In a California personal injury case, a claim adjuster is:
- Someone who works for the insurance company and is assigned to investigate your claim.
When you go through the insurance process, the adjuster is your primary point of contact. They represent the company, so it’s their job to look at your claim form, evidence, and anything else you provide to them. That’s not all they do, though. And every insurance company has an army of them. So when you’re dealing with an adjuster, it’s helpful to have someone on your side to explain things. That’s where our personal injury team at Maison Law can help. Set up a free consultation to talk through your options.
What Does a Claim Adjuster Do?
Every insurance company has its own team of adjusters, but their job is basically the same across the board: they look at your claim, decide what they think it’s worth, and figure out whether the company should pay. They’re the ones sorting through the details and shaping the outcome on the insurance side. In most claims, an adjuster will:
- Look over the details you provided
- Gather documents, photos, and witness statements
- Check what the insurance policy covers (and what it doesn’t)
- Estimate how much the company is willing to pay
- Watch for anything they think looks suspicious
- Ask doctors or employers for more information if something isn’t clear
It’s a big role—and it can feel like everything hinges on their opinion. But reviewing your claim is only the first step in the process.
What Happens After An Adjuster Reviews My Claim?
Once the adjuster has all the information they think they need, they (on behalf of the company) make a decision about your claim. What happens next usually falls into one of a few paths:
- You get an initial settlement offer. Most of the time, the adjuster will come back with a number. It’s almost always lower than what your claim is actually worth. Insurance companies start low to see if you’ll accept it quickly.
- They ask for more information. Sometimes the adjuster needs more clarity—another medical record, a statement, or proof of missed work. This can slow things down, but it’s a normal part of the process.
- Your claim is denied. If the adjuster thinks the policy doesn’t apply, or they believe your injuries weren’t caused by the accident, they may deny the claim. A denial isn’t the end of the road—you can challenge it.
- Negotiation begins. If you don’t accept the offer (and you shouldn’t accept a low one), the negotiation phase starts. This is where evidence, documentation, and a clear explanation of your injuries matter most. With legal help, this is often where the offer begins to move closer to what you actually need.
You decide whether to settle or take the next step. If the insurance company still won’t make a fair offer, the next option is filing a lawsuit. Most cases settle before trial, but a lawsuit often pushes the company to take your claim seriously. Either way, our team will be with you from the start. We’ll make sure that the insurance company and its adjusters treat you fairly. Reach out today to set up a free consultation.
