What Does an Insurance Adjuster Do?

The responsibility of an independent insurance adjuster is to determine the amount of loss coverage that the insurance company is accountable for. He/she investigate, examine, and determine the amount of damage claimed to ensure a right settlement payment that would satisfy the needs of the client and protect the insurance company from excessive loss.

Insurance companies often hire independent insurance adjusters when they see a reason to suspect there is some form of insurance fraud. They are also hired when the insurance company does not have an independent insurance adjuster in the region where the claim is located.

These professionals mostly work with claims related to property or vehicle damage, although health-related claims are not exceptional. When dealing with these claims, Insurance Adjusters visit and investigate the scene of the accident to determine its cause, interview witnesses and experts to collect further information, and evaluate the policy contract to verify the extent of the coverage granted.

Responsibilities:

Here’s a non-exhaustive list of common tasks Insurance Adjusters are required to complete.

Examining claims to determine insurance coverage:

• Determining the cause of the accident;
• Analyzing all possible variables;
• Interviewing claimants, witnesses, and other relevant parties (e.g. Police Officers, Physicians, or other experts); and
• Verifying the integrity of the information collected.

Assessing damages caused to a property:

• Apprising the value of damaged property;
• Estimating the value of the losses; and
• Calculating an appropriate settlement payment.

Reviewing reports (e.g. medical records, medical bills, or property damage reports) related to the claim:

• Valuing the cost of all damages caused; and
• Validating that the policy covers all damages.
• Authorizing or rejecting a settlement payment based on findings.

Negotiating a settlement with the claimant:

• Elucidating the policy contract and what it covers to the claimant;
• Trying to find a solution that profits both parties; and
• Suggesting a litigation process if negotiations prove futile.

Investigating suspicious claims:

• Analyzing records and evidence to validate the integrity of a claim;
• Determining if insurance fraud is at play; and
• Referring to cases of fraud to the company and the corresponding legal authorities.

These are some of the roles and responsibilities of insurance claim adjusters.