Written by Andy Gurczak

September 27, 2021

Insurance Adjuster: What You Should Know

What is an Insurance Adjuster; Also Known as Claim Adjuster?

An insurance adjuster is someone who investigates insurance claims to determine if your insurance company should pay you for your damages/losses. In addition, an insurance adjuster, also known as a claims adjuster, determines how much your insurance company should pay you if you make a claim.

Adjusters can handle any type of claim, from personal injury to property damage. In property insurance claims, the main role of the insurance adjuster is to carry out a detailed investigation into the claim by:

  • First, determining insurance coverage
  • Second, inspecting the damage
  • Then, reviewing police reports
  • After, speaking to witnesses
  • Finally, talking to property owners

After reviewing a claim, the claims adjuster then submits the documentation to the insurance company. They usually describe the incident and give recommendations for the claim settlement amount.

Once the investigation is complete, the loss adjuster will then be in a position to determine the amount of the insurance company’s potential liability to its insured.

Insurance Adjuster Adjusting

There are two types of common insurance adjusters:

Insurance claim adjusters are usually insurance representatives that work for the insurance company. On the other hand, public adjusters are independent insurance professionals that you hire.

The main difference between the two is that an insurance claims adjuster carries out the adjusting for the insurer. Therefore, they usually tend to favor the insurance company. Meanwhile, a public insurance adjuster works for you. So they are trained to maximize claim settlements and to protect your rights as a policyholder. Therefore, hiring a public adjuster could benefit your claim greatly.

Whatever the case, an insurance adjuster makes sure the insurance claims process is fulfilled, in order to determine settlements. In order to become a claims adjuster, check out your state’s guidelines on licensing. The states that do require a license, may require a pre-license course and continuing education credits.

Other Types of Insurance Adjuster

Occasionally, a claim is not handled by an insurance company’s own adjuster, but instead is referred to a firm of independent adjusters. Insurance companies often do this if they do not have a local claims office in a particular area.

Independent claims adjusters representing an insurance company operate the same as in-house claims adjusters. And the insurance claim process is exactly the same.

Government Claims Adjuster

Meanwhile, public entities such as state governments or large cities that receive lots of claims often have their own claims adjustment offices. However, the negotiation process with these government claims adjusters works the same as with private insurance adjusters.

The only notable difference in negotiating with a government claims adjuster is when a claim winds up in court. In that case, judges and juries tend to award significantly smaller settlements. Since, of course, it’s public money. If you have a claim against a public entity, expect your settlement to be 10% to 25% lower than if it were against a private party.

An Attorney as an Insurance Adjuster

Self-insured corporations and some insurance companies without a local claims office sometimes use this method. They use their own staff attorney or local attorney as a claims adjuster. Moreover, government entities sometimes have assistant city, county, or state attorneys who deal directly with claims even before they get to court.

Regardless, if an attorney is handling your claim instead of a claims adjuster, don’t worry. A lawyer cannot change the claims negotiation process. Nor can they do anything different from a non-attorney claims adjuster.

A lawyer may seem more aggressive than a claims adjuster. For instance, they may bluff a little more about the law regarding negligence and liability. But there are easy techniques to call that kind of bluff, so don’t panic.

Insurance Adjuster Attorney as Adjuster

How Private Insurance Adjusters Deal with Claims

Although an insurance adjuster’s job seems pretty straightforward, there are more than a few layers to it.

  • Once you have filed an insurance claim and filled out the proper insurance claim forms, the insurance company will first assign an insurance claim adjuster to your case.
  • This insurance claim adjuster will first begin preparing a claim file on your case. They will then present this claim file to the insurance company and the insured (that’s you.) Moreover, this claim file consists of various documents, including photographs, forms, statements from people directly involved in the claim, and testimonies.
  • Depending on the case, an insurance adjuster will then visit your property for a thorough inspection of the damage. As well as conduct an interview with the policyholder and witnesses of the incident.
  • After the claims adjuster’s visits, they will take their time to analyze your case. They will subsequently determine their personal recommendation on how much the insurer should pay.
  • If you don’t agree with their settlement recommendation, you can proceed to negotiate with the insurance adjuster.
  • Finally, once you and the adjuster reach an agreement, the insurance adjuster will approve your settlement and issue your payout.

Insurance Adjuster Dealing How to Deal With an Adjuster

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