Dealing with Insurance Adjusters: What You Need to Know About Texas Bodily Injury Claims
When someone else’s carelessness causes your injury, you’re not just dealing with pain.
Suddenly, you may be facing medical bills, unpaid time off work, and a family worried about what comes next. On top of that, you’re also dealing with insurance companies and adjusters who seem friendly on the phone but are not on your side. I’m Brad Parker, the attorney you want but hope you never need. At Parker Law Firm, we know how insurance companies work behind the scenes, and we want you to understand what you’re walking into when you make a bodily injury claim in Texas.
The Foundation of a Negligence Claim
A bodily injury claim is your request for fair compensation when someone else’s negligence causes you physical harm. Your injury might come from a car wreck, a hazardous condition on someone else’s property, or another cause. You’re not asking for a handout, you’re seeking to be restored to the position you were in before the injury.
That includes medical expenses, lost wages, and non-economic harms like pain, physical limitations, and mental health struggles. In Texas, most of these cases are based on negligence. That means you have to show that the other person or company owed you a duty to act reasonably, and they failed to do that. That failure, in return, caused your injuries. Sometimes it’s obvious, like a driver rear-ending you at a stoplight. In other situations, it’s more complex, such as when a property owner violates building code requirements. In these cases, a violation of a safety rule or ordinance can be strong evidence that the owner did not act reasonably. If you want to learn more about how these cases work on unsafe property, we explain Texas rules in more depth in our resource on premises liability in Texas at/texas-premises-liability.
The True Role of the Insurance Adjuster
When you make a claim, the insurance company assigns an adjuster to your file. Adjusters often sound calm, polite, and helpful. Adjusters might claim they just want to “wrap up” your claim so you can move on, but it’s crucial to understand their actual role.
The adjuster works for the insurance company, not for you. Their job is to gather information, evaluate your claim, and pay as little as the company can get away with under the policy. Insurance companies handle hundreds of claims each year and train their staff to find ways to deny or reduce yours. That experience gap matters: you may be facing the process for the first time while injured and stressed, while they navigate it hundreds of times a year.
How Adjusters Calculate Damages
When an adjuster looks at your claim, they usually start with your economic damages.These include measurable items like medical bills and lost income. But they don’t just accept the numbers. Insurance adjusters may review your medical records to claim that some treatments were unnecessary, unrelated to the injury, or excessively costly. Opposing counsel might argue that therapy lasted “too long” or that your recovery should have been faster. The defense team also assesses non-economic damages, such as pain and suffering, physical limitations, or emotional distress.
Those are subjective, and without an advocate explaining what you’ve truly lost, adjusters often try to give the lowest value they think they can get away with. Many of these insurance adjuster companies use computer programs that plug in diagnosis codes, treatment length, and other data to spit out a settlement range. That software doesn’t know you, your family, or how your injuries have changed your way of life and daily routines.
Shifting Blame: Liability and Causation
Liability and causation are two other areas where adjusters turn their focus. During these areas, they look for any way to shift blame to you or to something other than their client. This is especially common and easier to do in premises liability and building code violation cases. For example, maybe you fell on a poorly lit stairway with no proper handrail. The adjuster may admit the stairs were less than ideal, but argue the danger was “open and obvious” and that you should have paid more attention to your surroundings and been more careful. Or they might try to say your back problems came from an old injury instead of your recent fall. In building code violation cases, adjusters know that proving which code applied, how it was broken, and how it caused your injury often requires technical experts and detailed records.
If the adjusters think you don’t have those resources, they may flatly deny your claim of building code violations and hope you give up. In reality, questions about who is liable for building code violations can involve owners, property managers, contractors, or other resources. Untangling those questions and about who is responsible is critical to holding the right people accountable.
Navigating Complex Insurance Coverage
Insurance coverage itself plays a huge role in how an adjuster values your case. In auto cases, the at-fault driver may carry only minimum liability coverage, which can fall far short of what you need, especially after a serious injury.
Your own coverages, such as Personal Injury Protection (PIP) or Uninsured/Underinsured Motorist (UM/UIM), may come into play. When you file a UM/UIM claim, your own insurer often acts just like the other driver’s insurance and fights your claim to save money. Sometimes, their adjuster will suggest that because PIP paid your medical bills, the at-fault driver’s company doesn’t need to fully reimburse you. That is a misunderstanding of how the law handles the collateral source rule. Do not rely on an insurance company’s explanations of your rights without speaking to a lawyer who understands Texas personal injury law.
The Risks of Recorded Statements
One of the first tactics adjusters use is calling quickly to get a recorded statement. They aim to catch you while you’re in pain, on medication, or just trying to be polite. They may say they want “your side of the story” or to clarify details, but these statements are often used later to limit or deny your claim. Misspeak, forget a detail, or downplay your pain, and they can use it against you months later. You usually have no legal duty to give a recorded statement to the at-fault insurer. At Parker Law Firm, we advise clients not to provide a statement without legal guidance, because there’s little upside and significant risk.
Minimizing Your Injuries Through Medical Records
Adjusters are also clever and think of ways ask questions in a way that’s designed to minimize your injuries. They may ask about hobbies, prior accidents, or long-ago medical treatment. Then they dig through your medical history looking for anything they can call a pre-existing condition.For example, if you sue over a balcony collapse and previously had a knee arthroscopy, they may argue that your current issues stem from the old surgery, not the accident that threw you to the ground. They may even ask you to sign broad medical releases so they can comb through years of records. Without guidance, many people sign forms thinking they must to move their case forward. You have rights regarding what information you share and how it’s used, you don’t have to comply or make a statement just because they keep calling and pressuring you.
Surveillance and the Impact of Social Media
Modern surveillance goes far beyond someone parked outside your home with a video camera. Adjusters and investigation teams may review your public social media posts, search for photos, and monitor anything online that appears to show you as active or happy. Even a photo of you smiling at a family dinner can be used to suggest you’re not in pain. They also scrutinize the timing of your medical care. If you delay seeing a doctor hoping to improve on your own, they may claim your injuries aren’t serious. If you miss treatment due to childcare or costs, they may treat that gap as proof you’ve fully recovered. The reality of how real people live is often very different from how an adjuster chooses to interpret your records.
Protecting Your Settlement from Liens
Another area that often catches people by surprise involves liens and subrogation. Health insurance companies, Medicare, and hospitals may have a legal right to repayment from your settlement. If these liens aren’t handled correctly, you could end up with little or nothing after the bills are paid. Sometimes adjusters push for a quick settlement, knowing you’re under financial pressure and hoping you’ll accept an amount without realizing how much will go to repayment. A careful lawyer looks at these third-party interests ahead of time and negotiates when possible so that the settlement actually helps you move forward.
Gathering Vital Evidence Early On
Proving your claim means gathering and preserving evidence. In property cases, such as premises liability and building code violations, that often means acting quickly to photograph the condition that caused your injury and identify witnesses for fresh memories. Property owners sometimes repair a broken step, fix lighting, or change a layout shortly after an accident. If you don’t have photos or measurements from before the repair, it’s much harder later to show what caused your fall. Good evidence also includes your medical records, but those records are only as complete as the information you share with your doctors. If you don’t mention headaches, dizziness, or anxiety because you’re focused on your broken leg, those issues may never be documented, and the adjuster will act as if they don’t exist, so it’s important to mention any symptoms you may have when you see the doctor.
Proving the Link: Medical Causation and Future Losses
Medical causation links the incident to your specific injuries. Adjusters often claim MRI findings are “degenerative” or pre-existing. In cases like building code violations, they may argue your injuries existed before the accident. We work with treating physicians and outside experts, including those familiar with building codes, to show how the event likely caused or worsened your condition. Their testimony can be critical in proving that unsafe, non-compliant conditions led to your injuries.
A fair resolution also requires looking ahead, not just at the bills you have right now. Future damages can include additional medical treatment, medications, therapy, reduced earning capacity, and long-term physical limitations. An adjuster may offer to pay your current medical bills plus a small amount, but that rarely reflects the true cost of a serious injury. For example, in a severe building code violations claim where faulty wiring leads to a fire and significant burns, the cost of future surgeries, scar revisions, counseling, and time off work can be enormous. Part of our job is to work with medical and economic professionals when needed to estimate these future losses so we can present a clearer picture of what you will genuinely need over time.
Deadlines and Defenses: The Importance of Timing
Timing is also critical. Texas law generally gives people only a limited window to file a lawsuit for personal injuries, and in many cases, that period is around two years from the date of the incident. There are exceptions and special rules, especially for minors or certain types of defendants, but the deadlines can be strict and confusing. You can read more about how the statute of limitations for personal injury in Texas works at /texas-statute-of-limitations-personal-injury. This information is general and does not replace legal advice. The important point is that talking to a lawyer sooner rather than later helps protect your rights. Negotiating with an adjuster does not usually stop the clock. We see situations in which people have been in “ongoing settlement discussions” with an adjuster, only to learn that the deadline has passed and the insurer no longer has to pay.
How Comparative Negligence Affects Texas Warehouse Injury Claims
Insurance companies use legal defenses to limit what they pay. One key defense in Texas is comparative negligence, or the 51 percent bar rule, which lets a jury assign fault percentages to everyone involved. If you’re over 50% at fault, you may recover nothing; if 50% or less, your award can be reduced by your share of blame. Adjusters often argue you share significant fault, saying you weren’t paying attention in a fall or were distracted in a crash. In premises liability and building code violation cases, we show that the property owner’s failure to follow safety rules played the primary role, making it unfair to place most of the blame on you.
Protecting Your Rights After an Accident
Another favorite defense is to argue that you had pre-existing conditions. Many of us have some wear and tear in our backs, necks, or joints by middle age, even if we never had formal treatment before. An insurer may try to use that to say the accident didn’t really harm you, it only revealed problems that were already there. Under Texas law, however, a negligent party can be responsible when their conduct aggravates a pre-existing condition. The challenge is explaining that difference and proving, usually with medical support, how your pain levels, function, and daily life changed after the incident compared to before.
If you’re reading this, you may already be dealing with calls from adjusters and feeling unsure about what to say or do. There are a few simple protections that help most people. You don’t have to agree to a recorded statement to the other driver’s insurance company. You’re usually better off getting medical care promptly, following through with reasonable treatment, and keeping your appointments as best you can. It can also help to keep a basic journal of your symptoms, activities you can no longer do, sleep problems, and how the injuries affect your family life and work. Those notes can be very helpful later when memories have faded. If your situation involves unsafe property, especially something that may relate to building codes or negligence claims, keeping copies of past complaints or emails about the condition can also matter.
Why You Need a Texas Personal Injury Lawyer
Most importantly, you don’t have to handle this alone. A Texas personal injury lawyer’s job is to step between you and the insurance company, gather and present evidence, explain your rights, and push for a fair resolution, whether that’s through negotiation or, when necessary, through a lawsuit. At Parker Law Firm, we treat you like family, and we take on the legal and insurance battles so you can focus on healing. We fight tirelessly for you, but we’re also here to listen, answer your questions, and give you honest feedback about your options. There is no fee unless we win, so we only get paid if we recover money for you.
Every case is different, and deadlines and legal rules can vary based on your specific facts. If you’ve been hurt in Texas and you’re wondering what to do next, it’s always best to talk directly with a licensed Texas personal injury attorney as soon as you can so you can get advice that fits your particular situation.
