Insurance Adjusting 101

Insurance adjusters are trained to look for coverage per the terms of an insurance policy. It’s a common myth that insurance companies are trying to avoid paying claims; this couldn’t be further from the truth. So what is insurance adjusting?

The job duties of an insurance adjuster are to review the damage, communicate with claimants, and negotiate a settlement. A professional adjuster works for a company or independently as a freelancer. Click here for more info.

Assessing Damages

Insurance adjusters are professionals who investigate and evaluate claims to determine how much an insurer should pay a policyholder for a covered loss. This is accomplished through a process of reviewing and analyzing evidence, interviewing claimants and witnesses, consulting police and medical records, and inspecting property damage.

Adjusters review the facts of a loss, compare it to a policy’s coverages and limits, and then calculate a fair and reasonable settlement. They also examine the policy to identify potential risks and fraud and report their findings.

Desk adjusters, or inside adjusters, work in the office, where they collect information and data on a claim using their computers. Field and Catastrophe (or CAT) adjusters travel to the scene of an accident or disaster to take pictures, meet with witnesses and victims, inspect the property, consult with roofing or fence experts, etc. These professional investigators are the first people from an insurance company that you will encounter after a loss.

Communicating with Insureds

Insurance adjusters must have great people skills, especially when on a catastrophe deployment. Their job is to communicate with insureds, who may be upset and suspicious. They also often have to work under less-than-ideal conditions, such as power outages and spotty cell service.

Adjusters investigate the details of a loss and determine how much to pay on behalf of an insurer. They must be familiar with the insured’s policy, the insurer’s policies and procedures, and their company’s specific policies.

An insurance adjuster must also be aware of any potential ethical issues that arise in the course of their investigation, such as accepting bribes or contractor kickbacks. These pitfalls can result in an adjuster being decertified or even losing their license. This is why it’s essential that all adjusters maintain the highest standards of integrity.

Negotiating with Insurance Companies

Insurance adjusters investigate and settle insurance claims with insurers. They can be employees of an insurer, independent third parties, or licensed public adjusters.

It’s important to understand how insurance adjusting professionals negotiate with insurers to get you the most out of your claim. Adjusters are professional negotiators who have experience working for the insured as well as the insurer.

They know the law in ways you don’t, and they use this knowledge to swindle you out of a fair settlement offer. This is why being well-informed about your policy and armed with evidence is essential.

Many people report to United Policyholders that their first adjuster offered a settlement sum, then left the company or was reassigned and rescinded that offer. This is a practice called the “unauthorized practice of adjusting” and it’s a growing problem in our industry. Accountants, restoration companies, and contractors all too often attempt to perform adjusting tasks without a license. This is dangerous to both insureds and the profession as a whole.

Litigating

After you’ve submitted a claim, it can go through a long process. Many claims are resolved out of court, but some end up in litigation. In this case, an insurance adjusting professional will be in your corner every step of the way.

Litigated adjusting professionals are responsible for reviewing, investigating, evaluating, and negotiating toward the resolution of litigated property, homeowner, and liability insurance claims. This includes providing pre-suit mediation and pursuing legal liability in complex property and homeowner insurance matters.

Insurance adjusting professionals may be employed by an insurance company or independent adjusters working on behalf of the insured. Those who work for an insurance company have a vested interest in saving money, while those who are independent are interested in maximizing the size of the settlement. Click here for more interesting articles.