

The At-Fault Driver's Liability Adjuster

A second adjuster may call from the liability insurer for the driver accused of causing the crash. That insurance adjuster works under a policy you never bought and wants to estimate what the company could owe you.

For negligence claims between people covered by no-fault insurance over a crash in New York, Insurance Law § 5104 bars recovery for non-economic loss, meaning pain and suffering, unless the injury is a serious injury. Insurance Law § 5102(d) defines a serious injury as death, dismemberment, significant disfigurement, a fracture, loss of a fetus, or one of three categories of permanent or significant loss or limitation of use.

Expect this adjuster to comb your records for anything that keeps your injury short of the serious injury threshold. Knowing how no-fault and at-fault claims differ shows why this call carries higher stakes, so we build the medical record early.

The Property Owner's or Contractor's Adjuster

Falls on unsafe property and construction site injuries usually bring an adjuster from the liability insurer for a building owner, manager, or contractor. That adjuster may be the first insurance representative you hear from.

This adjuster often moves quickly to collect incident reports, surveillance video, maintenance logs, and employee statements. We send our own evidence preservation requests early, because much of that proof sits in the owner's or contractor's files.

If several adjusters are already calling, let us sort out who represents whom before you say more. Call The Law Offices of Darren T. Moore, P.C. at (917) 809-7014 for a free case evaluation.

What Adjusters Look for in a Serious Injury File

An insurance adjuster rarely explains the review, but the same pressure points appear in file after file. Before a client speaks with any adjuster, we check for the following weak spots:

• Recorded statement answers: A casual "I'm doing okay" or a guess about speed can turn into a quoted line in the adjuster's report. We keep early statements to verified facts or decline them.
• Gaps in treatment: Missed appointments let the adjuster argue that you healed or that something else caused your symptoms. We track treatment dates and document the reason for any break.
• Earlier injuries to the same body part: An old back strain or a prior knee surgery invites the argument that the incident changed nothing. We gather records showing how your condition looked before and after.
• Inconsistent accounts: Differences between emergency room notes, the police report, and what you told an adjuster get used to question your credibility. We compare every version of events before the claim moves forward.
• Your share of the fault: Under Civil Practice Law and Rules (CPLR) § 1411, your share of fault reduces damages proportionally in most injury cases without barring recovery. In crash injury cases covered by the no-fault law, recovery is barred when your fault is greater than the defendant's or greater than all defendants' fault combined.

Each of these weak spots is easier to address before an adjuster writes it into the file than after.

How to Handle an Insurance Adjuster's Phone Call

You do not have to be rude to an adjuster, but you do need a plan before you answer. Our team gives injured clients the following steps for any adjuster contact:

1. Identify the caller: Write down the adjuster's name, company, phone number, and claim number, and ask whom that company insures.
2. Notify your own carrier in writing: Send written notice to your no-fault insurer promptly after a crash rather than waiting for its adjuster to call.
3. Stick to basic facts: Confirm your contact details and when and where the incident happened, then decline to give the other side's insurer a recorded statement.
4. Skip the guesses: Avoid estimating speeds, distances, or how you feel, and say only that your treatment is ongoing.
5. Confirm conversations in writing: Send a short email or letter summarizing each call, and keep copies of everything the adjuster sends.
6. Hand off the calls: Once you hire a lawyer, give the adjuster your attorney's contact information and stop discussing the claim yourself.

These habits keep the insurance adjuster's file limited to verified facts. Once The Law Offices of Darren T. Moore, P.C. is involved, we ask every adjuster to direct claim communication to our office. If talks stall, we explain the difference between an insurance claim and a lawsuit and your next options.

When an Adjuster's Conduct Crosses the Line

New York's Insurance Law § 2601 treats certain acts as unfair claim settlement practices when an insurer commits them without just cause and often enough to show a general business practice. Examples include knowingly misrepresenting pertinent facts or policy provisions and failing to attempt in good faith to reach prompt, fair, and equitable settlements once liability is reasonably clear. After notice and an opportunity to be heard, violations can lead to monetary penalties against the insurer.

You can report that conduct through the DFS consumer complaint system, which notes that it may share your complaint with the company. One slow callback is not a pattern, so we document each delay and misstatement with dates. We also explain when claim handling becomes insurance bad faith.

Frequently Asked Questions About Dealing With Insurance Adjusters

Do I have to give a recorded statement to the other driver's adjuster?

That insurer's policy covers the other driver, so we generally advise declining. Your own no-fault carrier can require sworn questioning called an examination under oath when reasonably needed.

Can a public adjuster negotiate my personal injury claim in New York?

The state's adjuster licensing guidance describes public adjusters as negotiating an insured's property loss or damage claims. For injury claims, we recommend a personal injury attorney.

Does an open claim with an adjuster satisfy New York's lawsuit deadline?

No. CPLR § 214 requires most personal injury lawsuits to be commenced within 3 years, and we track that deadline throughout negotiations.

What if the adjuster says my injury is not a serious injury?

That is the insurer's position, not a court ruling. We gather imaging and specialist findings that connect your injury to the legal categories.

Can I hire a lawyer after I already spoke with the adjuster?

Yes. We review what you said, notify each insurer that we represent you, and ask adjusters to contact our office.

What should I do when an insurance adjuster stops returning my calls?

Send a dated written follow-up with your claim number and keep a copy. If the silence continues, we escalate with the insurer and, if needed, state regulators.

Talk to a New York Injury Lawyer Before the Insurance Adjuster Calls Back

You should be able to focus on recovering from a serious injury without screening calls from the company trying to decide what that injury is worth. A lawyer can take those calls so you can focus your energy on treatment.

Our team includes founding attorney Darren T. Moore, who has more than 17 years of legal experience, and managing attorney Nicholas Blatti. We take over contact with the adjusters on your claim, respond to their requests in writing, and push back when an insurer tries to shrink your injury on paper.

We work on a contingency fee basis and assist Spanish-speaking clients. Call MooreJustice Accident & Injury Lawyers at (917) 809-7014 for a free case evaluation with a New York injury lawyer before you speak with another insurance adjuster.