A large limb from your beautiful oak tree just broke off and damaged the side of your home. As a result, you filed a claim with your homeowners insurance provider and might be wondering what happens next. After you submit the claim, an insurance adjuster will come to look at your property and evaluate the damage. There might be a few questions for you regarding the damage and the house’s condition before the damage occurred.
After the home insurance adjuster submits a report on your claim, the company will likely send you money, also known as a settlement, to replace your damaged siding. The process that began with your claim and an insurance adjuster usually ends after the payment.
This is a relatively simple example of an insurance adjuster’s role, and it is sometimes more complicated. You might still be wondering, what does a claims adjuster do? Read on to find out.
What is an insurance adjuster?
Insurance adjusters can have various job titles, such as claims representative, claims specialist, and independent claims analyst. Whatever their title, they all do approximately the same work for the insurance industry: inspect property damage or personal injury claims to determine the amount the insurance company should pay for the loss. They could be examining a home, business, or automobile.
Adjusters are responsible for interviewing the claimant, along with witnesses. They will look at the property and any police reports. They may check with other professionals—lawyers, engineers, architects, accountants, or physicians–who can add an expert’s perspective in evaluating a claim.
The adjuster’s job is to gather as much information as possible, including statements and photographs written or recorded. When they have it all put together, they forward a report to a claims examiner for review before approving it. After approval, the insurance adjuster will negotiate with the policyholder and settle the claim.
Does an insurance adjuster always work for an insurance company?
While claims adjusters might not always work for an insurance company, they will be working on their behalf. Independent claims adjusters serve as contractors, sometimes representing several companies or third-party administrators. Insurance companies usually hire independent adjusters if they do not have a claims office in the area or do not employ an in-house adjuster of their own.
An independent adjuster will often work on catastrophe insurance claims, traveling to areas affected by hurricanes, earthquakes, tornados, and other natural disasters. No matter what they work on, independent and in-house adjusters operate in the same manner with one exception: independent adjusters often have less authority to settle a case and must have any settlement approved by a claims supervisor.
How do adjusters settle claims?
Claims adjusters are assigned 50 to 100 new claims each month, on average. Their job is to clear or close them as quickly as possible while not spending more of their company’s money than necessary. Their job performance might also be rated based on how many claims they settle without involving company lawyers or supervisors.
Claims adjusters typically do not have any special legal or medical training. While the adjuster may be an expert in the claims business, they will not know the specifics of any case as thoroughly as the claimant.
In the case of a personal injury claim, the adjuster will negotiate with the claimant based not only on photos, medical records, and various documents, but also on what the claimant tells them about the accident and the injuries from their perspective.
The insurance adjuster usually has the authority to come to a settlement agreement with a claimant over the telephone. Once the two parties agree on an amount, the adjuster will send the paperwork to make it final.
An adjuster’s authority to settle claims may be restricted to specific dollar limits, and those limits often depend on the adjuster’s experience level. Less experienced adjusters will need approval from a claims supervisor or claims manager before settling a claim.
What skills do successful insurance adjusters have?
Aside from the technical skills required to be an insurance adjuster, here are some soft skills that might be essential for success:
- Listening: The best claims adjusters have great skills when it comes to listening and paying close attention.
- Time management: With all those claims to close each month, insurance adjusters must learn to successfully manage their time.
- Empathy: Adjusters are constantly working with clients who may be stressed out after a loss. They must know how to put themselves into the shoes of that person.
- Emotional self-control: The best adjusters know how to control their emotions and know how to handle them in a work environment.
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