A claims adjuster reviews insurance claims and establishes whether or not – and how much – an insurance company will pay an insured. Each case is reviewed by a claims adjuster who speaks with the claimant, interviews any witnesses, researches records (such as police or medical records), and inspects any connected property.
What does an insurance claims adjuster do?
An insurance adjuster must complete a number of responsibilities. They investigate a claim, make sure that the claim is covered under your insurance, and try to come to a reasonable payment.
The adjuster begins by going over any information submitted during the claims filing process. They may visit the premises to inspect the damage and take photographs. They will often want to talk with you and any witnesses or affected parties to learn what happened from as many perspectives as possible.
Once the adjuster has much information about the claim as possible, they will try to find an equitable solution and offer a payment to you as the insured. In many cases, you can negotiate with the claims adjuster, but if you are not satisfied, you can hire a lawyer to compel the insurance company to pay a higher amount.
Most personal injury lawsuits are brought because the insurance claims adjuster offers a very low amount of money in compensation, but the insured feels shortchanged. Your insurance policy is a contract, and a lawsuit may be the only way you can get a recalcitrant claims adjuster to live up to the promises the insurance company made in their contract with you.
A key part of the insurance adjuster’s job it to determine whether the insurance policy should be responsible for the claim. The adjuster may look at an insured’s primary and excess insurance policies to see if their carrier fits one or the other classification. If the adjuster is working for the carrier of the excess insurance policy, they may pay after the primary policy insurance carrier has finished their adjustment.
Types of Insurance Claims Adjusters
There are several types of insurance claims adjusters, and each will have an impact on resolving an insurance claim.
Staff Adjuster: A full-time staff adjuster works solely for one insurance company. In general, these people are salaried and receiving benefits from the company. In many cases, staff adjusters have a lot of experience in specific types of claims. For example, staff claims adjusters for several Intellectual Property insurance companies are often patent attorneys with deep litigation experience. They have a lot of expertise in handling these types of issue.
Independent Adjuster: Independent adjusters work as independent contractors for a variety of insurance companies or third-party administrators. They frequently help with disaster claims and will visit the affected areas following severe weather disasters or disasters.
Public Adjuster: Public insurance adjusters represent policyholders directly. They assist businesses and individuals in filing insurance claims when an offered settlement from an insurer appears unsuitable. Public adjusters are typically contract workers rather than salaried employees. Sometimes, an independent public adjuster will be paid a percentage of the resolved claim.
How Insurance Adjusters Handle Claims
When an insurance claim is submitted, the insurance company either assigns a staff adjuster or hires an independent adjuster to handle the claim.
This always entails some level of investigative work, and all insurance claims adjusters — whether staff adjusters, independent adjusters, or public adjusters — devote a significant amount of their time to it.
As previously noted, different types of insurance claims adjusters have varied objectives. Staff adjusters and freelance adjusters operate on behalf of the insurance company and are therefore concerned with the insurance carrier’s best interests. In other words, they have an incentive to pay as little as possible while still keeping you happy enough that you do not hire a lawyer to sue them.
Meanwhile, public adjusters attempt to obtain the greatest possible settlement on behalf of the claimant. Public adjusters represent you, not the insurance company. In many cases, independent insurance agencies will fight to help you resolve your situation as best and as quickly as possible.