Marine Insurance Claim Disputes
Unfair & Unethical Conduct by Maritime Insurance Adjusters
When a maritime accident or offshore injury claim is filed, it's often handed to a marine insurance adjuster for processing. These adjusters commonly come from within the insurance company itself, or a third-party adjustment firm hired by the insurance company. It's their job to gather evidence and present findings back to the insurance company.
These adjusters can put up friendly fronts, and even try to imply that they're working in favor of the plaintiff—but they're not. Their interest is in the insurance company's bottom line and that means they're trying to minimize or dismiss your claim altogether. This can be particularly damaging in offshore injury cases, where most workers are unaware of their rights and the array of complex conditions affecting their benefits under maritime law.
Some adjusters will try to use this uncertainty to their advantage and to deface a legitimate claim. That's why it's crucial for injured workers to seek timely representation from a maritime law attorney. These cases are always facing large and infinitely more resourceful entities who are vigilant to dispel any claims against them. Disputes often come out of offshore injury cases, which is why informed counsel is crucial.
Is a marine insurance adjuster adversely affecting your claim? Contact our team to discuss your case and options. Your consultation is free!
What Does a Marine Insurance Adjuster Do?
Here are some key responsibilities and tasks of a marine insurance adjuster:
- Claim Assessment: When an incident occurs that may lead to a claim, such as damage to a ship, loss of cargo, or a marine accident, the insurance adjuster is called in to investigate and assess the situation.
- Documentation: They gather and review all relevant documents, including insurance policies, shipping records, bills of lading, survey reports, and any other pertinent information to understand the details of the claim.
- On-Site Inspections: In many cases, marine insurance adjusters visit the location of the incident, which could be a port, shipyard, or the vessel itself, to inspect the damage or loss firsthand.
- Loss Evaluation: The adjuster evaluates the extent of the loss or damage and determines whether it falls within the scope of the insurance policy. They also assess the cause of the loss, such as accidents, weather events, etc.
- Report Preparation: They prepare detailed reports outlining their findings, including the assessment of the loss, recommended settlement amounts, and supporting evidence. These reports are crucial in making claim decisions.
How Can a Marine Insurance Adjuster Hurt My Claim?
While marine insurance adjusters are generally tasked with assessing and processing claims related to maritime incidents, there are situations where their actions or decisions could adversely affect an injured seaman's claim.
This can often happen with the cooperation of the vessel owner or offshore company, as their pockets and reputation can also be hurt. Here are some ways this can happen:
One of the most common ways an adjuster can negatively impact a seaman's claim is by undervaluing the injury or loss. Downplaying the severity of the seaman's injuries or the value of their claim can result in a lower settlement offer, which may not adequately compensate the seaman for medical expenses, lost wages, pain, suffering, and other damages.
Some maritime insurance adjusters may try to shift the blame onto the injured seaman or their actions in an attempt to reduce the insurance company's liability. This attempted shifting of blame can result in delays in claim processing and lead to legal disputes that can be stressful and financially burdensome for the seaman.
In some cases, an adjuster may outright deny a seaman's claim, arguing that it does not fall within the scope of the insurance policy. This can happen when the adjuster interprets policy language in a way that is unfavorable to the seaman, even if a different interpretation might be more reasonable.
Delaying the Claims Process
Adjusters may intentionally delay the claims process by requesting additional documentation, investigations, or assessments, which can cause financial strain on the injured seaman who is waiting for compensation, making them more likely to accept a lower (but faster) settlement offer.
Lowball Settlement Offers
In some situations, adjusters might make low initial settlement offers with the hope that the seaman will accept a smaller sum rather than going through a protracted legal battle. This can be especially disadvantageous if the injured party is not fully aware of their rights or the potential value of their claim.
Countering Claims of Unseaworthiness
If the seaman's claim is based on the vessel's unseaworthiness, the adjuster may work to dispute this claim by asserting that the vessel was in a seaworthy condition at the time of the incident.
Seeking Biased Medical Opinions
The adjuster, in some cases, may seek medical opinions from doctors who are more favorable to the insurance company's position, and if these opinions contradict the assessment of the seaman's treating physician, they can be used to challenge the severity or causation of the injury.
Often, maritime workers may not realize that adjusters are working to counter their claim—or feel they have nothing to hide—and will cooperate with medical record requests and access to treatment plans. It isn't until later that victims realize that this information is being gathered to strategize and implement measures that can hurt their claim.
We're Ready to Fight for You
It can be a rude awakening for many injured offshore workers to realize that the legitimacy of their claim is being marred by the insurance company and they have to fight to prove their case. Disputes with an adjuster’s findings are common and are always an unwelcome source of conflict—especially when dealing with serious injuries and an uncertain financial future. At Arnold & Itkin, we've made it our firm's mission to give a voice to offshore workers who are all too often silenced by employers and their insurance companies. We can help push back against and resolve adjuster disputes.
Make sure you understand your legal rights. Contact Arnold & Itkin today!