Insurance Company Tactics: 12 Moves Adjusters Use to Shrink Your Claim
The person calling you after your accident sounds helpful. Concerned, even. They ask how you’re feeling. They say they want to get this resolved quickly so you can move on with your life. And they mean it. They do want to resolve this quickly. Just not for the reasons you think.
Insurance adjusters are experienced professionals who handle hundreds of claims each year. Their role, by design, is to evaluate and close claims efficiently and at the lowest possible cost to their employer. That doesn’t make them bad people – it is simply how the system is structured. The faster they close your claim and the less they pay out, the better their numbers look. Understanding that single fact changes how you hear every word they say to you.
Key Takeaways
Priority
Insurance adjusters are evaluated on financial performance metrics — average payout amounts, closure speed, and settling below reserved amounts. Bonuses of 10–30% of base salary can ride on those targets. Their incentives and yours are not aligned.
California’s Fair Claims Settlement Practices Regulations require insurers to acknowledge your claim within 15 days and accept or deny it within 40 days of receiving proof of loss. Violations are evidence of bad faith.
→ Missing these deadlines is legally actionable
You have the right to refuse recorded statements and blanket medical authorizations that would expose your entire health history — not just records relevant to your injury.
California Insurance Code § 790.03(h) lists 16 specific prohibited claims practices. Even a single knowing violation can trigger enforcement action. If an adjuster’s behavior feels wrong, there may be a statute that says it is.
→ Document every interaction — dates, names, what was said
Why Do Adjusters Use These Tactics? The Business Model Behind the Behavior
Claims departments run on metrics. Average paid claim amounts, claim severity ratios, closure rates, and reserves management. In a 2024 federal case, Barten v. State Farm, an Arizona court compelled State Farm to disclose internal documents about adjuster financial goals and incentive structures, ruling that this information was discoverable in bad faith litigation because it directly impacts how policyholders get treated.
Industry commentators have noted that performance bonuses rewarding adjusters for paying claims fully and promptly are largely absent from most incentive plans. What does get rewarded: settling below the reserved amount, closing files quickly, and avoiding litigation. None of these metrics measures whether you received fair compensation.
This matters because every tactic below flows from this reality. The adjuster isn’t freelancing. They’re following a playbook designed to protect the company’s bottom line.
Tactic #1: They Call Within 48 Hours Asking for a Recorded Statement?
You’re still in a hospital gown. Or sitting in a pharmacy parking lot, filling a pain prescription. The adjuster calls, voice warm and reassuring, and asks if you’d mind giving a quick recorded statement about what happened.
This is not routine. You are under no legal obligation to provide a recorded statement to the other driver’s insurance company during the claims process. They want to catch you while you’re medicated, exhausted, and still processing what happened. “I’m feeling okay today” becomes evidence six months later that your injuries weren’t severe. A vague description of the accident (because you can’t think straight on Vicodin) becomes a locked-in version they’ll use to challenge anything you remember more clearly later.
Tactic #2: The Lowball “Final Offer”
Within weeks of your accident, before you’ve finished physical therapy, before you know whether you’ll need surgery, an offer appears. It sounds like a lot of money when you’re staring at a pile of bills. The adjuster may call it their “best and final offer” or say their authority is limited.
It’s rarely final. Adjusters typically have settlement authority ranges, not fixed amounts, and claim files often include reserves exceeding the initial offer. The urgency is manufactured. They know that once you finish treatment and understand the full scope of your injuries, your claim is worth significantly more.
Tactic #3: Spying on You
Insurance companies hire private investigators. They review your social media accounts. They drive through your neighborhood. They may sit outside your home in an unmarked car and film you taking out the trash or playing with your dog in the front yard.
Under California Civil Code § 1708.8, insurers need an “articulable suspicion” that a claim might be fraudulent before deploying video surveillance. They can observe you in public spaces. They cannot trespass on private property, record audio without consent, or engage in harassment. If you suspect you’re being followed or watched, document it. Dates, times, vehicle descriptions.
Tactic #4: Endless Documentation Loop
You submit your medical records. They ask for more. You send those. They need them in a different format, or from a different date range, or from a provider you saw once three years ago. Every request comes with a polite apology and a two-week turnaround.
This is attrition. California’s two-year statute of limitations for personal injury is ticking the entire time. The regulations say insurers cannot “persist in seeking information not reasonably required for or material to the resolution of a claim dispute.” But proving what’s “reasonably required” is where the gray area lives.
Tactic #5: The “Independent” Medical Examination?
The insurance company asks you to see their doctor for an “independent” evaluation. The doctor is selected by the insurer, paid by the insurer (often $1,000 to $5,000+ per exam), and may see dozens of claimants per week for that same insurer.
IME doctors who consistently find that injuries are less severe than treating physicians believe tend to stay on the roster. Doctors who agree with your treating physician’s assessment tend not to get called back. The examination itself is often brief, sometimes 15-20 minutes for injuries that your own doctor spent months evaluating. If you’re asked to attend an IME during the pre-litigation claims process, know that you can bring a witness, record the exam, and request a copy of the report.
Tactic #6: The Friendly Adjuster
Adjusters receive training in rapport-building. The friendly tone, the personal questions, the “I’m on your side” energy. It serves a purpose. Casual conversation gets documented. When you mention you went to your kid’s soccer game last weekend, that goes in the file as evidence you’re physically active. When you say you’re feeling “a little better,” it becomes proof that your injuries are resolving.
They’re also monitoring your social media. A photo of you smiling at a family barbecue. A check-in at a bowling alley. Activity on a fitness app. All of it gets pulled into the claim file and used against you at the negotiating table.
Tactic #7: Using Pre-Existing Conditions Against You
If you’ve ever had back pain, a prior car accident, or any kind of chronic condition, expect the adjuster to argue your current injuries are really just old problems resurfacing. They’ll pull medical records going back years, looking for anything they can pin your symptoms on.
California law is clear on this. Under CACI jury instructions No. 3927 and 3928, a defendant must take you as they find you. If a pre-existing condition was manageable before the accident and debilitating after it, the person who caused the accident owes you for the aggravation. The legal term is the “eggshell plaintiff” doctrine, and it means your medical history doesn’t let the at-fault party off the hook.
Tactic #8: They Inflate Your Share of Fault
California uses a pure comparative negligence system established by Li v. Yellow Cab Co. in 1975. You can recover damages even if you were partially at fault, but your award gets reduced by your fault percentage.
Adjusters exploit this aggressively. If they can bump your fault from 10% to 30%, that’s a 20% reduction in what they pay. Common arguments: you were on your phone, you didn’t brake fast enough, you weren’t wearing a seatbelt, you waited too long to see a doctor. Some of these arguments are legitimate. Many are inflated specifically because most unrepresented claimants don’t know they can push back.
Tactic #9: The “Scope of Authority” Lie
“I wish I could offer more, but I’ve reached the limit of my authority.” This is a negotiation tactic. Adjusters do operate within authority levels that require supervisory approval above certain thresholds. But the threshold is often well above what they’re offering you. The claim of limited authority creates an artificial ceiling that discourages you from negotiating further.
Tactic #10: They Make You Sign a Blanket Medical Authorization
The adjuster sends you a form and asks you to sign it so they can “get your medical records and move things along.” The form authorizes access to your complete medical history from every provider you’ve ever seen. Psychiatric records. Substance abuse treatment. Reproductive health. Conditions that have zero connection to your car accident.
Under the HIPAA Privacy Rule’s minimum necessary standard, covered entities should only request the minimum PHI needed for a specific purpose. But when you sign a broad authorization, disclosures made under that authorization become exempt from the minimum necessary requirement. That’s why the scope of what you sign matters so much. Limit authorizations to treatment related to your injury, from specific providers, for a defined time period.
Tactic #11: Statute of Limitations Trick
California gives you two years from the date of injury to file a personal injury lawsuit. The insurance company knows this deadline. You might not. And they will never remind you.
In fact, the Fair Claims Settlement Practices Regulations require insurers to notify unrepresented claimants of applicable deadlines at least 60 days before expiration. But that notice might arrive as a form letter that gets lost in a stack of medical bills. Meanwhile, the documentation loop from Tactic #3 keeps churning, eating months off your clock.
Tactic #12: Settlement Release Language Fine Print
When you finally reach a settlement number, the release you’re asked to sign typically contains language waiving all future claims related to the incident. Including injuries that haven’t shown up yet.
Traumatic brain injuries can take months to fully manifest. Internal soft tissue damage sometimes worsens over time. If you sign a release with broad waiver language and develop complications six months later, you generally cannot reopen the settlement. The finality of that document is something most people don’t fully appreciate until it’s too late.
When Do These Tactics Cross Into Bad Faith Territory?
Not every frustrating experience with an adjuster is illegal. Insurance companies have a right to investigate claims, request documentation, and negotiate settlements. The line gets crossed when these practices violate California Insurance Code § 790.03(h), which enumerates 16 specific prohibited unfair claims settlement practices.
A few that map directly to the tactics above:
- Misrepresenting policy provisions or pertinent facts to claimants
- Failing to acknowledge and act promptly on communications
- Not attempting in good faith to effectuate fair settlements when liability is reasonably clear
- Compelling claimants to file lawsuits by offering substantially less than what a court would later award
- Failing to provide a reasonable explanation for denying a claim or offering a low settlement
A single knowing violation can trigger enforcement by the California Department of Insurance. If you believe an insurer is engaging in unfair practices, you can file a complaint with the CDI online or by calling 1-800-927-HELP. The CDI investigates complaints, contacts the insurer, and can order them to reconsider improperly denied claims. It won’t award you damages directly, but it creates an official record of the insurer’s conduct, and that record matters if the claim escalates to litigation.
If any of these tactics sound familiar, you may need more than a web article. Contact DK Law for a free consultation. Our attorneys have spent years on both sides of personal injury claims, and we know how to counter every move on this list.
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