Occasionally in an injury claim, the "other side"—whether it's an insurance adjuster, an attorney, or the person who caused the accident—will tell you "the law" says that you're liable for the accident. Most of these people, adjusters especially, are talking through their hats.
Adjusters work for insurance companies. Many have a general idea of what the law is on certain liability subjects, but they're not usually legal experts. Only rarely does an insurance adjuster know the law in any detail.
How should you respond when the other side denies liability? Read on for some tips.
If an adjuster claims that the law is on the insurance company's side, demand proof. Ask the adjuster to send you the statute, rule, or regulation that they're claiming applies to your situation.
If the adjuster sends you something, make sure it's a copy of an actual legal rule or law. It could be merely the insurance company's own memo, a letter from a lawyer, or some other unofficial opinion about the law.
If you do get a copy of an official rule or law, read it carefully. Often what you'll receive is just a general statement of law that can be applied differently in different situations and doesn't answer the central question of who was at fault for your accident.
For example, a traffic law might state that the driver to the right has the right-of-way at a four-way stop intersection. But that doesn't determine whether you got to the intersection first, giving you the right to go through before the other vehicle, or whether the other driver was careless and failed to stop at the stop sign.
If the adjuster doesn't send you any documentation of the law, make clear in your reply that you can't consider something that's undocumented. If the adjuster sends something that isn't a copy of an actual statute, rule, or regulation, reply the same way. State that you asked for the law that applies to your case, and the adjuster failed to supply it, so you can't consider something that can't be documented.
Despite your arguments, an insurance adjuster might continue to rely on an interpretation of a law that denies all liability by the other driver and refuse any settlement at all. In that case, you'll have to turn to other negotiating options, or even go to court.
A police accident report in an injury claim is often a point of focus for what it says about what caused the event in question. The police report can be helpful, but it isn't the final word on liability. Especially in traffic accident cases, an adjuster will sometimes argue that nothing in the police report confirms your description of how the accident happened.
You can point out that nothing in the police report contradicts your version of what happened, either. Remind the adjuster that the police officer didn't actually witness the accident, having arrived after it happened.
You have a more difficult problem if the police report specifically contradicts your version of events and who caused the accident. If the claims adjuster points out something in the police report that indicates you were at fault for the accident and suggests you have no claim at all because of it, there are several ways to respond:
(That's assuming those statements line up with the facts—if any of them don't, adjust accordingly.)
These are all ways of telling the adjuster that the police report is useless as legal evidence of what actually happened.
An attack on the legal value of a police report might or might not immediately get the claims adjuster to rethink their reliance on the report in your settlement negotiations. But it will at least let the adjuster know that you know the police report won't help much should your claim eventually wind up in court.
An adjuster who knows you won't drop your claim just because of a bad police report will probably get back to bargaining with you. But you may have to lower your demand somewhat because of the report—even if you think it's wrong. It's strong evidence in favor of the insurance company.
It's important not to let an insurance adjuster intimidate you into giving up. When you've been injured in an accident, you have certain rights. That includes getting a fair settlement when someone else's actions caused your injuries.
When you're facing an obstinate insurance adjuster, don't be afraid to stand your ground. And consider that it might be time to consult an attorney.
This article is based on How to Win Your Personal Injury Claim by attorney Joseph Matthews (Nolo).