{"id":21882,"date":"2025-10-16T19:57:25","date_gmt":"2025-10-16T19:57:25","guid":{"rendered":"https:\/\/incredipros.com\/?p=21882"},"modified":"2025-10-16T19:57:27","modified_gmt":"2025-10-16T19:57:27","slug":"the-3-insurance-myths-a-claims-adjuster-wishes-would-go-away","status":"publish","type":"post","link":"https:\/\/incredipros.com\/?p=21882","title":{"rendered":"The 3 Insurance Myths a Claims Adjuster Wishes Would Go Away"},"content":{"rendered":"\n<li>\n<strong>Review your policy<\/strong> so you understand what is and is not covered.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li style=\"list-style-type: none;\">\n<ul class=\"wp-block-list\">\n<li>\n<strong>Maintain your property<\/strong> to reduce disputes over whether damage is sudden or gradual.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li style=\"list-style-type: none;\">\n<ul class=\"wp-block-list\">\n<li>\n<strong>Communicate openly<\/strong> with your adjuster. If it feels like they are asking many questions, it is because they must evaluate exclusions before confirming coverage.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li style=\"list-style-type: none;\">\n<ul class=\"wp-block-list\">\n<li>\n<strong>Stay objective<\/strong> and remember that adjusters apply policy language, not personal judgment.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n            <\/div>\n        <\/div>\n    <\/div>\n<\/section>\n\n\n\n<h2 data-position=\"3\" data-beam-element-viewed=\"\" data-id=\"br-h2-3-onpage-placement\" data-type=\"h2\" data-location=\"Editorial\" data-name=\"h2_all\" data-text=\"Myth 3: Insurers delay claims payments for profit\" data-outcome=\"\">Myth 3: Insurers delay claims payments for profit<\/h2>\n\n\n\n\n<p>The word \u201cfloat\u201d used to mean writing a check at the grocery store on Wednesday when you knew you didn\u2019t have enough in your account, hoping the bank would not cash it before payday on Friday. That grace period was the float. With debit cards, that old version is mostly gone.<\/p>\n\n\n\n\n\n<p>The idea of float is still around, but it has taken on a negative connotation. I see this myth often in my work as an expert witness, and it frustrates me the most. It undermines trust in the claims process and reflects a misunderstanding of how insurers actually earn money.<\/p>\n\n\n\n\n\n<p>Insurers have two main sources of revenue: premiums and investment income. Insurers collect premiums up front and pay claims later. On their own, auto and home premiums are not enough to cover all claims and operating expenses. To supplement that, insurers invest premium dollars. The interest earned helps pay company expenses and keeps premiums from climbing even higher.<\/p>\n\n\n\n\n\n<p>Some policyholder advocates oversimplify this process, stating that carriers know they must pay a claim, but they hold off as long as possible to keep earning interest. The suggestion is that claims departments intentionally delay cutting settlement checks, so the company can profit from the float.<\/p>\n\n\n\n\n\n<p>State regulators require insurers to set aside a specific amount of money to pay claims and expenses. For example, one requirement might be for insurers to set aside 1.5 percent of funds for every dollar of premiums collected. Because those funds are already earmarked, and the investment income is not tied to one particular claim, there is no incentive to delay claim payments just to earn more interest. The money is set aside for that purpose from the start to pay the claim.<\/p>\n\n\n\n\n\n<p>In my experience, delays are almost always tied to other issues: missing documentation, waiting for a contractor\u2019s estimate or needing upper management approval for a large payout. These situations can slow the process, but they are procedural, not financial strategies.<\/p>\n\n\n\n<section class=\"editorial-insight-box --insight-box +mg-vertical-md\" data-template=\"insight_box\">\n    <div class=\"card-body border-l-4 border-blue-800\">\n                    \n                <div class=\"content-wrapper\">\n                            <p>\n                    What you can do:\n                <\/p>\n                        <div class=\"content wysiwyg wysiwyg--flush\">\n                \n\n\n<ul class=\"wp-block-list\">\n\n<li>Ask questions if your claim feels stalled. Often, the reason is a missing report or unresolved documentation.<\/li>\n\n\n\n<li>Stay engaged with your adjuster, and request updates regularly.<\/li>\n\n\n\n<li>Avoid assumptions that a delay is intentional. Believing the float myth can escalate disputes unnecessarily.<\/li>\n\n\n\n<\/ul>\n\n\n\n\n            <\/div>\n        <\/div>\n    <\/div>\n<\/section>\n\n\n\n<h2 data-position=\"4\" data-beam-element-viewed=\"\" data-id=\"br-h2-4-onpage-placement\" data-type=\"h2\" data-location=\"Editorial\" data-name=\"h2_all\" data-text=\"Myths persist \u2014 but you don\u2019t have to buy into them\" data-outcome=\"\">Myths persist \u2014 but you don\u2019t have to buy into them<\/h2>\n\n\n\n\n<p>Insurance can seem complex, leading people to rely on simplified phrases or common sayings to understand it. Over time, these shortcuts evolve into myths. These myths can create unnecessary tension between policyholders and the people working their claims, so if you\u2019re ever skeptical about how your policy or claim is being managed, ask questions for clarification. Your agent or adjuster has insights into procedural details, and the answer is probably simpler than you\u2019re imagining.<\/p>\n\n        <div class=\"HelpfulCTA mx-auto flex flex-col items-center gap-6 my-6 max-w-108 py-12 text-base border-y border-gray-200\" data-helpful-cta=\"\" data-beam-element-viewed=\"\" id=\"did-you-find-this-helpful\" data-type=\"cta\" data-location=\"article-bottom\" data-position=\"banner\" data-text=\"Did you find this page helpful?\">\n    <div class=\"HelpfulCTA-initial w-full flex flex-col items-center gap-4\" data-cta-initial=\"\">\n        <div class=\"HelpfulCTA-question text-lg font-bold text-center text-gray-900\">\n            Did you find this page helpful?\n            <div id=\"mKxsGMCikl\" class=\"hidden\">\n        <div class=\"wysiwyg wysiwyg--sm wysiwyg--flush max-w-xs\">\n                        <p class=\"mb-6 text-base\">\n                            <strong class=\"block font-bold text-gray-900\">Why we ask for feedback<\/strong>\n                            Your feedback helps us improve our content and services. It takes less than a minute to\n                            complete.\n                        <\/p>\n                        <p>Your responses are anonymous and will only be used for improving our website.<\/p>\n                    <\/div>\n    <\/div>\n\n\n\n\n        <\/div>\n        <p>Help us improve our content<\/p>\n        <div class=\"HelpfulCTA-actions flex gap-4 mt-2\">\n            <button type=\"button\" class=\"HelpfulCTA-btn HelpfulCTA-btn--yes border border-2 border-blue-600 text-blue-600 rounded px-6 py-2 transition font-semibold flex items-center gap-2 hover:bg-blue-50\" data-cta-yes=\"\" data-beam-element-clicked=\"\" id=\"did-you-find-this-helpful-yes\" data-type=\"button\" data-location=\"article-bottom\" data-position=\"banner\" data-text=\"Yes\" data-outcome=\"response submitted\">\n                <span class=\"Icon\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"Icon-glyph\" viewbox=\"0 0 24 24\" fill=\"currentColor\" focusable=\"false\"><title>Thumbs Up Icon<\/title><path d=\"M13.165 2.175c.322 0 .57.022.774.065.796.161 1.43.624 1.85 1.345.71 1.216.722 3.067.023 5.499h.516c2.28 0 3.422 0 4.337.548a3.844 3.844 0 0 1 1.721 2.25c.29 1.032 0 2.13-.592 4.336l-.516 1.926c-.312 1.151-.484 1.786-.882 2.324a3.368 3.368 0 0 1-1.442 1.098c-.625.247-1.28.248-2.475.248l-.021.01h-4.595c-.42 0-.636 0-.84-.032a4.19 4.19 0 0 1-.635-.15c-.204-.065-.387-.162-.763-.355l-1.69-.856c-.014.034-.026.069-.043.102a2.334 2.334 0 0 1-1.044 1.044c-.495.247-1.012.248-1.948.248h-.161c-.936 0-1.453 0-1.947-.248a2.333 2.333 0 0 1-1.044-1.044C1.5 20.038 1.5 19.52 1.5 18.585v-7.683c0-.936 0-1.452.248-1.947A2.387 2.387 0 0 1 2.792 7.91c.494-.248 1.01-.247 1.947-.247h.16c.937 0 1.454 0 1.95.247.353.177.653.44.875.763.64-.606 1.788-2.184 3.31-5.142.183-.366.312-.603.538-.819.193-.193.462-.355.72-.441.302-.097.539-.097.873-.097ZM4.739 9.288c-.624 0-1.076 0-1.227.076a.721.721 0 0 0-.323.322c-.075.15-.075.603-.075 1.216v7.683c0 .624 0 1.076.075 1.227.065.14.183.248.323.323.151.075.603.075 1.227.075h.16c.625 0 1.078 0 1.228-.075a.722.722 0 0 0 .323-.323c.075-.15.075-.603.075-1.227v-7.683c0-.624 0-1.065-.075-1.227a.672.672 0 0 0-.323-.322c-.15-.075-.603-.076-1.227-.076h-.161v.01ZM13.057 3.8c-.14 0-.226 0-.259.011-.032 0-.086.043-.107.064a2.98 2.98 0 0 0-.226.399c-2.187 4.272-3.53 5.647-4.33 6.092.003.162.004.34.004.536v7.82l2.217 1.122c.28.14.42.216.56.27.107.032.214.064.332.075.151.021.314.021.626.021h4.594c1.022 0 1.539 0 1.862-.129a1.84 1.84 0 0 0 .763-.58c.215-.28.355-.808.613-1.765l.517-1.927c.495-1.85.775-2.873.603-3.475a2.309 2.309 0 0 0-1-1.313c-.538-.323-1.594-.323-3.51-.323h-1.129c-.226 0-.473 0-.72-.15a1.087 1.087 0 0 1-.464-.614c-.075-.301 0-.528.076-.754.957-2.97.603-4.26.301-4.777-.183-.312-.44-.506-.774-.57-.14-.033-.377-.033-.549-.033Z\" class=\"icon-base\"\/><\/svg><\/span> <span class=\"text-base leading-4\">Yes<\/span>\n            <\/button>\n            <button type=\"button\" class=\"HelpfulCTA-btn HelpfulCTA-btn--no border-2 border-blue-600 text-blue-600 rounded px-6 py-2 transition font-semibold flex items-center gap-2 hover:bg-blue-50\" data-cta-no=\"\" data-beam-element-clicked=\"\" id=\"did-you-find-this-helpful-no\" data-type=\"button\" data-location=\"article-bottom\" data-position=\"banner\" data-text=\"No\" data-outcome=\"response submitted\">\n                <span class=\"Icon\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"Icon-glyph\" viewbox=\"0 0 24 24\" fill=\"currentColor\" focusable=\"false\"><title>Thumbs Down Icon<\/title><path d=\"M19.26 2.175c.936 0 1.454 0 1.949.247.452.226.818.592 1.044 1.043.247.495.248 1.012.248 1.948v7.678c0 .936 0 1.453-.248 1.948a2.333 2.333 0 0 1-1.044 1.042c-.495.248-1.013.248-1.95.248h-.16c-.937 0-1.454 0-1.95-.248a2.33 2.33 0 0 1-.885-.777c-.637.596-1.79 2.176-3.314 5.155-.183.365-.312.602-.538.828a1.924 1.924 0 0 1-.722.441c-.258.086-.484.097-.742.097l.022-.011a5.39 5.39 0 0 1-.905-.064 2.741 2.741 0 0 1-1.852-1.345c-.71-1.216-.721-3.066-.022-5.496h-.516c-2.283 0-3.424 0-4.34-.548a3.843 3.843 0 0 1-1.722-2.248c-.29-1.033 0-2.13.593-4.324l.517-1.925c.312-1.162.484-1.786.882-2.323.377-.495.872-.871 1.443-1.097.624-.248 1.281-.248 2.476-.248h4.597c.42 0 .635 0 .84.032.215.032.431.086.636.15.193.065.387.162.753.345l1.702.864c.017-.04.033-.082.053-.122a2.333 2.333 0 0 1 1.044-1.043c.496-.247 1.013-.247 1.95-.247h.16ZM7.503 3.798c-1.022 0-1.54 0-1.862.13-.302.118-.56.322-.765.58-.215.28-.345.775-.614 1.753l-.517 1.926c-.495 1.85-.775 2.871-.602 3.474a2.308 2.308 0 0 0 1 1.312c.539.323 1.594.322 3.51.322h1.142c.236 0 .473 0 .72.15.227.14.388.367.453.625.075.28 0 .516-.075.742-.959 2.969-.603 4.27-.301 4.775.183.312.44.506.774.57.162.033.41.033.572.033.128 0 .203 0 .236-.01.021 0 .085-.044.107-.065.032-.032.14-.237.227-.399 2.208-4.308 3.556-5.671 4.352-6.102a39.945 39.945 0 0 1-.003-.523v-7.79L13.63 4.175c-.28-.14-.41-.215-.56-.27a1.796 1.796 0 0 0-.344-.085c-.151-.022-.313-.01-.625-.022H7.503Zm11.596.001c-.625 0-1.077 0-1.228.076a.72.72 0 0 0-.323.322c-.075.15-.075.603-.075 1.226v7.68c0 .623 0 1.075.075 1.226.075.14.183.247.323.322.15.075.603.075 1.228.075h.16c.625 0 1.078 0 1.228-.075a.778.778 0 0 0 .324-.322c.075-.151.075-.603.075-1.227V5.423c0-.623 0-1.076-.075-1.226a.722.722 0 0 0-.324-.322c-.15-.076-.603-.076-1.227-.076h-.161Z\" class=\"icon-base\"\/><\/svg><\/span> <span class=\"text-base leading-4\">No<\/span>\n            <\/button>\n        <\/div>\n    <\/div>\n    <!-- Yes Form -->\n    \n    <!-- No Form -->\n    \n    <div class=\"HelpfulCTA-thankyou flex flex-col items-center gap-2\" data-cta-thankyou=\"\" style=\"display:none;\">\n        \n        <p>Thank you for your\n            feedback!<\/p>\n        <p>Your input helps us improve our\n            content and services.<\/p>\n    <\/div>\n<\/div>\n\n    <\/div>\r\n<br>Read the full article <a href=\"https:\/\/www.bankrate.com\/insurance\/the-insurance-myths-a-claims-adjuster-wishes-would-go-away\/\" target=\"_blank\" rel=\"noopener\" rel=\"nofollow\">here<\/a><!-- \/wp:list-item --><div>\n        \n        <p>People rely on fables or common phrases to make sense of complicated ideas. If Jack works all day, he is going to be a dull boy. If you keep making that face, it will freeze like that. These shortcuts help us explain the world, and insurance is no different.<\/p>\n\n\n\n\n\n<p>Because the claims process can feel overwhelming, simplification often turns into myth. Some myths start with a grain of truth. Others stem from misunderstandings of how coverage works. Some myths are easily dispelled \u2014 for example, it\u2019s often claimed that red cars cost more to insure. But others are more persistent. And a few have been repeated so often that they sound like fact.<\/p>\n\n\n\n\n\n<p>Let\u2019s break down three myths I see come up frequently in my day-to-day as an adjuster.<\/p>\n\n\n\n\n<h2 data-position=\"1\" data-beam-element-viewed=\"\" data-id=\"br-h2-1-onpage-placement\" data-type=\"h2\" data-location=\"Editorial\" data-name=\"h2_all\" data-text=\"Myth 1: Injury settlements are three times medical bills\" data-outcome=\"\">Myth 1: Injury settlements are three times medical bills<\/h2>\n\n\n\n\n<p>One of the most common myths in liability claims is that the value of a bodily injury settlement is calculated as \u201cthree times medicals.\u201d In other words, if your medical bills after an accident total $5,000, you should expect a settlement of $15,000.<\/p>\n\n\n\n\n\n<p>Many claimants come into negotiations believing this is the standard, even the law. It is not. No formula determines settlement value. Each claim is evaluated on its own facts.<\/p>\n\n\n\n\n\n<p>When adjusters calculate the value of a bodily injury claim, they look at a range of factors, including:<\/p>\n\n\n\n\n<ul class=\"wp-block-list\">\n<li>\n<strong>Liability<\/strong>: Who is at fault and to what degree.<\/li>\n\n\n\n<li>\n<strong>Severity of injuries<\/strong>: Medical bills, lost wages, long-term impact, and whether there is permanent disability or scarring.<\/li>\n\n\n\n<li>\n<strong>Medical treatment<\/strong>: Whether the treatment provided is relevant and necessary for the injury.<\/li>\n\n\n\n<li>\n<strong>Pain and suffering<\/strong>: The claimant\u2019s emotional distress, lifestyle changes and impact on relationships.<\/li>\n\n\n\n<li>\n<strong>Policy limits<\/strong>: The maximum amount of insurance coverage available.<\/li>\n<\/ul>\n\n\n<section class=\"editorial-insight-box --insight-box +mg-vertical-md\" data-template=\"insight_box\">\n    <div class=\"card-body border-l-4 border-blue-800\">\n                    \n                <div class=\"content-wrapper\">\n                            <p>\n                    What you can do\n                <\/p>\n                        <div class=\"content wysiwyg wysiwyg--flush\">\n                \n\n\n\n<p>It is difficult to be objective about your own claim, but these steps can help you understand how the adjuster reached their numbers:<\/p>\n\n\n\n\n<ul class=\"wp-block-list\">\n<!-- wp:list-item -->\n<li>Establish a realistic demand that accounts for medical expenses, lost wages and other damages.<\/li>\n\n\n\n<li>Listen when the adjuster explains their decision, then respond from that starting point.<\/li>\n\n\n\n<li>Negotiate in good faith by being honest and open to a fair resolution.<\/li>\n\n\n\n<li>Consider mediation if discussions stall. A neutral third party can help both sides move forward.<\/li>\n\n\n\n<li>Consult an attorney if negotiations break down or if the injuries are severe. An experienced personal injury attorney can guide the process and protect your rights.<\/li>\n\n\n\n<\/ul>\n\n\n\n\n            <\/div>\n        <\/div>\n    <\/div>\n<\/section>\n\n\n\n<h3\/>\n\n\n\n\n<p>Overall, the adjuster\u2019s goal is to reach a settlement that fairly compensates for losses and expenses, while also taking into consideration any applicable insurance policies, state laws and other factors that may affect the final settlement amount.<\/p>\n\n\n\n\n<h2 data-position=\"2\" data-beam-element-viewed=\"\" data-id=\"br-h2-2-onpage-placement\" data-type=\"h2\" data-location=\"Editorial\" data-name=\"h2_all\" data-text=\"Myth 2: Adjusters are paid to deny claims\" data-outcome=\"\">Myth 2: Adjusters are paid to deny claims<\/h2>\n\n\n\n\n<p>This myth persists because much of the claims process happens behind the scenes. Policyholders often assume adjusters are rewarded for issuing denials or delaying payments, which makes the process feel adversarial.<\/p>\n\n\n\n\n\n<p>The reality is different. Adjusters are not paid to deny claims. In fact, the metrics we are judged on often include how quickly and fairly we resolve claims. Regulators set standards for timeliness, documentation and communication. Supervisors audit claim files to ensure those standards are met.<\/p>\n\n\n\n\n\n<p>Claims are denied when the loss is not covered by the policy, not because denial is the goal. Most homeowners have open peril dwelling policies, which mean that all losses to the home\u2019s structure are covered except what is specifically excluded. To determine if coverage is applicable, the adjuster must look at the exclusions, and if none are appropriate, the claim moves toward payment.<\/p>\n\n\n\n\n\n<p>It is also important to remember that insurance policies are not warranties or maintenance contracts. As a homeowner or driver, you are responsible for upkeep. I handled a home insurance claim where hail damage was alleged, but the inspection showed the roof had years of wear and tear with no signs of fresh hail impact. The policy covered sudden and accidental damage, not gradual deterioration. The claim was denied.<\/p>\n\n\n\n<section class=\"editorial-insight-box --insight-box +mg-vertical-md\" data-template=\"insight_box\">\n    <div class=\"card-body border-l-4 border-blue-800\">\n                    \n                <div class=\"content-wrapper\">\n                            <p>\n                    What you can do:\n                <\/p>\n                        <div class=\"content wysiwyg wysiwyg--flush\">\n                \n\n\n<ul class=\"wp-block-list\">\n<li style=\"list-style-type: none;\">\n<ul class=\"wp-block-list\">\n<!-- wp:list-item -->\n<li>\n<strong>Review your policy<\/strong> so you understand what is and is not covered.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li style=\"list-style-type: none;\">\n<ul class=\"wp-block-list\">\n<li>\n<strong>Maintain your property<\/strong> to reduce disputes over whether damage is sudden or gradual.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li style=\"list-style-type: none;\">\n<ul class=\"wp-block-list\">\n<li>\n<strong>Communicate openly<\/strong> with your adjuster. If it feels like they are asking many questions, it is because they must evaluate exclusions before confirming coverage.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li style=\"list-style-type: none;\">\n<ul class=\"wp-block-list\">\n<li>\n<strong>Stay objective<\/strong> and remember that adjusters apply policy language, not personal judgment.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n            <\/div>\n        <\/div>\n    <\/div>\n<\/section>\n\n\n\n<h2 data-position=\"3\" data-beam-element-viewed=\"\" data-id=\"br-h2-3-onpage-placement\" data-type=\"h2\" data-location=\"Editorial\" data-name=\"h2_all\" data-text=\"Myth 3: Insurers delay claims payments for profit\" data-outcome=\"\">Myth 3: Insurers delay claims payments for profit<\/h2>\n\n\n\n\n<p>The word \u201cfloat\u201d used to mean writing a check at the grocery store on Wednesday when you knew you didn\u2019t have enough in your account, hoping the bank would not cash it before payday on Friday. That grace period was the float. With debit cards, that old version is mostly gone.<\/p>\n\n\n\n\n\n<p>The idea of float is still around, but it has taken on a negative connotation. I see this myth often in my work as an expert witness, and it frustrates me the most. It undermines trust in the claims process and reflects a misunderstanding of how insurers actually earn money.<\/p>\n\n\n\n\n\n<p>Insurers have two main sources of revenue: premiums and investment income. Insurers collect premiums up front and pay claims later. On their own, auto and home premiums are not enough to cover all claims and operating expenses. To supplement that, insurers invest premium dollars. The interest earned helps pay company expenses and keeps premiums from climbing even higher.<\/p>\n\n\n\n\n\n<p>Some policyholder advocates oversimplify this process, stating that carriers know they must pay a claim, but they hold off as long as possible to keep earning interest. The suggestion is that claims departments intentionally delay cutting settlement checks, so the company can profit from the float.<\/p>\n\n\n\n\n\n<p>State regulators require insurers to set aside a specific amount of money to pay claims and expenses. For example, one requirement might be for insurers to set aside 1.5 percent of funds for every dollar of premiums collected. Because those funds are already earmarked, and the investment income is not tied to one particular claim, there is no incentive to delay claim payments just to earn more interest. The money is set aside for that purpose from the start to pay the claim.<\/p>\n\n\n\n\n\n<p>In my experience, delays are almost always tied to other issues: missing documentation, waiting for a contractor\u2019s estimate or needing upper management approval for a large payout. These situations can slow the process, but they are procedural, not financial strategies.<\/p>\n\n\n\n<section class=\"editorial-insight-box --insight-box +mg-vertical-md\" data-template=\"insight_box\">\n    <div class=\"card-body border-l-4 border-blue-800\">\n                    \n                <div class=\"content-wrapper\">\n                            <p>\n                    What you can do:\n                <\/p>\n                        <div class=\"content wysiwyg wysiwyg--flush\">\n                \n\n\n<ul class=\"wp-block-list\">\n<!-- wp:list-item -->\n<li>Ask questions if your claim feels stalled. Often, the reason is a missing report or unresolved documentation.<\/li>\n\n\n\n<li>Stay engaged with your adjuster, and request updates regularly.<\/li>\n\n\n\n<li>Avoid assumptions that a delay is intentional. Believing the float myth can escalate disputes unnecessarily.<\/li>\n\n\n\n<\/ul>\n\n\n\n\n            <\/div>\n        <\/div>\n    <\/div>\n<\/section>\n\n\n\n<h2 data-position=\"4\" data-beam-element-viewed=\"\" data-id=\"br-h2-4-onpage-placement\" data-type=\"h2\" data-location=\"Editorial\" data-name=\"h2_all\" data-text=\"Myths persist \u2014 but you don\u2019t have to buy into them\" data-outcome=\"\">Myths persist \u2014 but you don\u2019t have to buy into them<\/h2>\n\n\n\n\n<p>Insurance can seem complex, leading people to rely on simplified phrases or common sayings to understand it. Over time, these shortcuts evolve into myths. These myths can create unnecessary tension between policyholders and the people working their claims, so if you\u2019re ever skeptical about how your policy or claim is being managed, ask questions for clarification. Your agent or adjuster has insights into procedural details, and the answer is probably simpler than you\u2019re imagining.<\/p>\n\n        <div class=\"HelpfulCTA mx-auto flex flex-col items-center gap-6 my-6 max-w-108 py-12 text-base border-y border-gray-200\" data-helpful-cta=\"\" data-beam-element-viewed=\"\" id=\"did-you-find-this-helpful\" data-type=\"cta\" data-location=\"article-bottom\" data-position=\"banner\" data-text=\"Did you find this page helpful?\">\n    <div class=\"HelpfulCTA-initial w-full flex flex-col items-center gap-4\" data-cta-initial=\"\">\n        <div class=\"HelpfulCTA-question text-lg font-bold text-center text-gray-900\">\n            Did you find this page helpful?\n            <div id=\"mKxsGMCikl\" class=\"hidden\">\n        <div class=\"wysiwyg wysiwyg--sm wysiwyg--flush max-w-xs\">\n                        <p class=\"mb-6 text-base\">\n                            <strong class=\"block font-bold text-gray-900\">Why we ask for feedback<\/strong>\n                            Your feedback helps us improve our content and services. It takes less than a minute to\n                            complete.\n                        <\/p>\n                        <p>Your responses are anonymous and will only be used for improving our website.<\/p>\n                    <\/div>\n    <\/div>\n\n\n\n\n        <\/div>\n        <p>Help us improve our content<\/p>\n        <div class=\"HelpfulCTA-actions flex gap-4 mt-2\">\n            <button type=\"button\" class=\"HelpfulCTA-btn HelpfulCTA-btn--yes border border-2 border-blue-600 text-blue-600 rounded px-6 py-2 transition font-semibold flex items-center gap-2 hover:bg-blue-50\" data-cta-yes=\"\" data-beam-element-clicked=\"\" id=\"did-you-find-this-helpful-yes\" data-type=\"button\" data-location=\"article-bottom\" data-position=\"banner\" data-text=\"Yes\" data-outcome=\"response submitted\">\n                <span class=\"Icon\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"Icon-glyph\" viewbox=\"0 0 24 24\" fill=\"currentColor\" focusable=\"false\"><title>Thumbs Up Icon<\/title><path d=\"M13.165 2.175c.322 0 .57.022.774.065.796.161 1.43.624 1.85 1.345.71 1.216.722 3.067.023 5.499h.516c2.28 0 3.422 0 4.337.548a3.844 3.844 0 0 1 1.721 2.25c.29 1.032 0 2.13-.592 4.336l-.516 1.926c-.312 1.151-.484 1.786-.882 2.324a3.368 3.368 0 0 1-1.442 1.098c-.625.247-1.28.248-2.475.248l-.021.01h-4.595c-.42 0-.636 0-.84-.032a4.19 4.19 0 0 1-.635-.15c-.204-.065-.387-.162-.763-.355l-1.69-.856c-.014.034-.026.069-.043.102a2.334 2.334 0 0 1-1.044 1.044c-.495.247-1.012.248-1.948.248h-.161c-.936 0-1.453 0-1.947-.248a2.333 2.333 0 0 1-1.044-1.044C1.5 20.038 1.5 19.52 1.5 18.585v-7.683c0-.936 0-1.452.248-1.947A2.387 2.387 0 0 1 2.792 7.91c.494-.248 1.01-.247 1.947-.247h.16c.937 0 1.454 0 1.95.247.353.177.653.44.875.763.64-.606 1.788-2.184 3.31-5.142.183-.366.312-.603.538-.819.193-.193.462-.355.72-.441.302-.097.539-.097.873-.097ZM4.739 9.288c-.624 0-1.076 0-1.227.076a.721.721 0 0 0-.323.322c-.075.15-.075.603-.075 1.216v7.683c0 .624 0 1.076.075 1.227.065.14.183.248.323.323.151.075.603.075 1.227.075h.16c.625 0 1.078 0 1.228-.075a.722.722 0 0 0 .323-.323c.075-.15.075-.603.075-1.227v-7.683c0-.624 0-1.065-.075-1.227a.672.672 0 0 0-.323-.322c-.15-.075-.603-.076-1.227-.076h-.161v.01ZM13.057 3.8c-.14 0-.226 0-.259.011-.032 0-.086.043-.107.064a2.98 2.98 0 0 0-.226.399c-2.187 4.272-3.53 5.647-4.33 6.092.003.162.004.34.004.536v7.82l2.217 1.122c.28.14.42.216.56.27.107.032.214.064.332.075.151.021.314.021.626.021h4.594c1.022 0 1.539 0 1.862-.129a1.84 1.84 0 0 0 .763-.58c.215-.28.355-.808.613-1.765l.517-1.927c.495-1.85.775-2.873.603-3.475a2.309 2.309 0 0 0-1-1.313c-.538-.323-1.594-.323-3.51-.323h-1.129c-.226 0-.473 0-.72-.15a1.087 1.087 0 0 1-.464-.614c-.075-.301 0-.528.076-.754.957-2.97.603-4.26.301-4.777-.183-.312-.44-.506-.774-.57-.14-.033-.377-.033-.549-.033Z\" class=\"icon-base\"\/><\/svg><\/span> <span class=\"text-base leading-4\">Yes<\/span>\n            <\/button>\n            <button type=\"button\" class=\"HelpfulCTA-btn HelpfulCTA-btn--no border-2 border-blue-600 text-blue-600 rounded px-6 py-2 transition font-semibold flex items-center gap-2 hover:bg-blue-50\" data-cta-no=\"\" data-beam-element-clicked=\"\" id=\"did-you-find-this-helpful-no\" data-type=\"button\" data-location=\"article-bottom\" data-position=\"banner\" data-text=\"No\" data-outcome=\"response submitted\">\n                <span class=\"Icon\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"Icon-glyph\" viewbox=\"0 0 24 24\" fill=\"currentColor\" focusable=\"false\"><title>Thumbs Down Icon<\/title><path d=\"M19.26 2.175c.936 0 1.454 0 1.949.247.452.226.818.592 1.044 1.043.247.495.248 1.012.248 1.948v7.678c0 .936 0 1.453-.248 1.948a2.333 2.333 0 0 1-1.044 1.042c-.495.248-1.013.248-1.95.248h-.16c-.937 0-1.454 0-1.95-.248a2.33 2.33 0 0 1-.885-.777c-.637.596-1.79 2.176-3.314 5.155-.183.365-.312.602-.538.828a1.924 1.924 0 0 1-.722.441c-.258.086-.484.097-.742.097l.022-.011a5.39 5.39 0 0 1-.905-.064 2.741 2.741 0 0 1-1.852-1.345c-.71-1.216-.721-3.066-.022-5.496h-.516c-2.283 0-3.424 0-4.34-.548a3.843 3.843 0 0 1-1.722-2.248c-.29-1.033 0-2.13.593-4.324l.517-1.925c.312-1.162.484-1.786.882-2.323.377-.495.872-.871 1.443-1.097.624-.248 1.281-.248 2.476-.248h4.597c.42 0 .635 0 .84.032.215.032.431.086.636.15.193.065.387.162.753.345l1.702.864c.017-.04.033-.082.053-.122a2.333 2.333 0 0 1 1.044-1.043c.496-.247 1.013-.247 1.95-.247h.16ZM7.503 3.798c-1.022 0-1.54 0-1.862.13-.302.118-.56.322-.765.58-.215.28-.345.775-.614 1.753l-.517 1.926c-.495 1.85-.775 2.871-.602 3.474a2.308 2.308 0 0 0 1 1.312c.539.323 1.594.322 3.51.322h1.142c.236 0 .473 0 .72.15.227.14.388.367.453.625.075.28 0 .516-.075.742-.959 2.969-.603 4.27-.301 4.775.183.312.44.506.774.57.162.033.41.033.572.033.128 0 .203 0 .236-.01.021 0 .085-.044.107-.065.032-.032.14-.237.227-.399 2.208-4.308 3.556-5.671 4.352-6.102a39.945 39.945 0 0 1-.003-.523v-7.79L13.63 4.175c-.28-.14-.41-.215-.56-.27a1.796 1.796 0 0 0-.344-.085c-.151-.022-.313-.01-.625-.022H7.503Zm11.596.001c-.625 0-1.077 0-1.228.076a.72.72 0 0 0-.323.322c-.075.15-.075.603-.075 1.226v7.68c0 .623 0 1.075.075 1.226.075.14.183.247.323.322.15.075.603.075 1.228.075h.16c.625 0 1.078 0 1.228-.075a.778.778 0 0 0 .324-.322c.075-.151.075-.603.075-1.227V5.423c0-.623 0-1.076-.075-1.226a.722.722 0 0 0-.324-.322c-.15-.076-.603-.076-1.227-.076h-.161Z\" class=\"icon-base\"\/><\/svg><\/span> <span class=\"text-base leading-4\">No<\/span>\n            <\/button>\n        <\/div>\n    <\/div>\n    <!-- Yes Form -->\n    \n    <!-- No Form -->\n    \n    <div class=\"HelpfulCTA-thankyou flex flex-col items-center gap-2\" data-cta-thankyou=\"\" style=\"display:none;\">\n        \n        <p>Thank you for your\n            feedback!<\/p>\n        <p>Your input helps us improve our\n            content and services.<\/p>\n    <\/div>\n<\/div>\n\n    <\/div>\r\n<br>Read the full article <a href=\"https:\/\/www.bankrate.com\/insurance\/the-insurance-myths-a-claims-adjuster-wishes-would-go-away\/\" target=\"_blank\" rel=\"noopener\" rel=\"nofollow\">here<\/a><!-- \/wp:post-content --><!-- \/wp:list-item --><!-- wp:post-content --><div>\n        \n        <p>People rely on fables or common phrases to make sense of complicated ideas. If Jack works all day, he is going to be a dull boy. If you keep making that face, it will freeze like that. These shortcuts help us explain the world, and insurance is no different.<\/p>\n\n\n\n\n\n<p>Because the claims process can feel overwhelming, simplification often turns into myth. Some myths start with a grain of truth. Others stem from misunderstandings of how coverage works. Some myths are easily dispelled \u2014 for example, it\u2019s often claimed that red cars cost more to insure. But others are more persistent. And a few have been repeated so often that they sound like fact.<\/p>\n\n\n\n\n\n<p>Let\u2019s break down three myths I see come up frequently in my day-to-day as an adjuster.<\/p>\n\n\n\n\n<h2 data-position=\"1\" data-beam-element-viewed=\"\" data-id=\"br-h2-1-onpage-placement\" data-type=\"h2\" data-location=\"Editorial\" data-name=\"h2_all\" data-text=\"Myth 1: Injury settlements are three times medical bills\" data-outcome=\"\">Myth 1: Injury settlements are three times medical bills<\/h2>\n\n\n\n\n<p>One of the most common myths in liability claims is that the value of a bodily injury settlement is calculated as \u201cthree times medicals.\u201d In other words, if your medical bills after an accident total $5,000, you should expect a settlement of $15,000.<\/p>\n\n\n\n\n\n<p>Many claimants come into negotiations believing this is the standard, even the law. It is not. No formula determines settlement value. Each claim is evaluated on its own facts.<\/p>\n\n\n\n\n\n<p>When adjusters calculate the value of a bodily injury claim, they look at a range of factors, including:<\/p>\n\n\n\n\n<ul class=\"wp-block-list\">\n<li>\n<strong>Liability<\/strong>: Who is at fault and to what degree.<\/li>\n\n\n\n<li>\n<strong>Severity of injuries<\/strong>: Medical bills, lost wages, long-term impact, and whether there is permanent disability or scarring.<\/li>\n\n\n\n<li>\n<strong>Medical treatment<\/strong>: Whether the treatment provided is relevant and necessary for the injury.<\/li>\n\n\n\n<li>\n<strong>Pain and suffering<\/strong>: The claimant\u2019s emotional distress, lifestyle changes and impact on relationships.<\/li>\n\n\n\n<li>\n<strong>Policy limits<\/strong>: The maximum amount of insurance coverage available.<\/li>\n<\/ul>\n\n\n<section class=\"editorial-insight-box --insight-box +mg-vertical-md\" data-template=\"insight_box\">\n    <div class=\"card-body border-l-4 border-blue-800\">\n                    \n                <div class=\"content-wrapper\">\n                            <p>\n                    What you can do\n                <\/p>\n                        <div class=\"content wysiwyg wysiwyg--flush\">\n                \n\n\n\n<p>It is difficult to be objective about your own claim, but these steps can help you understand how the adjuster reached their numbers:<\/p>\n\n\n\n\n<ul class=\"wp-block-list\">\n<!-- wp:list-item -->\n<li>Establish a realistic demand that accounts for medical expenses, lost wages and other damages.<\/li>\n\n\n\n<li>Listen when the adjuster explains their decision, then respond from that starting point.<\/li>\n\n\n\n<li>Negotiate in good faith by being honest and open to a fair resolution.<\/li>\n\n\n\n<li>Consider mediation if discussions stall. A neutral third party can help both sides move forward.<\/li>\n\n\n\n<li>Consult an attorney if negotiations break down or if the injuries are severe. An experienced personal injury attorney can guide the process and protect your rights.<\/li>\n\n\n\n<\/ul>\n\n\n\n\n            <\/div>\n        <\/div>\n    <\/div>\n<\/section>\n\n\n\n<h3\/>\n\n\n\n\n<p>Overall, the adjuster\u2019s goal is to reach a settlement that fairly compensates for losses and expenses, while also taking into consideration any applicable insurance policies, state laws and other factors that may affect the final settlement amount.<\/p>\n\n\n\n\n<h2 data-position=\"2\" data-beam-element-viewed=\"\" data-id=\"br-h2-2-onpage-placement\" data-type=\"h2\" data-location=\"Editorial\" data-name=\"h2_all\" data-text=\"Myth 2: Adjusters are paid to deny claims\" data-outcome=\"\">Myth 2: Adjusters are paid to deny claims<\/h2>\n\n\n\n\n<p>This myth persists because much of the claims process happens behind the scenes. Policyholders often assume adjusters are rewarded for issuing denials or delaying payments, which makes the process feel adversarial.<\/p>\n\n\n\n\n\n<p>The reality is different. Adjusters are not paid to deny claims. In fact, the metrics we are judged on often include how quickly and fairly we resolve claims. Regulators set standards for timeliness, documentation and communication. Supervisors audit claim files to ensure those standards are met.<\/p>\n\n\n\n\n\n<p>Claims are denied when the loss is not covered by the policy, not because denial is the goal. Most homeowners have open peril dwelling policies, which mean that all losses to the home\u2019s structure are covered except what is specifically excluded. To determine if coverage is applicable, the adjuster must look at the exclusions, and if none are appropriate, the claim moves toward payment.<\/p>\n\n\n\n\n\n<p>It is also important to remember that insurance policies are not warranties or maintenance contracts. As a homeowner or driver, you are responsible for upkeep. I handled a home insurance claim where hail damage was alleged, but the inspection showed the roof had years of wear and tear with no signs of fresh hail impact. The policy covered sudden and accidental damage, not gradual deterioration. The claim was denied.<\/p>\n\n\n\n<section class=\"editorial-insight-box --insight-box +mg-vertical-md\" data-template=\"insight_box\">\n    <div class=\"card-body border-l-4 border-blue-800\">\n                    \n                <div class=\"content-wrapper\">\n                            <p>\n                    What you can do:\n                <\/p>\n                        <div class=\"content wysiwyg wysiwyg--flush\">\n                \n\n\n<ul class=\"wp-block-list\">\n<li style=\"list-style-type: none;\">\n<ul class=\"wp-block-list\">\n<!-- wp:list-item -->\n<li>\n<strong>Review your policy<\/strong> so you understand what is and is not covered.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li style=\"list-style-type: none;\">\n<ul class=\"wp-block-list\">\n<li>\n<strong>Maintain your property<\/strong> to reduce disputes over whether damage is sudden or gradual.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li style=\"list-style-type: none;\">\n<ul class=\"wp-block-list\">\n<li>\n<strong>Communicate openly<\/strong> with your adjuster. If it feels like they are asking many questions, it is because they must evaluate exclusions before confirming coverage.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li style=\"list-style-type: none;\">\n<ul class=\"wp-block-list\">\n<li>\n<strong>Stay objective<\/strong> and remember that adjusters apply policy language, not personal judgment.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n            <\/div>\n        <\/div>\n    <\/div>\n<\/section>\n\n\n\n<h2 data-position=\"3\" data-beam-element-viewed=\"\" data-id=\"br-h2-3-onpage-placement\" data-type=\"h2\" data-location=\"Editorial\" data-name=\"h2_all\" data-text=\"Myth 3: Insurers delay claims payments for profit\" data-outcome=\"\">Myth 3: Insurers delay claims payments for profit<\/h2>\n\n\n\n\n<p>The word \u201cfloat\u201d used to mean writing a check at the grocery store on Wednesday when you knew you didn\u2019t have enough in your account, hoping the bank would not cash it before payday on Friday. That grace period was the float. With debit cards, that old version is mostly gone.<\/p>\n\n\n\n\n\n<p>The idea of float is still around, but it has taken on a negative connotation. I see this myth often in my work as an expert witness, and it frustrates me the most. It undermines trust in the claims process and reflects a misunderstanding of how insurers actually earn money.<\/p>\n\n\n\n\n\n<p>Insurers have two main sources of revenue: premiums and investment income. Insurers collect premiums up front and pay claims later. On their own, auto and home premiums are not enough to cover all claims and operating expenses. To supplement that, insurers invest premium dollars. The interest earned helps pay company expenses and keeps premiums from climbing even higher.<\/p>\n\n\n\n\n\n<p>Some policyholder advocates oversimplify this process, stating that carriers know they must pay a claim, but they hold off as long as possible to keep earning interest. The suggestion is that claims departments intentionally delay cutting settlement checks, so the company can profit from the float.<\/p>\n\n\n\n\n\n<p>State regulators require insurers to set aside a specific amount of money to pay claims and expenses. For example, one requirement might be for insurers to set aside 1.5 percent of funds for every dollar of premiums collected. Because those funds are already earmarked, and the investment income is not tied to one particular claim, there is no incentive to delay claim payments just to earn more interest. The money is set aside for that purpose from the start to pay the claim.<\/p>\n\n\n\n\n\n<p>In my experience, delays are almost always tied to other issues: missing documentation, waiting for a contractor\u2019s estimate or needing upper management approval for a large payout. These situations can slow the process, but they are procedural, not financial strategies.<\/p>\n\n\n\n<section class=\"editorial-insight-box --insight-box +mg-vertical-md\" data-template=\"insight_box\">\n    <div class=\"card-body border-l-4 border-blue-800\">\n                    \n                <div class=\"content-wrapper\">\n                            <p>\n                    What you can do:\n                <\/p>\n                        <div class=\"content wysiwyg wysiwyg--flush\">\n                \n\n\n<ul class=\"wp-block-list\">\n<!-- wp:list-item -->\n<li>Ask questions if your claim feels stalled. Often, the reason is a missing report or unresolved documentation.<\/li>\n\n\n\n<li>Stay engaged with your adjuster, and request updates regularly.<\/li>\n\n\n\n<li>Avoid assumptions that a delay is intentional. Believing the float myth can escalate disputes unnecessarily.<\/li>\n\n\n\n<\/ul>\n\n\n\n\n            <\/div>\n        <\/div>\n    <\/div>\n<\/section>\n\n\n\n<h2 data-position=\"4\" data-beam-element-viewed=\"\" data-id=\"br-h2-4-onpage-placement\" data-type=\"h2\" data-location=\"Editorial\" data-name=\"h2_all\" data-text=\"Myths persist \u2014 but you don\u2019t have to buy into them\" data-outcome=\"\">Myths persist \u2014 but you don\u2019t have to buy into them<\/h2>\n\n\n\n\n<p>Insurance can seem complex, leading people to rely on simplified phrases or common sayings to understand it. Over time, these shortcuts evolve into myths. These myths can create unnecessary tension between policyholders and the people working their claims, so if you\u2019re ever skeptical about how your policy or claim is being managed, ask questions for clarification. Your agent or adjuster has insights into procedural details, and the answer is probably simpler than you\u2019re imagining.<\/p>\n\n        <div class=\"HelpfulCTA mx-auto flex flex-col items-center gap-6 my-6 max-w-108 py-12 text-base border-y border-gray-200\" data-helpful-cta=\"\" data-beam-element-viewed=\"\" id=\"did-you-find-this-helpful\" data-type=\"cta\" data-location=\"article-bottom\" data-position=\"banner\" data-text=\"Did you find this page helpful?\">\n    <div class=\"HelpfulCTA-initial w-full flex flex-col items-center gap-4\" data-cta-initial=\"\">\n        <div class=\"HelpfulCTA-question text-lg font-bold text-center text-gray-900\">\n            Did you find this page helpful?\n            <div id=\"mKxsGMCikl\" class=\"hidden\">\n        <div class=\"wysiwyg wysiwyg--sm wysiwyg--flush max-w-xs\">\n                        <p class=\"mb-6 text-base\">\n                            <strong class=\"block font-bold text-gray-900\">Why we ask for feedback<\/strong>\n                            Your feedback helps us improve our content and services. 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href=\"https:\/\/www.bankrate.com\/insurance\/the-insurance-myths-a-claims-adjuster-wishes-would-go-away\/\" target=\"_blank\" rel=\"noopener\" rel=\"nofollow\">here<\/a><!-- \/wp:post-content -->","protected":false},"excerpt":{"rendered":"<p>Review your policy so you understand what is and is not covered. Maintain your property to reduce disputes over whether damage is sudden or gradual. Communicate openly with your adjuster. If it feels like they are asking many questions, it is because they must evaluate exclusions before confirming coverage. Stay objective and remember that adjusters<\/p>\n","protected":false},"author":1,"featured_media":21883,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[58],"tags":[],"class_list":{"0":"post-21882","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-homes"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.2 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>The 3 Insurance Myths a Claims Adjuster Wishes Would Go Away | IncrediPros<\/title>\n<meta name=\"description\" content=\"People rely on fables or common phrases to make sense of complicated ideas. 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