At its core, the insurance industry can be boiled down to two words: risk management. Each year, insurance companies invest millions of dollars in identifying which of their policyholders will pose more or less of a risk to them having to pay money to claimants. They do this because once they are able to forecast the likelihood of their policyholders’ liability, they can charge their premiums accordingly. Once a claim has been made on a policy for benefits, however, the rules that the insurance companies (more specifically, the adjusters) must abide by, become very strict. Both the Florida Legislature and its constituents are aware that insurance companies hold an advantage over policyholders. To prevent any wrongdoing when it comes to handling claims, there are laws that regulate the conduct of all insurance representatives. These laws are designed to protect the interests of the policyholders and the claimants by “levelling the playing field” between the giant insurance companies and ordinary individuals who are just trying to recover the benefits that they are legally entitled to. In other words, insurance adjusters have ethical obligations that they must adhere to by law. If an adjuster fails to meet these ethical standards, the insurance companies may find themselves in some trouble, and the claimant may be entitled to additional compensation in the form of punitive damages, a favorable judgment in a bad faith cause of action, or some other form of retribution that the Court deems fair and just. For example, pursuant to Fla. Admin. Code R. 69-220.201 Ethical Requirements for All Adjusters and Public Adjuster Apprentices, Rule (3)(i) states “[a]n adjuster shall not attempt to negotiate with or obtain any statement from a claimant or witness at a time that the claimant or witness is, or would reasonably be expected to be, in shock or serious mental or emotional distress as a result of physical, mental, or emotional trauma associated with a loss.” To illustrate the rule, suppose that you have just been involved in an auto accident after another driver ran a red light and T-boned you. The next day, the other driver’s insurance company gives you a phone call asking how you are feeling. They talk to you for a little while and ask whether you visited the hospital or saw a doctor. At the end of the conversation, they offer to pay you $500.00 for all of your medical bills and pain and suffering. According to the aforementioned rules, this could be a potential violation, because the day after a violent car crash such as a T-bone accident, you would likely be in shock or in distress; and the rule states that adjusters shall not attempt to negotiate when it would be reasonable to conclude that a claimant might be in shock or in distress. Further, Rule (3)(g) states “[a]n adjuster shall not negotiate or effect settlement directly or indirectly with any third-party claimant represented by an attorney, if the adjuster has knowledge of such representation, except with the consent of the attorney.” So hypothetically, if an adjuster knows that Hale Law represents you, but still tries to offer you money to settle your claim, the adjuster would be in violation of another rule. Unfortunately, insurance adjusters do not always follow these ethical rules and standards. The adjusters often have incentives to settle your claim as fast, and for as little amount, as possible. If you believe your insurance adjuster is not being fair, make sure you tell the insurance companies “you’re going to Hale” and then GO TO HALE™. Our team of experienced attorneys will consult with you about your important legal claim free of charge, and if you decide to sign up with us, none of our services come at a cost to you unless we win. Visit our website at halelaw.com or give us a call day or night to discuss your case further at 941-735-4529.
Auto Accident Insurance Adjusters Must Be Ethical And Fair