What to Do if You Disagree With the Car Insurance Adjuster [2024]

Suppose you’ve suffered damages or injuries in a car accident. In that case, it can be upsetting to get a settlement offer from your insurance company for less than the amount of your total damages and injuries. It’s even more devastating to have your claim denied outright.

Adjusters can give a variety of reasons to justify a claim decision, so you must make a strong case supported by documentation and other evidence. Here’s our detailed guide on how to dispute a car insurance claim.

It may feel like a whirlwind if you’ve recently been in a car accident. Taking care of everything after an accident can be stressful and overwhelming. But what if your claim for auto insurance coverage gets denied by your insurance company? Is there a way to dispute an insurance claim?

Fortunately, you can dispute and appeal decisions made by your car insurance company regarding any insurance claims you file. However, to get your insurer to change its mind, you may need to provide sufficient information and evidence that your policy should cover the accident.

Read on to learn some tips on what to do if you disagree with the car insurance adjuster for disputing, and then enter your ZIP code in our free tool to start comparing car insurance to get affordable car insurance quotes so you hopefully won’t find yourself needing to appeal a car insurance claim.

If You Can Dispute a Car Insurance Claim Settlement

Can you dispute an auto insurance claim? Insurance companies allow policyholders to dispute claims. However, it’s the policyholder’s responsibility to learn why their insurer denied the claim before appealing the decision.

To understand why your insurance company denied your claim, you must read your claim denial or settlement offer letter. This letter will explain how the company came to a specific decision, and it should allow you to understand what you’ll need to prove or disprove to change the outcome.

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Why Insurance Companies Deny Claims

Though you might be convinced your insurance company should accept your claim, there are many reasons insurance companies deny policyholders’ claims.

Here are examples of the different determinations an adjuster can make on a car insurance claim.

Claim Denial on Procedural Grounds

Was your claim denied on a technical ground, as the claims period expired? Did you let your coverage lapse or drive without insurance before the accident? Those kinds of claim determinations can’t be disputed because they are procedural.

Claim Denial for Lack of Coverage

It’s common for an insurer to deny an auto insurance claim based on a lack of coverage. If you only have liability car insurance coverage and get in a car accident, your provider may cover claims for other accident victims and their vehicles but deny your claims for property and injury damages. You must carry collision and comprehensive coverage to cover your damages.

Some insurance companies don’t cover other people when they drive your car. So before lending your vehicle to a friend, family member, or neighbor, read the fine print of your policy to discern whether your insurance company considers people not named on your policy to be excluded drivers.

Read More: Does car insurance cover excluded drivers?

Claim Denial Based on Fraud

Sometimes, claims are denied because the insurance company determined that fraud was involved in the accident, claim, or in applying for coverage.

Your insurance provider will deny your claim if you are dishonest. For example, some companies deny claims if a person was in an accident while driving for work-related reasons but told the insurance company they did not use their vehicle for business use.

More severe examples of dishonesty — such as filing a false claim — can get individuals into trouble. For instance, there may be an investigation if your insurance company believes you committed auto insurance fraud, depending on the claim and amount of money at stake. (For more information, read our “Car Insurance Claim Investigation (Expert Guide)“).

Before you dispute a claim denial based on allegations of fraud, you should consider consulting with a car insurance attorney.

Low Settlement Offers

Maybe your claim was approved, but the settlement check is insufficient to fully or adequately compensate you for your losses. It could be that the offer was based on inaccurate estimates or incomplete information. If so, the adjuster may increase the amount of your claim based on supplemental bills, estimates, and other documents proving your injuries and damages.

Whatever the basis for your insurance company’s decision, it can be found in the claim denial letter or settlement offer letter, so review it carefully. These documents might also identify additional information that could be provided to change the outcome.

Read more: Can I sue my own car insurance company?

How to Dispute a Car Insurance Claim Settlement Check

The adjuster may have approved your claim and included an insurance check with the claim determination, but if you don’t think the settlement offer is fair and want to dispute the claim, then you should not cash that check.

If you get an insurance settlement check, chances are there will be language on the bill that the amount being given is a full and final payment. Your act of cashing the settlement check could be seen as accepting that amount in full satisfaction of all claims. You will have essentially given up your right to dispute the claim by taking the money that was offered.

It’s important to understand that adjusters have a range of settlement dollars available to offer on a claim. Your adjuster will always try to pay out a claim for the lowest amount of money possible and, in doing so, anticipates some policyholders to dispute the offer and try to contest the amount of the car insurance payout.

It’s okay to hold onto the check until the dispute is resolved as long as you keep it somewhere safe.

Let’s get into the details about how to appeal an auto insurance claim decision so you have the info you need to answer, “What if I don’t agree with an insurance adjuster?”

Review Your Policy

First things first, read your policy. It’s always important to review and understand your car insurance policy whenever you make or dispute a car insurance claim. Your policy tells you what’s covered and the proper procedures to follow when filing and appealing a claim.

After you review your insurance policy, carefully review any determination your carrier has made about your claim. You can’t effectively dispute a car insurance claim if you don’t understand the basis of the adjuster’s decision. 

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Gather Evidence

Once you know why your insurance company denied your claim, the first step is to collect the necessary information and evidence to prove the company should cover your claim.

If you were in an accident and the police filed a report, you can request a copy of the accident report. If you’re at fault, attempts to dispute your insurance claim could be more complicated, depending on the insurance type you carry.

You should review your insurance policy to determine how your coverage level may impact your company’s decision. You should also be able to find a bill of rights testament on your insurance company’s website, which will explain your rights when it comes to appealing a claim.

Take a look at this table to see the average rates for various coverage types across the country.

Car Insurance Quotes by State

The rates in this table are averages to help you form a baseline expectation of what you could be paying in your state, but your personal situation, age, credit score, driving history, etc. will affect your exact rates. See details in our article, Factors That Affect Car Insurance Rates.

Get a Second Opinion on Auto Damages and Repairs

If you’re going to dispute the insurance company’s decision about your car insurance claim, you’ll need to be able to support your position. The support you need depends on the nature of your dispute.

For example, if you believe the adjuster made you an unfair settlement offer because it doesn’t cover all of the damages to your vehicle, you’ll need to get a second opinion on auto damages and the cost of repairs. For more information, read our How do I assess car damage for insurance purposes?

Another case could be that your automobile was declared a total loss, and you dispute the adjuster’s calculation of the car’s actual cash value. You may be wondering, “Can you get a second opinion on a total loss?” Yes, in that case, it’s important to have your own value comparisons to convince the adjuster to increase the offer.

The Insurance Information Institute (III) suggests turning to resources like Kelley Blue Book for comparisons that will help you to determine the overall value of your vehicle. You can also use other online tools to calculate the total loss for car insurance. 

Here’s a quick peek at Kelley Blue Book:

Read more: How Car Insurance Companies Determine Salvage Value

Write Your Appeal Letter

Once you’ve done your research and determined how you’ll dispute your insurance company’s decision, the next step is to write an appeal letter telling your company why its denial of your claim was incorrect.

Most insurance companies require policyholders to appeal a car insurance decision by submitting any appeals to claim decisions in writing. You have the option of doing this on your own, but you can also hire an insurance attorney to help you.

While hiring an attorney could be costly, it could be the right decision, especially if you’re disputing a claim denial of thousands or tens of thousands of dollars.

Your appeal letter is a simple statement explaining why your claim for coverage should be accepted. However, you may need to cite specific evidence to support your conclusion in the letter.

Your appeal letter is essential when disputing a car insurance claim. It’s important to clearly explain the nature of your dispute and provide supporting documentation to show the adjuster that your claim should be covered.

If you weren’t at fault in the accident but the claim was denied on fault grounds, your strongest evidence would be the police report and witness statements or affidavits.

When it comes to low-ball settlement offers, an adjuster will use their own estimates, which tend to be low. That’s why you have to provide your own repair estimates, replacement receipts, property values, medical bills and records, and lost wages calculations.

Without supporting documents, your adjuster won’t be able to calculate the right amount of property and personal injury damages or may wrongly deny your claim on fault grounds. 

Once your letter is ready, you will submit it via certified mail or email to your company. Check with a representative of your insurance company to determine how you should submit your appeal letter. Remember to adhere to the policy rules on formatting and submitting your appeal letter. You don’t want your dispute rejected because you failed to follow the proper appeals procedure.

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Give Proper and Timely Notice

The policy should explain the process for how disputes and appeals are handled. Typically, there are notice requirements that specify who, when, and how you are supposed to dispute or appeal a car insurance claim.

Make sure you notify the correct person or department. Simply calling or sending an email to your adjuster may be sufficient to engage in preliminary negotiations, but it may not be the proper way to file a dispute.

Also, be aware of and always follow any time requirements and deadlines. If you overlook or ignore deadlines, that alone can be a basis to deny your dispute.

When You May Need to Sue

The ultimate goal of disputing a car insurance claim is to have the claim approved and get fair and adequate compensation.

Most adjusters are open to negotiating a resolution of the dispute. It’s not hard to negotiate for a better settlement amount if you have your supporting documents to back up your negotiating position. If you don’t feel you can negotiate by yourself, you can engage a lawyer to negotiate on your behalf.

Read more: Should I hire an attorney for my car insurance claim?

If you can’t settle the claim or your insurer continues to deny coverage, and you believe there are legitimate grounds, you may have to sue your insurance company.

If you do, you will need to familiarize yourself with your state’s statute of limitations.

A statute of limitations is a law dictating the maximum amount of time an individual has to file a lawsuit from the date of the incident. The statute of limitations for personal injury and property damage claims varies from one state to another.

The table below shows each state’s statute of limitations.

Statute of Limitations by State

 

Research your state’s statute of limitations to ensure you still have time to initiate legal action.

Before suing your insurance provider, consult an insurance attorney who can help you decide how likely your insurance company will cover your claim and whether a lawsuit is worth it.

Case Studies: What to Do if You Disagree With the Car Insurance Adjuster

Case Study 1: Claim Rejection on Procedural Grounds

John’s car insurance claim was declined based on procedural grounds, specifically the expiration of the claims period. Despite undertaking efforts to challenge the denial through an appeal process, the rejection remained unassailable due to its adherence to established procedures.

Case Study 2: Claim Rejection Due to Inadequate Coverage

Sarah held liability car insurance coverage; however, her claim for property and injury damages was dismissed due to insufficient coverage. The absence of adequate coverage rendered it unfeasible to contest the denial.

Case Study 3: Claim Rejection on Suspected Fraudulent Activity

David’s claim was refuted by the insurance company on grounds of suspected fraudulent activity. Seeking legal counsel, he pursued an appeal to challenge the claim denial based on the allegations of fraud.

Case Study 4: Inadequate Settlement Offer

Emily’s claim was initially approved; nevertheless, the settlement amount proposed by the insurance company proved inadequate to compensate for her losses. To support her dispute and engage in negotiations for a more favorable settlement, she collated supplementary bills and estimates as additional evidence.

Case Study 5: Denied Coverage for Faulty Repairs

John’s car was involved in an accident, and he filed a claim with his insurance company to cover the repair costs. However, the insurance company denied his claim, stating that the damages were a result of faulty repairs from a previous incident. John contested the claim denial, gathering evidence including a reputable mechanic’s second opinion to prove the accident caused the damages.

Case Study 6: Disagreement Over Fault and Coverage

Sarah’s car was hit by another driver who ran a red light. Sarah’s insurance company initially denied her claim, arguing that she was partially at fault for the accident. However, Sarah believed she had the right of way and was not at fault.

Sarah answered the question, “What if I disagree (don’t agree) with an auto insurance adjuster?” by deciding to dispute the claim denial and obtaining surveillance footage from nearby cameras that clearly showed the other driver’s violation.

Case Study 7: Insufficient Payout for Total Loss

Mark’s car was severely damaged in a flood, resulting in a total loss. However, when Mark filed a claim, his insurance company offered a payout that was significantly lower than the market value of his vehicle. To challenge the offer, Mark researched comparable sales to determine the actual value and submitted evidence of his car’s condition and features in his appeal letter.

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The Bottom Line: What to Do if You Disagree With the Car Insurance Adjuster

If you don’t agree with the auto insurance adjuster, there are basic steps you can follow. In some cases, disputing a claim decision made by your insurance company can be a straightforward process.

Start with reviewing your policy terms and the claim determination letter. Make sure you understand the appeals process and the basis for the adjuster’s determination. 

Next, gather as much evidence as possible to support your appeal, including second opinions concerning your auto and personal injury damages. Submit your appeal letter and supporting documentation promptly per your insurance company’s procedures.

If your company decides to cover your claim, you should not have to do anything else. If you’re unable to resolve the dispute or your appeal is denied, your only remaining option may be to sue your insurance provider. Before considering any legal action, you should consult with an insurance attorney.

Before considering any legal action, you should speak with an insurance attorney.

We hope you now have a much better idea of how to appeal a car insurance claim decision and how to appeal a car insurance claim denial so you don’t need to go searching online for “what to do if you disagree (don’t agree) with car/auto insurance adjuster.”

Instead, to see how you can save on car insurance so you have the coverage you need so you hopefully won’t ever find yourself disputing a car insurance claim, type your ZIP code into our free tool now.

Read more:

• Can I cancel my car insurance after an accident?
• How to Cancel Car Insurance: Step-by-Step
• Cheap Car Insurance After an At-Fault Accident

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