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Claims adjuster is a term used to describe someone who evaluates the damage caused to property or people when an insurance related accident occurs. In the United Kingdom and the Republic of Ireland, the term Loss adjuster is used.
There are three classes of claims adjusters:
- staff adjusters (employed by an insurance company or self-insured entity),
- independent (independent contractors; not insurance company employees)
- public adjusters (employed by the policyholder).
It should be very clear that in the two first instances, the adjuster defends the rights of the insurer and works for a fair settlement for both parties.
Adjusters may handle "property claims" involving damage to buildings and structures, or "liability claims" involving personal injuries or third-person property damage from liability situations, such as motor vehicle accidents, slip and falls, dog bites, or alleged negligent behavior. Some adjusters handle both types of claims and are known as "Multi-Line" adjusters.
An adjuster will frequently verify that coverage applies through an insurance policy, investigate liability for the damages caused, and make restitution to the injured person based on their physical, emotional, or physical property damages.
Specific duties include:
- Responding to claims in a timely manner
- Filing paperwork
- Communicating with policy holders
- Investigate liability
- Assess damages
- Negotiate with product/service providers on time and cost of repairs for the purpose of making an offer of settlement to the insured.
- Ensuring accurate procedures
- Protect the interest of the insurance company the adjuster represents, when dealing with claimants.
Some states now require public adjusters disclose to claimants whose interest specifically independent, staff and public adjuster represent, before they are retained by the policyholder. There is no such requirement at this time for insurance companies to do the same.
Although there are not any claims adjuster majors in college, many insurance companies prefer their claims adjusters to have a 4-year college degree preferably in business related fields, however having a degree in liberal arts is acceptable as well. There are times in which a person with a high school education will become a claims adjuster usually by promotion from within the claims department while serving as a customer service representative. Since there are no college majors for claims adjusters, many states require a state certification in order to practice as an adjuster. States also require that a certain number of continuous educational credits for claims adjusters are earned each year in order to maintain their license. This continuous education is achieved by attending seminars and online training from different claim adjuster educational resources. One brief example of an educational seminar is where a group of claims adjusters will meet and discuss how to distinguish a false claim from a true claim.
Many claims adjusters have a 6 day work week, with benefits. The majority of claims adjusters work more than 50 hours a week, they work nights, and sometimes weekends because claims adjuster usually have to make appointments to see their clients, so the adjuster must be able to adapt their schedules in order to accommodate their clients.
The more experienced claims adjusters are able to work from home. They will receive their work load for that day through their private fax machine or their email accounts. The most common claim adjusters receive their assignments when they arrive at the office first thing in the morning. In the case of a severe natural disaster such as floods or tornadoes, adjusters from another city or town are called in to support the local government. This results in the adjuster being home for days at a time until all claims are resolved.
Laptop computers, cell phones, and other technology has made the process of claims adjusting easier and it consumes less time; however, there are positions that require physical strength as well as stamina. Property adjusters, for example, many times are required to operate a 50-pound ladder, able to stand, walk, kneel, crawl, and other physical demands as they investigate property that has been damaged.