What the Insurance Adjuster’s First Call Is Really For

The call usually comes within a day or two, and it is normally friendly. The adjuster asks how you are, confirms a few details about the collision, asks whether you have seen a doctor, and may ask to record the conversation. Sometimes a settlement figure is mentioned in the same call.

None of that is unusual or improper. It is worth understanding what the call is for, because the answer is not the same as what it feels like.

First, Work Out Whose Adjuster You Are Talking To

This distinction changes everything else and it is easy to miss when someone opens with your first name.

Your own insurer, on the no-fault side. Hawaii is a no-fault state for motor vehicle injuries. Under HRS §431:10C-304(1), your personal injury protection (PIP) insurer pays benefits for accidental harm without regard to fault, to the provider of services. That relationship is contractual: your policy sets out what you have agreed to do, and it is the source of any obligation you have to cooperate with your own insurer.

The other driver’s liability insurer. This company has no obligation to pay your medical bills as they accrue. Its role is to evaluate and resolve a claim against its own insured. Its interests and yours are not aligned, which is not a criticism of the adjuster — it is the structure of the arrangement.

If you are not certain which one is calling, it is entirely reasonable to ask who they represent and to call back once you know.

What the Call Is For

An early call does real work for the insurer, all of it legitimate and none of it directed at your interests:

• It fixes your account of the collision early, before you have seen a police report or spoken to a witness
• It captures a description of your injuries at the point where you know the least about them — often before the first specialist appointment
• It establishes what you say you were doing, where you were looking, and how fast you were going, all of which feed into the apportionment of fault
• It tests whether the claim can be resolved cheaply and immediately

The second point is the one that costs people the most. An honest “I’m sore but I think I’m fine” on day two is a reasonable thing to say and a difficult thing to walk back after an MRI six weeks later.

What Hawaii Law Requires of the Insurer

Hawaii’s insurance code sets standards for how claims are handled. HRS §431:13-103(a)(11) lists conduct that constitutes unfair claim settlement practices when it is committed or performed “with such frequency as to indicate a general business practice.” That qualifier is part of the provision and matters: the list describes a pattern of conduct, not a single phone call.

The listed conduct includes:

• Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue (subparagraph (A))
• Failing to respond with reasonable promptness — “in no case more than fifteen working days” — to communications from a policyholder or other persons, with a response that is more than an acknowledgment and that adequately addresses the concerns raised (subparagraph (B))
• Refusing to pay claims without conducting a reasonable investigation based upon all available information (subparagraph (D))
• Failing to affirm or deny coverage of claims within a reasonable time after proof of loss statements have been completed (subparagraph (E))
• Failing to offer payment within thirty calendar days of affirmation of liability, where the amount of the claim has been determined and is not in dispute (subparagraph (F))
• Failing to provide a reasonable written explanation for any delay on a claim that remains unresolved thirty calendar days from the date it was reported (subparagraph (G))
• Not attempting in good faith to effectuate prompt, fair, and equitable settlements of claims in which liability has become reasonably clear (subparagraph (H))
• Compelling insureds to institute litigation to recover amounts due by offering substantially less than the amounts ultimately recovered in actions brought by the insureds (subparagraph (I))

On the no-fault side there are also specific timing rules. HRS §431:10C-304(3)(A) requires payment of PIP benefits within thirty days after the insurer has received reasonable proof of the fact and amount of benefits accrued and a demand for payment. If the insurer denies a claim in whole or in part, §431:10C-304(3)(B) requires written notice of the denial and the reasons for it within thirty days. If it needs more information before it can pay or deny, §431:10C-304(3)(C) requires it to send an itemized list of the required documents within that same thirty days. Amounts unpaid after the thirty days bear interest at one and one-half per cent per month under §431:10C-304(4).

Knowing those rules exist is useful for a practical reason: it tells you that “we’re still reviewing it” is not an open-ended position, and that a written denial with reasons is something the statute contemplates rather than something you have to argue for.

The Recorded Statement

Whether you are obliged to give a recorded statement depends on who is asking and on the terms of your own policy. Insurance policies commonly include cooperation provisions, and those provisions are a matter of contract rather than a single statutory rule that this page could state for every situation. That is precisely why it is worth checking before agreeing rather than after.

What is reasonable in any case: ask who is asking and why, ask what the recording will be used for, and ask whether you can respond once you have your records in front of you. Nothing requires the conversation to happen at the moment it is first requested.

The Early Settlement Offer

An early offer is not evidence of bad faith. It is often a reasonable resolution of a small claim. What makes it difficult is timing: at the point it is usually made, neither side knows what the injury involves, and in Hawaii the injury total is not only a question of compensation — it can determine what kind of claim exists at all.

Under HRS §431:10C-306(a), the no-fault article abolishes tort liability for the owner, operator or user of an insured vehicle, except in the circumstances listed in subsection (b). Those include death; injury consisting in whole or in part of a significant permanent loss of use of a part or function of the body; a permanent and serious disfigurement resulting in mental or emotional suffering; and injury for which the PIP benefits incurred equal or exceed $5,000. Whether treatment eventually crosses that threshold is frequently unknown in the first weeks. This is covered further in how Hawaii’s no-fault insurance works when you are the one hurt.

Fault matters to the figure as well. Hawaii applies a modified comparative negligence rule under HRS §663-31: contributory negligence does not bar recovery so long as the injured person’s negligence was not greater than that of the persons against whom recovery is sought, but damages allowed are diminished in proportion to the injured person’s share of fault, and where that share is greater the court enters judgment for the defendant. An early conversation about how the collision happened is, among other things, a conversation about that percentage.

The Clock Does Not Stop While You Negotiate

Discussions with an insurer do not extend a filing deadline. Motor vehicle claims run under HRS §431:10C-315, which measures the period from the later of several dates, and injury claims generally run under HRS §657-7’s two years from accrual. The guide to Hawaii filing deadlines by claim type sets those out with their sources.

A Reasonable Way to Handle the Call

Nothing here suggests being adversarial, and nothing here suggests refusing to speak to anyone. What holds up well:

• Confirm who the adjuster represents and get the claim number
• Give the basic facts — where, when, which vehicles
• Decline to characterise injuries you do not yet understand; “I’m still being evaluated” is accurate and sufficient
• Ask for requests in writing, which the thirty-day rules above already contemplate
• Take time before agreeing to a recorded statement or a settlement figure

If the conduct you encounter looks like a pattern rather than a one-off — repeated non-responses, denials with no stated reason, or an offer that does not survive contact with your medical records — that is the point at which the list in §431:13-103(a)(11) becomes relevant, and the point at which it is worth having someone look at it. For the framework behind a Hawaii collision claim generally, see Hawaii car accident claims and no-fault rules, and for what any injury claim has to prove, see the elements of a Hawaii personal injury claim.