What Is an Insurance Adjuster?

Insurance Adjuster Explained in Less Than 5 Minutes

An insurance adjuster is a person who manages claims for an insurance company or insurance policyholder. Adjusters evaluate settlement amounts the insurers should pay to a person or business after a property loss. They also examine varieties of insurance fraud and strive to assist victims recover their losses.
Important Takeaways
  • Insurance adjusters are experts who assess how much money a person or business should get following a claim or loss.
  • Insurance adjusters may interact with industry professionals to analyze claims properly.
  • Adjusters may also examine instances of insurance fraud.
  • Insurance adjusters typically work for and with insurance firms, however there are numerous insurance adjuster types.

How Does an Insurance Adjuster Work?

Insurance adjusters act on behalf of a corporation or person to assist investigate, assess, and settle claims. Insurance adjusters may also be known as claims adjusters.

More over half of all insurance adjusters work for insurance companies or for agencies, brokerages, and other operations linked to insurance.

For example, following a natural catastrophe, an insurance company could temporarily contract with an independent insurance adjuster to examine house damage, if the insurer lacks adequate staff adjusters.

Insurance adjusters are responsible for assessing the amount of compensation that a policyholder is entitled to following a natural catastrophe, accident, or theft. They also examine situations that include fraud, arson, or vandalism, and are educated to guarantee that the firm is not accountable for any losses it shouldn't be.

An insurance adjuster’s tasks might include:

  • Ensuring an insurance covers a claim
  • Investigating and evaluating whether a claim is legitimate
  • Evaluating the damages
  • Dealing with claimants on behalf of an insurance and resolving claims
  • Working closely with lawyers, physicians, and other specialists such as engineers or appraisers, especially when a claim is difficult or problematic

Following a natural catastrophe causes severe property damage, adjusters may assess the greatest losses first. 

Example of an Insurance Adjuster

Another motorist struck your automobile, and the car is no longer driveable. You have the car hauled to an auto-body shop. An adjuster inspects your damaged automobile and determines the severity—can the car be fixed, or is it totaled? The adjuster analyzes the police report regarding the collision and takes pictures of the damage to both cars. If you were wounded in the accident, the adjuster may analyze any X-rays, diagnosis, and medical costs.

The adjuster will usually arrange their work schedule to accommodate nighttime or weekend interviews with you, the individual who struck you, and any witnesses. They take written or recorded statements.

The adjuster then calculates the repairs required and could work with an auto-damage assessor to estimate the cost of repairs. Next, the adjuster creates a report for the claims examiner, who checks through the vehicle claim to verify the adjuster follows business regulations and other requirements.

After the examiner authorizes your claim, the adjuster negotiates with you to settle the claim and determine how much money you receive. If you believe the offer isn’t excellent and fight the settlement, the adjuster will defend the insurer’s stance and settlement offer. If you accept the settlement offer, the insurance either gives you a cheque or pays the auto-body shop to complete the repairs.

Adjusters represent the insurance company’s best interests. When in doubt, talk with an attorney. You could also opt to engage a public adjuster, who negotiates with an insurance company on the policyholder’s behalf.

Types of Adjusters

Several adjuster categories exist, however some may go by various names depending on the position and state. A few examples:

  • Catastrophe adjusters: Conducts claim evaluations following an incident such as a hurricane or tornado
  • Crop adjuster: Investigates and resolves crop insurance-related claims
  • Property and casualty adjuster: Investigates and pays damages for a property and casualty insurance business, which generally includes vehicle insurance
  • Public adjuster: An adjuster employed by a policyholder to argue for a claim
  • Health insurance adjuster: Analyzes hospital and provider invoices, and negotiates compensation with out-of-network providers

Commonly Asked Questions (FAQs)

What are insurance adjuster education requirements?

To become an insurance claims adjuster, one must acquire a minimum of a high-school education or GED. Insurance claims adjusters normally are certified as specialists in their area of insurance and may need a license, depending on state standards. The adjuster knows numerous insurance plans and can read and interpret complicated contracts.

What is a public insurance adjuster?

A public insurance adjuster is engaged by consumers or companies to discuss their claim with the insurance company. Customers typically employ a public adjuster when a claim is refused or to contest their insurance company’s claim offer. In principle, you may pay up to 15% of your settlement offer to the public insurance adjuster, even if you don’t wind up with a greater payment.