The public adjuster is paid by the insurance company as part of the final claim. Thus, when your settlement amount is confirmed, the adjusters paycheck is on the way and hes off to the local fast food restaurant for a delicious meal, ready to get to work, ready to get to work!
There are a number of factors that influence the settlement. The public adjusters job is to understand how and why your insurance carrier determined your settlement amount.
How did you come up with your settlement amount? The public adjuster should thoroughly understand the impact of risk on insurance costs and premiums. He must understand how risk is evaluated and how premium discounts are determined. The adjuster should understand what criteria the insurance company uses to make settlement offers. He should understand how settlement information is communicated to you. The adjuster should understand the nature of claims (substandard, no claim, other), the nature of payments (bill/plead, settlement, bill/accept, bill/notice, judgment).
What factors influence the final settlement? This factor should be thoroughly understood. The public adjuster should understand how decisions are made by the insurance carrier regarding your final claim amount. This includes factors such as who is footing the bill for settlement, the status of appeals, final payment requirements, final determination of what constitutes a settlement, final determination of who gets what type of payment. The public adjuster should understand when a settlement is a done deal, when things are all hunky-dory, and when things get weird.
To ensure that the public adjusters job is stress free, he should at all costs learn the company policy on settlement. He should understand who has the final say when it comes to settlement (you or the insurance carrier). He should be aware of all aspects of settlement including the company policy on settling cases. The adjuster should understand how your insurance company conducts negotiations regarding settlement.
Know your insurance policy. You may be able to get the public adjuster to settle for less than what the policy calls for. He may be willing to settle for as little as possible. Remember, he is working for the insurance carrier and needs this determination to enter into an insurance contract with the employer.
In all of the cases I have investigated, I have found that if the public adjuster knows what the policy allows and the company policy on settlement, he will not settle for less. He will negotiate the amount to within the policy. In the vast majority of the cases, if the public adjuster does not know what the policy allows and the company policy on settlement, he will make whatever amount is called for in the policy.
In all but a few cases, I have found that if the public adjuster knows what the company policy on settlement is, he will settle for that amount as well.
Remember, every company has a policy on settlements. Some will do a settlement that is above the policy amount, some will do a settlement that is well below the policy amount, some may agree to any amount that the employee wants, and some will only settle for the stated policy amount. A company policy on settlements is not a hard and fast rule. Sometimes a company will agree to less than the policy amount. It is possible that a company will settle for more than the policy amount. It is important that the employer not give the employee too much discretion. Sometimes the employee is looking for a quick buck. The employee may be willing to settle below the policy amount in order to achieve his goals, but only if the settlement will not cause the employer to be in hot water with the employee’s union.