Ever wonder what really happens after you send a demand letter? As a former injury claims adjuster, I’ve seen the strategic moves, the costly missteps, and the silent factors that make or break a settlement. Behind every “we’re still reviewing your file” email lies a process most plaintiff attorneys never get to see.

In this blog, I’m pulling back the curtain on that process by tapping into my past career as a claims adjuster and claim department manager that spanned over a decade. You’ll get candid insights from the adjuster’s side of the table—what catches our attention, what slows things down, and how to position your case so it lands in the “let’s settle this” pile instead of the “let’s drag this out” one. Whether you’re new to personal injury or a seasoned negotiator, these behind-the-scenes perspectives can give you a sharper edge in your next negotiation.

Setting Reserves

When an auto injury claim first lands on an adjuster’s desk, the process begins with a quick review of the reported facts and injuries, followed by confirmation that coverage applies. Once coverage is verified, the adjuster makes an initial determination of liability based on available evidence, such as witness statements, points of impact, and each driver’s version of events.

Next comes a key step: Estimating the full value of the injury claim. The adjuster assesses all reported injuries and discounts that value according to the plaintiff’s potential share of fault, or:

(Full value × % of defendant’s negligence = estimated settlement value)

With that estimate in hand, usually within the first 3-5 days of receiving the claim, the adjuster requests initial reserves, which are the funds set aside by the insurance company to cover the anticipated settlement or judgment. Once reserves are established, they’re difficult to increase without management approval. This process takes time and will delay negotiations.

If a client’s injuries worsen, require surgery, or result in permanent impairment, the reserves may need to be raised, and sometimes the claim is reassigned to a more experienced handler.

Takeaways for the plaintiff's attorney:

• Report every injury early, no matter how minor, so they’re factored into the initial reserve amount.
• Notify the adjuster immediately whenever there’s a material change in your client’s condition. Delays make it harder to adjust reserves and can slow settlement.
• Provide clear and comprehensive medical documentation to support the initial claim and any subsequent changes to your client's condition. This helps justify the reserve amount.
• Understand that increasing reserves is a slow process that requires multiple levels of approval. Be patient, but persistent, when a legitimate increase is needed.

Demand Letters

Adjusters are trained to be highly skeptical. They expect plaintiff attorneys to present their client’s case in the most favorable light. They have also seen attorneys omit material facts in demand letters and supporting documents. They therefore conduct their own investigations accordingly and are generally not persuaded by lengthy cover letters.

Because of this, long, detailed demand letters rarely carry more weight. Adjusters typically skim them for key facts and supporting documentation rather than narrative persuasion, unless the case is unusually complex or involves catastrophic injuries.

Takeaways:

• Keep most demand letters short, professional, and precise.
• IMPORTANT: Always proofread. Even one typo or grammatical error can damage your credibility and reduce the perceived value of your case.
• Reserve lengthy, detailed demand letters for complex or high-value cases.

Policy Limit Demands for Every Case?

Whether you submit specific dollar amounts in your demands or send policy limits demands every time, first, it’s worth considering how adjusters evaluate claims. They start at zero. Based on their investigation, information gathered, and your arguments, dollars are added until they build to the ultimate settlement amount. Another way of looking at this is that to the adjuster, the claim is worth the minimum until the plaintiff attorney persuades them to add dollars to their evaluation. If we flip this perspective, as plaintiff attorneys, we should be thinking of every case as a policy limits case until the adjuster convinces us otherwise, only then reducing our counter demands accordingly. This shift in perspective will result in better plaintiff outcomes. 

Negotiations

Remember: Adjusters are just people doing their jobs. While your relationship is inherently adversarial, it doesn’t need to be hostile. Aggression, threats, or unprofessional conduct don’t help; in fact, they usually backfire by pushing your client’s case to the bottom of the pile.

Takeaways:

• Every case is a policy limits case until you convince me it’s not.
• Professionalism, courtesy, and polite, strategic persuasion consistently outperform hostility.

“Low and Slow” Tactics

Negotiations tend to follow a rhythm. With few exceptions, cases don’t settle at the first demand or offer. Typically, it takes three to four rounds of negotiation before both sides move toward resolution.

Some adjusters are taught to start low and increase offers slowly, believing this strategy results in a lower overall settlement. To counter this, plaintiff attorneys can adjust their own strategy: begin slightly higher than usual and make smaller, deliberate reductions with each round.

Takeaway:

• Recognize and adapt to the negotiation rhythm. Small, strategic adjustments in your demand strategy can neutralize the “low and slow” approach.

Negotiation vs. Litigation: A Mindset Shift

Many claims departments have specialized “High Exposure Teams” that handle serious cases after suit is filed. These adjusters often have greater settlement authority and direct access to management. Yet surprisingly few plaintiff attorneys reach out to discuss settlement during litigation. Instead, they often wait until the eve of trial when they could have resolved sooner.

These adjusters can and will negotiate throughout all phases of litigation, especially when new information emerges. Sometimes, one strong deposition or expert report is all it takes to reopen productive discussions.

Takeaway:

• Don’t wait for the eve of trial to call the adjuster if your case is not improving with time. 
• Resume negotiations whenever you have new facts or evidence that could change the adjuster’s evaluation.

Training: Leveling the Playing Field

Insurance companies invest heavily in training their adjusters. These adjusters regularly receive ongoing education from a diverse range of professionals, including nurses who can help them analyze medical records, accident reconstruction experts who can break down the physics of a collision, and former law enforcement officers who provide insights into police reports and investigations. They also receive constant guidance from in-house counsel. All this training is specifically aimed at sharpening their case evaluation and negotiation skills, giving them a strategic edge.

Takeaway:

Ask yourself: Is your team receiving the same level of training? If your firm isn't providing comparable, continuous education for your litigators and paralegals, your negotiators may be at a distinct disadvantage. Continuous professional development and targeted skill-building are absolutely essential to staying competitive and leveling the playing field against well-prepared adjusters.

Inside the Mind of the Opposition

Understanding how adjusters think and operate is one of the most effective ways to improve case outcomes and shorten settlement timelines. The claims process is built on systems, authority levels, and psychology. Attorneys who appreciate those dynamics have a clear advantage. By communicating early, staying professional, and adapting your negotiation approach to the adjuster’s playbook, you can avoid unnecessary delays and maximize your client’s recovery.

After spending more than a decade working in claims departments, I can say with absolute certainty that the plaintiff attorneys who truly stood out were those who came prepared, behaved with integrity, and negotiated with clear strategy. These qualities set the stage for smoother negotiations, faster resolutions, and, yes, better settlements for your clients. Take it from someone who’s reviewed numerous cases from the other side of the table: If you master these traits, you will maximize recoveries and earn the adjuster’s genuine respect.