Individuals who have been injured in a motor vehicle accident, on somebody else’s property, or those who are dealing with a denied or disputed long-term disability claim often come into contact with an insurance claims adjuster.

An adjuster is an insurance company representative assigned to manage the insured’s file. Their responsibilities include reviewing medical records, gathering information, approving or denying benefits, and ultimately attempting to resolve the claim. While adjusters are legally required to act in good faith in first-party claims, e.g. statutory accident benefit claims and long-term disability claims, their performance may be evaluated by the insurance company based on, among other things, how cost-effectively they can manage claims. This creates an inherent tension: the more benefits that are needed, the more pressure the adjuster feels to limit or deny the claim.

Because of this reality, the words you choose when speaking with an adjuster can significantly affect the outcome of your case. A single off-hand comment, even during an early telephone call, can later be used to question the severity of your injuries, reduce your benefits, or challenge your credibility. This is why the single most important step you can take after an injury in Ontario is to retain an experienced personal injury lawyer as early as possible.

At Preszler Injury Lawyers, our experienced Toronto personal injury lawyers communicate with insurers on behalf of all clients to ensure adjusters cannot deny or limit claims without cause. To speak with a member of our legal team, contact us today.

When Should You Speak Directly With an Insurance Adjuster?

In motor vehicle accident claims, the only time you should speak with the insurance company is at the very outset of your claim in order to report the claim.

For example, you may need to promptly report a motor vehicle accident to your own insurer to trigger statutory accident benefits coverage, or you may need to notify the property owner (or their insurer) after a slip and fall so that a claim file can be opened.

Long-term disability claims are different, as you will have regular communications with the insurance adjuster while your benefits are being paid. This communication will stop once the insurer notifies you that your benefits have been denied or terminated.

If you have not already hired a lawyer, you should do so immediately once notice of the claim has been provided and the claim has been accepted into the insurer’s system. By doing so, you can instruct the adjuster to direct all future communications through your legal representative.

This approach protects your rights, prevents unintentional missteps, and allows you to focus entirely on your medical recovery rather than on navigating complex insurance procedures, repeated phone calls, and administrative demands.

What to Do (And Not Do) When Talking to an Insurance Adjuster in Ontario

If you do find yourself speaking with an adjuster before you have retained a lawyer, the following practical guidance can help protect your interests.

Do: Always Tell the Truth

Insurance adjusters are trained to look for inconsistencies, and any misstatement—even about something that seems minor—can damage your credibility and give the insurer grounds to question your claim.

Do not exaggerate your injuries or symptoms, but also do not minimize them. Stick strictly to the facts you personally know and avoid guessing, speculating, or offering opinions about fault or how the accident occurred.

Do Not: Provide a Formal Statement

You should never provide a formal written or recorded statement, sign any authorizations for the release of records, or accept any settlement documents or releases without first consulting a lawyer. Once signed, these documents can permanently limit or extinguish important legal rights you may have otherwise been entitled to.

Do: Remain Courteous and Professional

When conversing or communicating with insurance adjusters, it is best to remain polite, professional, and respectful. Adjusters are more likely to respond positively when treated with respect. Being polite does not mean you have to be overly chatty or volunteer extra information; it simply means maintaining a calm and cooperative tone even if the questions feel repetitive or the process feels frustrating.

Do Not: Admit Any Degree of Fault

Even a polite, conciliatory comment such as “I should not have done that” can later be interpreted as an acceptance of responsibility and used against you. Only recite the facts of your case when asked without offering opinions about the cause or outcome of events.

Do: Record All Communication

It is important for you to keep your own detailed record of every conversation you have with an insurance company or adjuster. You are legally permitted to record calls with an adjuster in Ontario, although many people choose to mention it out of courtesy.

At a minimum, immediately after any calls or communication, note the date, time, name of the adjuster, and a summary of what was discussed. This creates an important paper trail for your lawyer.

Do Not: Become Confrontational

It is best to refrain from taking your frustration out on the adjuster. Dealing with a serious injury is emotionally and financially stressful, but yelling, arguing, or making hostile remarks will not help your case and may make the adjuster less inclined to work cooperatively with you and your legal team on your file.

Do: Keep Records of Important Documentation and Evidence

You should keep careful written records of all documents, photographs, receipts, and medical reports related to your claim. Insurance adjusters rely heavily on documentation when making decisions, especially when approving payments. Thorough records strengthen your position and can help your lawyer build a compelling case on your behalf.

Do Not: Post on Social Media

You should not post anything about your accident, injuries, or recovery on social media. Insurance adjusters and their investigators routinely search Facebook, Instagram, TikTok, and other platforms for evidence. Even seemingly innocent posts or photographs can be used to undermine your claim.

It is safest to set all accounts to private and refrain from sharing any related content until your case is fully resolved.

Do Not: Accept the First Settlement Offer

Initial settlement offers from adjusters are frequently far below the true value of a claim, particularly in cases involving serious motor vehicle injuries, long-term disability disputes, or significant slip and fall losses that affect your ability to work or enjoy life. Always obtain independent legal advice before considering any offer.

Contacted by an Insurance Adjuster During Your Claim? Speak With Preszler Injury Lawyers Today

Overall, it is important to remember one key fact: the adjuster works for the insurance company, not for you. While adjusters are generally decent people doing a job, their job is to investigate claims and, in many cases, settle them for as little as possible.

Navigating an insurance claim, whether it involves statutory accident benefits after a car accident, a long-term disability denial, or a slip and fall on someone else’s property, can be complex, time-consuming, and emotionally draining. Adjusters often manage very large caseloads, sometimes more than 150 files at once, which can result in delays, missed communications, and administrative oversights.

Having an experienced personal injury lawyer step in early and handle all communications with the adjuster removes this burden from your shoulders. Your lawyer ensures that your rights are protected at every stage, that all necessary evidence is properly presented, and that you receive the full compensation and benefits you are entitled to under Ontario law.

At Preszler Injury Lawyers, we regularly assist clients throughout Ontario with motor vehicle accident claims, statutory accident benefits disputes, long-term disability claims, and slip and fall injuries. Our role is to become involved as early as possible, communicate directly with the insurance company on your behalf, and advocate aggressively for the best possible outcome.

If you have recently been injured and have already had contact with an adjuster—or if you are about to report a claim—we strongly encourage you to reach out to us right away. The earlier you involve experienced legal counsel, the better protected your interests will be. You can focus on your health and recovery while we handle the insurance process for you.

Note: This article provides general information only and is not legal advice. Every case is different. Please speak with your personal injury lawyer for advice specific to your situation.

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