Check Out Our Podcast: The Verdict
After a workplace injury, most people think they’re dealing with someone who’s “on their side.” But what if that’s the biggest misunderstanding in the whole process? In this episode of The Verdict, Clarke talks with workers’ comp attorney Brian Groesser to discuss the real role of insurance adjusters.
They explain how adjusters — even the nice, polite ones — are not neutral parties, but trained professionals whose job is to reduce costs, limit medical treatment, and get you back to work as quickly as possible. Brian, who spent nearly two decades working with adjusters, shares how their job is structured to protect the insurance company — not the injured worker. This is a must-listen for anyone hurt on the job who’s wondering if they can “just work it out” with the insurance company.
Here’s what we discuss in this episode:
📉 What an adjuster’s job really is — and it’s not helping you
📞 Why polite questions can be part of a cost-cutting strategy
🚫 Why “adjusting” your claim often means downward
💼 Understanding the insurance company’s profit model
0:00 – Are they objective?
2:50 – Two main goals
Insurance adjuster, workers comp, insurance claim, workplace accident, claims process, injury lawyer, liability
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Speaker 1 00:00
I'm Clark, speaks the catastrophic injury lawyer, welcome to the verdict.
Clarke Speaks 00:06
Welcome back to the verdict. I'm here with attorney Brian grocer. Brian is the head workers comp lawyer at speaks law firm, Brian. Let's talk about the insurance adjusters role after a workplace accident. I think most people, again, they're thinking about it from the perspective of their employer, right? Their employer, their manager, Bob or Susan, they have a long history with them, or they have a working relationship with them, where they feel comfortable with them. And they're thinking that when they're communicating about their workplace accident, their workplace injury, their workers compensation case, that they're kind of communicating with a representative of the company they worked for. I think they think that this is an objective person, like a teacher. If you turn in a plus work, you're going to get an A plus on your grade. Or a doctor. If you say to a doctor, these are my symptoms, the jock doctor is going to give you objective feedback. Is the adjuster? Is the Workers Compensation adjuster? An objective, neutral person who's going to receive information and give an objective rendering opinion based on what they see
Brian Groesser 01:13
now. And you know, I know these folks very well. I mean, I worked with insurance adjusters for years, for 18 years, doing workers comp cases for them. So I'm familiar with who they are and how they operate, and for the most part, they're very good people, but at the end of the day, they are representing their insurance company. And when if you look at your case at the Industrial Commission, it'll say, Joe Smith versus Company X and Company Y. Company Y is the insurance company. They are against you. They're not your friend. They are looking to facilitate your claim, but their goal at the end of the day is to reduce their costs, to reduce their exposure and to reduce their expenses. How are they going to do that? They're going to try to return you back to work. They're going to try to deny their claim from the outset, if they can, if they don't have the ability to deny your claim at the beginning. And they're going to be paying for your medical treatment and paying for you while you're out of work. They're going to be looking to expedite that medical treatment as quickly as possible, avoid surgeries, avoid anything that's going to prolong medical treatment. And they're certainly going to be looking to return you back to work, whether you're ready to go back to work or not. They're looking to get the doctor to say, or some other professional that's in the case to say that you are able to go back to work. And the expectation is that you go back to work, because then the insurance company isn't paying you money anymore. Your employer is. So they're looking to curb their costs from day one. That's the adjusters job. Now, they may seem friendly and they may be good people, but at the end of the day, they are doing their job, and their job is to limit the exposure on the case the
Clarke Speaks 02:50
way I've always looked at it, in terms of these insurance adjusters, and in my experience, you're right. I've known them. I've been friends with them. I am friends with some of them. You know, it's not that they're bad people or unscrupulous or devious. It's their job. You know, their job is to represent the insurance company and their and to try to represent their interests and to mitigate their losses and to reduce their exposure. And so my experience is, is that insurance companies do two things, right? They, like all businesses, they want to maximize revenue and reduce or minimize expense, and that gives them profit. In fact, it's their duty to their ownership, or shareholders or whatever, to do exactly that. My experience is that they maximize revenue in the form of premiums, right? There's, there's a salesperson that goes out and sells as much as many policies, insurance policies, as they can. And when they do that, they say, Hey, we're gonna pay these claims. Then there's a different guy who or lady whose job it is to pay these claims. And these claims are expenses. They're liabilities. So we want to maximize our revenue and minimize our expenses. And so when a person is injured at work, they become, very quickly, a liability and expense, and the adjusters job is to reduce that expense. Is that a rational way to look at this and
Brian Groesser 04:11
say upside as business 101? I mean, that's how insurance companies operate and how most businesses operate, just as you describe it, especially insurance companies. And you're exactly right. And so the person that you are dealing with from day one, that person that calls you up and says, Hey, I'm Jane Smith, I'm adjusting your claim, and ask you all these questions, that is the person that you just described as being tasked with trying to keep the expenses down. They're not out there selling policies and driving up revenue. They are tasked with adjusting your claim, and by adjusting it, you can think of adjusting it down right. Adjusting the claim value down is never going to adjust it up, No, not unless they're forced to right. And so their job is to adjust it down and to keep the expenses down from the moment they call you. That is their number one goal. Yeah. Is to make sure that the expenses don't get out of control.
Clarke Speaks 05:02
One thing that I think is people have a hard time with is ordinary people work hard and they do the right thing, and they take take care of their families, and they go to church, and they're kind to each other and all this, they have a hard time getting their head around this, because the insurance adjuster is not in a red suit with horns and a in a pitchfork. They're nice people, and they behave nicely, and they say please and thank you, and they say yes, sir, and how's your grandma and how are your kids, and how did soccer tryouts go? But does that change the fact of what they're ultimately trying to
Brian Groesser 05:37
do? No, because you know the phrase kill you with kindness, you know, type thing. And I'm not saying that that's in a bad way, that they're trying to deceive you by any means, by all means, they, for the most part, good people, but they have a job to do, and they'll do it nicely, you know, they'll come across as a nice person, which they probably are. But at the end of the day, you just have to keep in mind that the motive on the other side is not to, you know, make sure that you get every single benefit that you are entitled to, and that you make a full recovery. Their goal is to make sure that the costs stay down and that you can make as best of a recovery as you can, while keeping the costs down.
Clarke Speaks 06:16
Thank you, Brian. When we come back, I'd like to talk to you about our role in the process. So join us in the next episode. Thanks for joining us. Don't forget to subscribe and follow us to stay up to date with our weekly episodes. We'll see you next time you.
Speaker 1 00:00
I'm Clark, speaks the catastrophic injury lawyer, welcome to the verdict.
Clarke Speaks 00:06
Welcome back to the verdict. I'm here with attorney Brian grocer. Brian is the head workers comp lawyer at speaks law firm, Brian. Let's talk about the insurance adjusters role after a workplace accident. I think most people, again, they're thinking about it from the perspective of their employer, right? Their employer, their manager, Bob or Susan, they have a long history with them, or they have a working relationship with them, where they feel comfortable with them. And they're thinking that when they're communicating about their workplace accident, their workplace injury, their workers compensation case, that they're kind of communicating with a representative of the company they worked for. I think they think that this is an objective person, like a teacher. If you turn in a plus work, you're going to get an A plus on your grade. Or a doctor. If you say to a doctor, these are my symptoms, the jock doctor is going to give you objective feedback. Is the adjuster? Is the Workers Compensation adjuster? An objective, neutral person who's going to receive information and give an objective rendering opinion based on what they see
Brian Groesser 01:13
now. And you know, I know these folks very well. I mean, I worked with insurance adjusters for years, for 18 years, doing workers comp cases for them. So I'm familiar with who they are and how they operate, and for the most part, they're very good people, but at the end of the day, they are representing their insurance company. And when if you look at your case at the Industrial Commission, it'll say, Joe Smith versus Company X and Company Y. Company Y is the insurance company. They are against you. They're not your friend. They are looking to facilitate your claim, but their goal at the end of the day is to reduce their costs, to reduce their exposure and to reduce their expenses. How are they going to do that? They're going to try to return you back to work. They're going to try to deny their claim from the outset, if they can, if they don't have the ability to deny your claim at the beginning. And they're going to be paying for your medical treatment and paying for you while you're out of work. They're going to be looking to expedite that medical treatment as quickly as possible, avoid surgeries, avoid anything that's going to prolong medical treatment. And they're certainly going to be looking to return you back to work, whether you're ready to go back to work or not. They're looking to get the doctor to say, or some other professional that's in the case to say that you are able to go back to work. And the expectation is that you go back to work, because then the insurance company isn't paying you money anymore. Your employer is. So they're looking to curb their costs from day one. That's the adjusters job. Now, they may seem friendly and they may be good people, but at the end of the day, they are doing their job, and their job is to limit the exposure on the case the
Clarke Speaks 02:50
way I've always looked at it, in terms of these insurance adjusters, and in my experience, you're right. I've known them. I've been friends with them. I am friends with some of them. You know, it's not that they're bad people or unscrupulous or devious. It's their job. You know, their job is to represent the insurance company and their and to try to represent their interests and to mitigate their losses and to reduce their exposure. And so my experience is, is that insurance companies do two things, right? They, like all businesses, they want to maximize revenue and reduce or minimize expense, and that gives them profit. In fact, it's their duty to their ownership, or shareholders or whatever, to do exactly that. My experience is that they maximize revenue in the form of premiums, right? There's, there's a salesperson that goes out and sells as much as many policies, insurance policies, as they can. And when they do that, they say, Hey, we're gonna pay these claims. Then there's a different guy who or lady whose job it is to pay these claims. And these claims are expenses. They're liabilities. So we want to maximize our revenue and minimize our expenses. And so when a person is injured at work, they become, very quickly, a liability and expense, and the adjusters job is to reduce that expense. Is that a rational way to look at this and
Brian Groesser 04:11
say upside as business 101? I mean, that's how insurance companies operate and how most businesses operate, just as you describe it, especially insurance companies. And you're exactly right. And so the person that you are dealing with from day one, that person that calls you up and says, Hey, I'm Jane Smith, I'm adjusting your claim, and ask you all these questions, that is the person that you just described as being tasked with trying to keep the expenses down. They're not out there selling policies and driving up revenue. They are tasked with adjusting your claim, and by adjusting it, you can think of adjusting it down right. Adjusting the claim value down is never going to adjust it up, No, not unless they're forced to right. And so their job is to adjust it down and to keep the expenses down from the moment they call you. That is their number one goal. Yeah. Is to make sure that the expenses don't get out of control.
Clarke Speaks 05:02
One thing that I think is people have a hard time with is ordinary people work hard and they do the right thing, and they take take care of their families, and they go to church, and they're kind to each other and all this, they have a hard time getting their head around this, because the insurance adjuster is not in a red suit with horns and a in a pitchfork. They're nice people, and they behave nicely, and they say please and thank you, and they say yes, sir, and how's your grandma and how are your kids, and how did soccer tryouts go? But does that change the fact of what they're ultimately trying to
Brian Groesser 05:37
do? No, because you know the phrase kill you with kindness, you know, type thing. And I'm not saying that that's in a bad way, that they're trying to deceive you by any means, by all means, they, for the most part, good people, but they have a job to do, and they'll do it nicely, you know, they'll come across as a nice person, which they probably are. But at the end of the day, you just have to keep in mind that the motive on the other side is not to, you know, make sure that you get every single benefit that you are entitled to, and that you make a full recovery. Their goal is to make sure that the costs stay down and that you can make as best of a recovery as you can, while keeping the costs down.
Clarke Speaks 06:16
Thank you, Brian. When we come back, I'd like to talk to you about our role in the process. So join us in the next episode. Thanks for joining us. Don't forget to subscribe and follow us to stay up to date with our weekly episodes. We'll see you next time you.
