What is an Insurance Claims Adjuster?

Cathy's Tuesday TipThe world of independent claims adjusting is an opportunity to get out of the cubicle, go out into the field and a chance to help people put their lives back together. When weather or tragedies arrive, independent adjusters arrive on the scene to help pick up the pieces. Working as an independent adjuster means just that — working independently. Claims adjusting is not a 9 to 5 office job where you punch a time card. You are given a set of claims and are expected to own the claims-handling procedure yourself from start to finish. This means your time, space, and resources are your own. Every day is an adventure! Let me know if you are interested in becoming an independent insurance adjuster. I am looking for licensed and preferably experience adjusters across the southeast. Hope you enjoy Cathy’s Tuesday Tip! ~ Cathy

Definition: An insurance claims adjuster performs many important tasks for an insurance company. Processing insurance claims makes up a large part of the work an insurance company has to perform and insurance claims adjusters make it possible for the insurance claims process to run smoothly. To better understand how an insurance claims adjuster performs their job, let’s first quickly review the insurance claims process.

People purchase insurance policies to protect their personal property. Businesses, of course, do this too. The insurance policies protect one by providing money in place of the property that one has a risk of losing. If the time comes that a policyholder or a business must file an insurance claim because the property that they had insured was damaged or destroyed due to a covered risk, there are a number of insurance professionals that can become involved to help the insurance company decide how much money to give to the claimant. The insurance adjuster has a large role in determining that monetary amount to give to the policyholder.

An insurance adjuster’s job is varied as they are expected to perform a wide variety of tasks for the insurance company regarding insurance claims. In a nutshell, the insurance adjuster organizes, plans, and prepares the claim. To do this, insurance adjusters have to work with the claimant, witnesses to the damage, police officers, lawyers and hospital professionals, just to name a few.

Besides working with a variety of individuals and professionals, insurance adjusters gather a variety of information such as statements, photographs and other items that may help the insurance adjuster make a better assessment of the claim being processed. The insurance adjuster takes all the information and evidence they have gathered about the claim and puts it all together as a claim report that can then be used by the insurance company and other professionals as an evaluation tool for processing the claim.

Let’s look at an example of how an insurance adjuster may handle a specific claim. Say a homeowner contacted their insurance company because they had damage to their roof due to a storm. The insurance adjuster would be sent to the homeowner’s residence to interview the policyholder about how and when the storm damage happened. The claim adjuster would then review the storm damage by writing down in a report what items the storm damage has destroyed along with taking pictures of the storm damage. The insurance adjuster then may contact local construction professionals to get an idea of the average repair costs that would be associated the type of storm damage the homeowner’s house suffered. Then the insurance claims adjuster would put all the information they gathered into a report to present to the insurance company to review. If the insurance company reviews the insurance adjuster’s claim report and it is approved by the homeowner, the homeowner would then receive monetary compensation for the storm damage on their home.

Claims Examiners

There are other insurance professionals sometimes involved and/or utilized by insurance companies, businesses or individuals. Claims examiners are one of these professionals and they often assist a claims adjuster by reviewing submitted claims to make sure all the proper procedures were followed.

Claims examiners also sometimes assist the claims adjusters with their duties of gathering evidence and preparing the claim especially when there are a large amount of claims, such as during a natural disaster.

Another type of professional that works with insurance claims adjusting is the public insurance claims adjuster. A public insurance claims adjuster is often hired by businesses and individuals alike. Public insurance claims adjusters are self-employed, so some feel that a public insurance claims adjuster may be more impartial since they are not an employee of the insurance company. The public insurance claims adjuster prepares the insurance claim in a similar fashion as the insurance company’s insurance claim adjuster and presents their findings to the insurance company that the claim is being sent to.

This is used as a negotiation tool that some individuals and businesses feel has been able to help them get more monetary compensation than just using the insurance company’s hired claims adjuster and therefore is worth the extra cost of paying for a public insurance claims adjuster.

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