What Does an Insurance Claims Adjuster Do?

by RAJ KAMAL Technology, Travel,Health & Medical

An important role is played by insurance claims adjusters in the insurance industry. Catastrophes and accidents are common occurrences around the world, and that’s why the need for adjusters remains consistent.

Claims adjusters evaluate insurance claims on behalf of insurance companies and decide who is liable. They are responsible for investigating the circumstances of insurance claims by consulting with witnesses, reviewing police reports, and putting together evidence from other sources. They oversee that claims are paid out to policyholders. For this, they negotiate claim settlements.

Insurance claims adjusters make work for the following:

Insurance companies
Agencies
Government organizations
Health insurance carriers, etc.

Using investigative, analytical and critical thinking skills, an insurance claim adjuster gathers information and essential details to find out what exactly happened and after that, he/she finds a fair settlement price. Police reports, witness statements, photos of an incident or property damage, statements from people involved, etc. are also collected as a standard practice.

Common responsibilities for Insurance Claims Adjusters

Investigating the nature of the damage being claimed
Interviewing witnesses to understand the nature of the claim
Gaining an understanding of what occurred prior to the claim
Assessing police reports, video footage, previous insurance claims, etc. to understand everything about the incident in detail
Creating reports detailing the events and damages related to the claim
Researching the costs of damage repair
Reviewing the claim holder’s insurance policy for determining the coverage
Coordinating the services of mechanics, architects, contractors, etc. for ensuring damage is repaired
Negotiating claim settlements with claimants and/or their legal teams

In order to determine the extent of insuring a company’s liability, a claims adjuster thoroughly investigates the claims. He/she also handles property claims that include damage to structures as well as liability claims (personal injuries or third-person property damage). The adjuster reviews the case after speaking with the claimant and witnesses, researching police or medical records, and inspecting any involved property.

Claims covered

Roof Damage
Flood Damage
Fire Damage
Water Damage

Storm Damage
Lightning
Mold Damage

Insurance claims adjusters evaluate the claims and calculate the payout of the policyholder on the basis of the severity of policy coverage and the loss. For instance, your insurance company assigns you a claims adjuster when you file a home insurance claim. His job is to fairly reimburse you for your claims keeping in mind your policy coverage and your loss.

However, many homeowners choose to hire public adjusters to assist them during the entire claims procedure. These professionals work independently and act on behalf of the policyholder. Just like a claims adjuster, a public adjuster also evaluates the damage to your property, assesses the scope of repairs, and determines the replacement value for the repairs.

The insurance claims adjuster gets a percentage of the claims payout when he/she settles the claim. When deciding the claims payout amount, the insurer should not consider the payment amount owed to the adjuster as this amount comes from the homeowner who appointed the adjuster.

Hire an insurance claims adjuster

You may hire an insurance claims adjuster in a number of situations. He/she will take care of everything when you work with him/her. So in case you do not have the time or the energy to deal with the stressful claim procedure, you should consider hiring a professional. A claims adjuster will represent you, and the entire process will be quite smooth. Save yourself from the trouble!

Especially when you are facing a large claim, then insurance claims adjusters are of great help. They look closely at your claim and make sure they miss nothing. In some cases, you may get a bigger payout for repairing the identified damage depending on the findings.

Many homeowners are choosing to hire insurance claims adjusters in order to save themselves from stress. If you have had poor claims experiences in the past, then you should also think of hiring a professional to do the task for you. An independent works for you, not for the insurance company. His/her main priority is your claim payout. Also, there is no conflict of interest with the insurance company.

Based in Florida, Santos Public Adjusters is a well-known name when it comes to insurance claims adjusting. Having more than 25 years of experience in the insurance industry, Gustavo Santos, President & Lead Public Adjuster, is well-versed in the nitty-gritty of insurance company procedures and guidelines. Over all these years, he has successfully represented a huge number of people on their claims detail-oriented approach, and strong communication skills.

Our experts will help you if your claim has been denied on your damaged business or home. We also offer the facility of scheduling free inspections. Thus, we guarantee excellent quality service to all our esteemed clients!