What Does an Insurance Claims Adjuster Do?

A claims adjuster (also known as an insurance adjuster) investigates and determines how much your insurance company should pay you when you make a claim for damage or losses. A property and casualty adjuster investigates automobile, business and home claims.

Claims adjusters may handle property claims involving damage to vehicles or structures, or liability claims involving property damage or personal injuries to other persons. They have a variety of tasks (depending on the type of company they work for) but typically they investigate, evaluate and settle insurance claims.

Three types of insurance claims adjusters

There are three different types of claims adjusters.

  1. Staff adjuster: A staff adjuster works full-time for one insurance company. Generally, these adjusters are salaried and receive benefits, such as life and health insurance and continuing education training. Staff adjusters respond only to claims for the one insurance company they work for.
  2. Independent adjuster: Independent adjusters work as contractors for multiple insurance companies or adjusting firms. They often work on catastrophe claims and travel to affected areas after major weather events or emergencies.
  3. Public adjuster: Public insurance adjusters work directly on behalf of policyholders. They help businesses or individuals with insurance claims if a proposed settlement is unacceptable.

Claims process

Adjusters research your insurance policy to find out the amount the insurance company should pay. They prepare a report (a claims file) about your claimed loss to present to the insurance company. Sometimes they conduct surveillance and investigations to ensure the claim is not fraudulent.

A claims adjuster may investigate your claim by:

  • Speaking to you, the claimant
  • Inspecting the damage and taking photos or video
  • Interviewing any witnesses
  • Researching records (such as police or medical records)
  • Consulting with experts (such as physicians or roofing professionals)

Once the investigation is complete, the adjuster determines how much the insurance company should pay for your loss. They report their evidence to a claims examiner, who ensures guidelines are properly followed.

Adjusters then negotiate with you, the policyholder, to arrive at a final payment amount for the claim.

Getting you back on your feet

Insurance adjusters help people in the aftermath of a loss, whether it’s a natural disaster, an accident, a theft or something else. Oftentimes, the insurance adjuster is one of the very first people who will reach out to assist you after a loss.

Automation is evolving to streamline the process

While claims adjusters do a majority of the work on all types of claims at most insurance companies, some companies are now using technology and artificial intelligence (AI) to automate parts of the claims process.

For example, you may be able to submit a simple claim online or through a smartphone app. A chatbot may rapidly review the claim, cross-reference it with your policy, run anti-fraud algorithms, send fund wiring instructions to the bank, and inform you the claim has been closed.

Do you need to file an insurance claim?

Visit the Cheney Insurance Claims Center for more information or contact us directly with any questions.



Reposted with permission from original author.  Applied Systems Inc.