After an accident, the question of fault can weigh heavily on your mind. You’re dealing with injuries, repair costs, and the uncertainty of how it will all resolve. Understanding how insurance adjusters determine fault can bring clarity and even a sense of control during this stressful time.
Insurance adjusters play a critical role in evaluating the accident and gathering the details needed to decide who is responsible.
By understanding what they look for and how they analyze each piece of evidence, you can feel more confident as you work through the claims process. For further details and a no-cost consultation, feel free to call us at (419) 455-1410 or contact us online.
So, how do adjusters determine who is at fault? Let’s break down the steps adjusters take and the evidence they consider to make a fair decision.
What Does a Car Insurance Adjuster Do?
When you file a claim after an accident, the insurance adjuster becomes a central figure in the process. Their job is to investigate the incident, review the evidence, and determine who is responsible for what happened. But how do adjusters determine who is at fault? Essentially, they are tasked with piecing together the story of the accident.
Sources
To do this, adjusters collect information from several sources. They may interview the drivers involved, talk to witnesses, review police reports, and inspect the damage to the vehicles. Each detail helps them create a clearer picture of what led to the crash. Their ultimate goal? Ostensibly, their goal is to figure out liability and ensure the claim is handled according to the policy and Ohio state laws.
Proceed with Caution
However, it is wise to remember that insurance adjusters work for the insurance company—not you. Therefore, they also aim to lower the amount of money their company pays to injured parties. The more the company pays, the lower its profits. So keep in mind that insurers have a vested interest in paying you as little as possible.
What is your best defense against their sometimes unethical practices? Have a lawyer by your side. Insurers know that unrepresented individuals might fall for tactics designed to get desperate victims to accept fast, lowball offers.
However, those with an attorney are protected by the attorney’s knowledge of what their case is actually worth. So simply having representation can protect you from potential unethical practices by some adjusters.
What Do Car Insurance Adjusters Look For?
Insurance adjusters determine who is at fault using a variety of evidence. Each piece helps them reconstruct the events leading up to the crash and assign responsibility. Here’s what they focus on:
- Police reports. A police report is often one of the most reliable pieces of evidence. It confirms the involved parties and includes an objective account of the accident and information on any citations issued at the scene.
- Eyewitness statements. Witnesses can provide critical details about what happened before and during the collision. Their unbiased accounts often help clarify the sequence of events.
- Photos and videos from the scene. Visual evidence, such as photos of vehicle damage or dashcam footage, helps adjusters understand the physical dynamics of the crash.
- Vehicle damage. The location and extent of damage on the vehicles can reveal how the accident occurred and which driver may be at fault.
Knowing what adjusters look for can help you gather the correct information and strengthen your claim.
What Do Car Insurance Investigators Look For?
Insurance investigators play a distinct yet essential role in the claims process. Their primary responsibility is to investigate potential fraud, verify the accuracy of claims, and gather information to ensure that claims are legitimate.
Insurance companies rely on investigators to detect and prevent fraudulent activity, ensuring that payouts are made only for valid claims. These investigators use the following processes to accomplish their goals:
- Conducting Investigations: Insurance investigators primarily focus on gathering evidence to verify the legitimacy of a claim. When there are suspicions of fraud or inconsistencies in a claim, investigators may conduct interviews, gather documents, and speak with witnesses or experts to uncover the facts.
- Surveillance: In cases where fraud is suspected, investigators may perform surveillance on claimants to observe their behavior and actions. For example, if a claimant is alleging a severe injury that prevents them from working, an investigator might monitor the individual to see if their activities suggest that the injury is exaggerated or fabricated.
- Interviews and questioning: A key aspect of an investigator’s work is interviewing the policyholder, witnesses, medical professionals, and other involved parties. The goal is to identify any discrepancies in the story or gather conflicting information that might raise red flags.Â
- Document review and analysis: Investigators often review documents such as medical records, police reports, witness statements, and financial records to look for inconsistencies or signs of fraud. For example, they may compare medical bills to the stated injuries or examine a claimant’s history to determine if they have made similar fraudulent claims in the past.
- Collaboration with law enforcement and legal teams: In cases of suspected criminal fraud, insurance investigators often collaborate with law enforcement agencies to gather further evidence or even pursue criminal charges.Â
- Reporting and documentation: Insurance investigators document their findings by writing detailed reports that outline the steps taken during the investigation, the evidence gathered, and their conclusions.Â
This work and the resultant reports are crucial for the insurance company’s decision-making process and may also be used in legal proceedings if fraud charges are filed.
Ohio’s Comparative Fault Laws
Once the adjuster has gathered all the evidence and reviewed the circumstances, they will make their final determination regarding liability.
Ohio is an at-fault state that follows a modified comparative negligence law. What does that mean? The adjuster might decide that one party is 100% at fault, or they might say that both parties share liability:Â
- Complete fault. If one driver is clearly at fault—such as running a red light or rear-ending another vehicle—the adjuster might assign that party 100% of the responsibility.
- Shared fault. More often than not, more than one person may share responsibility. For example, if one driver was speeding and the other failed to yield, both could be found partially at fault.
The degree of fault matters, as it influences how much compensation is available under Ohio’s comparative negligence rules. You could be barred from recovery if you’re more than 50% at fault.
How You Can Protect Yourself During the Claims Process
While the insurance adjuster’s role is to evaluate the accident fairly, it’s still important to advocate for yourself. The more prepared you are, the better chance you have of ensuring the evidence supports your side of the story. Here’s how you can protect yourself:
- Document everything. Take photos of the accident scene, vehicle damage, and any injuries. Write down your account of what happened while it’s fresh in your mind.
- Request a copy of the police report. This report provides an official accident record and can be a key piece of evidence.
- Provide accurate information. Stick to the facts when speaking to the adjuster. Avoid speculation or assigning blame.
- Consult an attorney. If you’re unsure about the process or feel overwhelmed, seeking legal guidance can help you avoid mistakes and strengthen your claim.
By taking these steps, you can help ensure that the adjuster has everything they need to make an accurate assessment.
Contact an Ohio Car Accident Lawyer
Dealing with an insurer can feel overwhelming, especially when recovering from an accident. You don’t have to face it alone. At Bensinger Legal Services, attorney Aaron Bensinger is here to help. With years of experience in personal injury and civil litigation, Aaron knows how to hold insurance companies accountable and fight for the compensation you deserve.
Whether gathering evidence, negotiating with adjusters, or taking your case to trial, Aaron and his team are ready to step in. He combines his attention to detail with a relentless commitment to his clients, ensuring that every case—big or small—receives the care it deserves.
Let us worry about the legal process so you can focus on healing. Contact Aaron Bensinger today for a consultation. You can call us at (419) 455-1410 or contact us online. Together, we’ll fight the insurance companies and help you get your life back on track.
Aaron L. Bensinger is an Ohio attorney serving personal injury and civil litigation clients. He has extensive trial experience and makes client service is his primary focus. As a partner at Balyeat, Leahy, Daley, Miller & Bensinger, LLC, Aaron happily works in Lima, OH, and serves the entire Northwest region of the state and beyond.
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