What Does A Claims Adjuster Do?

Many things in the legal world can be confusing, and often we find ourselves thinking, what does that mean? A claims adjuster is no different.

It can sound a bit alien, like a piece of online tech rather than a person. Today, we will answer the question once and for all: what does a claims adjuster do?

A Definition 

A claims adjuster is a person who will inspect the damage for insurance purposes. They will examine the damage done to vehicles, homes, or businesses to determine how much financial obligation your insurance company has to payout.

For example, if you were in a car accident, a claims adjuster would view the damage on your car and the events of the accident to determine the amount of money you should be awarded.

Claims adjusters are often asked to provide surveillance for the insurance company within their community or state too. Let’s take a closer look at the role of a claims adjuster now. 

What does a claims adjuster do

What does the job look like?

There is a lot involved in being a claims adjuster, and the variety of the role will depend on the insurance company they are employed by. Generally speaking, a claims adjuster is responsible for investigating, evaluating, and settling insurance claims.

So how do they do this? We are going to run you through generally how this is done. The first thing they will need to do is some research. The research involves studying the insurance policy to find out how much the company should be paying out.

Sometimes surveillance will be required to rule out any fraudulent claims. This is vital to ensure that the insurance company’s money is not being wasted. Police reports can also be helpful to determine what occurred during the accident.

The next step involves contacting people, such as doctors or the employer of the claimant. They may need to question these professionals about questionable claims that have been made and may need to confer with legal counsels if necessary.

A claims adjuster is responsible for negotiating the settlement and authorizing your payments, so they need to understand what their company insures.

For example, if they are assessing the damage to a house, they will need to understand housing and construction costs to ensure the cost is appropriately covered.

Once they have evaluated the cost to cover the insurance company’s damages, it is time to settle with all parties. They must ensure that everyone agrees with the settlement to ensure that the issue can be resolved swiftly.

It would be at this point you could enter into negotiations with the settlement amount if you wish.

What’s the work like?

Claims adjusters typically work in an office but will spend time out in the community while investigating, speaking to the relevant people, and assessing the damage.

Sometimes the work can be done over the phone, although some will prefer face to face contact. Sometimes a claims adjuster will visit the incident scene, such as the home or scene of an accident, to take their notes or photographs if that is necessary.

Typically the hours are around 40-50 per week and can be quite stressful at times. It can be a very demanding job, and there can be pressure applied to ensure that the insurance companies are not paying out unnecessarily.

Who can you work for?

As a claims adjuster, you can work as an independent contractor, which provides you with an element of flexibility surrounding your working week.

As a successful claims adjuster, you may be approached directly by clients to work on assessing claims. The choice of who you work with can be very freeing, although there are always drawbacks to freelance work.

More often, claim adjusters work for insurance companies, such as a car or home insurance firms. According to the Bureau of Labor Statistics, the job growth rate for this field is slower than the average, but with a shift in the population, this is set to change.

Now that people live longer, medical insurance companies are frequently looking for claim adjusters to intervene in medical disputes. A claims adjuster would need a working understanding of medical costs and health insurance policies within this area.

How do you become a claims adjuster?

If this sounds appealing to you, you may be wondering how you, too, can be a claims adjuster. At a minimum, a high school diploma and on-the-job training are a good way into this field.

However, it’s increasingly common for employers to look for employees with associates currently or hold a bachelor’s degree in business, accounting, or a relevant field such as law.

The requirements vary depending on what state you are working in, but you may need a license to work as a claims adjuster. To get the license, you must take a relevant exam, and in certain states, you need to have clocked a certain number of hours of experience.

Be sure to check in your state to find the requirements you will need to meet. This information will be easily accessible online or by speaking to a local insurance company also.

As well as this, you will also need to be a hard-worker who can work independently and as part of a larger team. You will need to have excellent communication skills and researching skills. Whichever relevant field you would be working in, you would need to understand it, such as housing costs to assess fire damaged properties.

Final Word

Before you leave today, let’s round-up what it is a claim adjuster does. A claim adjuster’s job is to assess the cost an insurance company will pay out after damage to vehicles, homes, or businesses.

It is their job to determine the claim’s validity, make adjustments where necessary, and suggest how much money the insurance company should pay for the damages.

The work can involve research, assessing the damage, and speaking to professionals to chase up any suspicious claims to ensure they are all valid or dismissed.

The work can be stressful at times and has opportunities at corporate or independent levels assessing a wide range of claims. It can be an exciting field, ensuring that claims are correctly dealt with. 


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