Insight into How Insurance Adjusters Determine Liability: A Practical Guide

Everyday, countless accident scenarios play out on our roads, driveways, and in public spaces. These incidents often give rise to a question that's central to the claims process: who is at fault?

Technically, the determination of liability in an accident can only be made by a court of law. However, in the practical realm of claims handling, insurance adjusters play a crucial role in assessing and resolving liability claims. This article delves into the methods used by insurance adjusters to determine liability without the need for a court of law.

Factors Considered by Insurance Adjusters

When an adjuster evaluates an accident claim, they carefully examine a range of factors to make a value judgment on liability. Key elements that contribute to their assessment include:

Recorded Statements: The adjuster will gather statements from the parties involved in the accident. These statements provide firsthand accounts of the incident and can offer insight into the sequence of events. Witness Statements: Statements from witnesses can provide valuable details that may not be available from the parties directly involved. These accounts can help clarify the circumstances surrounding the accident. Official Reports: Official reports, such as police reports, weather reports, traffic control timing sequences, fire marshal reports, and skid mark measurements, are essential in establishing a factual record of the incident. These reports can provide objective data that supports the adjuster's assessment. Photographic Evidence: Images of the vehicles' damage and the accident site often provide clear visual evidence. These photos can be instrumental in substantiating the adjuster's conclusions. Diagrams and Schematics: Detailed diagrams of the accident site can offer a visual representation of the incident. These diagrams help clarify the spatial relationships between vehicles, objects, and people involved. Statutory and Case Law Knowledge: The adjuster's expertise in statutes and case law is crucial. This knowledge, combined with experience from handling similar cases, informs the adjuster's judgment.

Setting a fair settlement is based on these assessments. Settlements are often subject to negotiation, and parties with differing opinions can present their best possible cases.

Common Liability Scenarios

The process of determining liability can sometimes be straightforward. For instance, if one driver runs a red light, the fault is clear. In cases like this, it is usually the driver who breached the traffic rules who is at fault. Similarly, if a roller skate left in a driveway trip someone, the property owner may have liability for not promptly removing the obstacle.

However, there are instances where the situation is more complex, and the adjuster's assessment of liability may be contested by the insurance company. In such situations, the matter may be referred to a subrogation board for a determination. The subrogation board reviews the evidence, assesses liability, and ultimately renders a decision on which party is responsible.

Legal and Contractual Basis of Liability

It's important to recognize that liability is ultimately determined by the law, through the courts, and by contractual agreements. Insurance adjusters, while experienced, do not hold the authority to legally establish who is at fault.

A skilled adjustor may strongly suspect the likely outcome of a liability determination based on the available evidence. This allows them to either authorize payment or withhold payment appropriately. If all parties agree with the adjuster's decision, there is no need to escalate the matter to the courts.

Understanding the role of insurance adjusters in accident claim resolution is crucial for anyone involved in a collision. Knowing the methods and considerations they employ can help you navigate the claims process more effectively and ensure fair treatment of your case.