Insurance adjusters ALL have war stories?

Question

Care to tell yours? I would like to hear some good ones!
I am a former adjuster, and I don't miss it.

Answer 1

I'm not an adjuster, but I WILL share two of my favorite Workers Comp claim stories.

1. Had a teacher at a public high school try to file a workers comp claim on her broken finger nail. She "broke her nale when something hit her rist.". I don't know what she taught, but I HOPE it wasn't English.

2. Had a cafeteria worker at a different public high school, lifting a 5lb block of cheese out of the fridge, "injuring her back". OK, nothing too weird yet, but then she wanted permanent disability for it, because it caused her to become depressed and she couldn't sleep, because whenever she would go to sleep, she'd "dream of being chased by blocks of cheese".

Gotta love it.

Answer 2

Back in the late 80's I worked for a high risk company that was part of the Nationwide Group. One of our drunk insureds ran a stop sign and broadsided a 4-door Honda Accord driven by a 24 yr old guy named Dean. He was taken to the E/R by ambulance. The accident happened in St. Paul and the other guy had his coverage, including PIP through St. Farm.

The property damage claim went quickly but the injury claim was the most bizarre I have ever handled. He was kept overnight in the hospital for observation. His injuries were a concussion, neck/back strain and a broken middle finger.

My statement from him lasted 2.5 hours and was cheap entertainment for the entire dept. He started out nice and coherent then he went off the deep end. When I asked where he lived he said Omaha. When I asked how long he had been visiting in St. Paul he said 1.5 yrs. So being the idiot I am I asked where in St. Paul he was staying. He said that he lived in the backseat of his Accord. I asked how I could get a hold of him by phone. He said I could call him on his car phone. I asked for the number and he gave his SS#.

When I had appraised his car I never looked into the back seat. When I went back to see the car again there was an old beige ATT Desktop phone on the floor in the backseat next a small blk & wht TV. Obviously neither could work in the car.

When I asked about his occupation he said he was an inventor who had just gotten a patent for a "billion dollar" invention. He claimed that the invention was a laser for removing hemorrhoids. He said that he was intending to have a company in St. Paul manufacture the device.

When I tried to explain how his PIP and the BI would work he went nuts when I told we had 30K limits. He said we owed him "at least" a billion and half dollars for the concussion because he stored all the plans in his head for the laser and now he couldn't remember them all since the accident. Now keep in mind that I keep a straight face and not laugh because I was taking a statement. It was nuts.

He called three times a week and I recorded all the calls for the heck of it. When he got mad at my first offer he hired an attorney then he quit. After 3 more lawyers dropped him he said he had hired "an international Law Firm" from London and they had filed a multi-billion dollar lawsuit with the "World Court"

I finally got wise and had a PI do a background check on the guy. It turned out he had walked away from a mental health center in NE. We contacted his parents who were delighted to know where he was. The BI was settled quickly after the parents produced a power of attorney and that ended one of the most bizarre claims I have handled over a 20+ yr career.

If you are going to be a claim adjuster work for a high risk company those are the most fun claims to handle.

Answer 3

I lost a case in arbitration a couple of years ago. It still has me steaming. KS comp neg state - have to be greater than 50% at fault before other party can collect. I denied based on 50/50.

My insured was behind clmnt on 2 lane highway. She pulled out to pass and it was not clear. She ended up running the car she was going to pass (the clmnt) off the road. In the clmnts recorded statement he admitted no less than 3 times that he saw my insd and he saw that she was not going to make the pass. He did not slow down, speed up, or make ANY evasive actions because he had the right of way on the highway. She was the one passing him so it was not his responsibility to avoid accident.

I lost based on us owing 100%. Okay I admit 50/50 may have been a little harsh - but 100% when the clmnt had multiple last clear chances to avoid. He had fault in this accident!

The was another claim in my office when the clmnt r/e our insured. Clmnt was uninsured but we tried to pursue coverage from the girl that was ON the clmnt's lap. Our argument was that she was in the drivers seat as well. I don't remember the outcome on that one.

Answer 4

Former insurance adjuster, huh, ...here's a few flash backs for you.

Q: What color was your traffic light?
A: Turning Green.
(in your head and you really wish you could say it..."so it was half green ...half red?... It was sitting on red and was thinking about turning green?)

Q: What was the speed limit for the road you were traveling?
A: I don't know
Q: How fast were you going?
A: The speed limit.
Q: So you don't know what the speed limit was but what ever it was that is how fast you were going?
A: yes


Q:Had you had any alcohol to drink that night?
A: no
Q It's my understanding you were arrested for DUI, is that correct?
A: oh yeah, I forgot
Q: so how much had you had to drink?
A: two beers

(why is it always 2? )

Q: Whose fault do you think the accident is?
A: his
Q: why?
A: because he was speeding
Q: What makes you say he was speeding?
A: Because I did not see him.
Q: So he was going so fast that it was physically impossible for you to see his vehicle?
A: yes