Definition of "Insurance Adjuster"

The adjuster definition is directly related to insurance and, more exactly, insurance claims. An insurance adjuster is responsible for evaluating insurance claims to determine how liable the insurance company is based on the terms of the owner’s policy. They handle various facets of insurance claims depending on their expertise and type.

The two main focuses of insurance adjusters are property claims and liability claims. They evaluate the insurance claim that the insurance company covers through a policy and the amount covered. There are three main types of insurance adjusters, and they are also known as insurance claims agents or claims adjusters.

What is an Insurance Adjuster?

Probably most people came in contact with insurance companies and agents, so we know what an insurance policy is for. But what does an insurance adjuster do? 

Well, to put it simply, once you have the insurance policy for your car, house, health, or life insurance, you are, technically, covered. We only say technically because the policy ensures a cover, but its value is determined based on the individual case. So, once you are covered, in case an event happens that requires the coverage of the policy, you file a claim. That is when the insurance adjuster comes into play.

The first thing that they do is verify that the insurance policy is valid and not expired. Then they have to determine if the policy covers that particular event. Lastly, they investigate the event that occurred and incurred the damage on which you claim compensation. They are the ones that can determine if an insurance fraud takes place along with lawyers and law enforcement when necessary or when a fraudulent claim occurs. They are also the ones who determine the amount of the claimant’s compensation, which may include negotiations.

How to become an Insurance Adjuster?

There are several requirements to become an insurance adjuster. Firstly, a high school diploma is mandatory, while many insurance companies also demand an associate or bachelor’s diploma in a relevant field. There are also state licensing regulations that an insurance adjuster must conform to, and obtain the insurance license, which is the final step.

Types of Adjusters

There are three principal types of insurance adjusters, but the requirements above apply to all of them. Based on the type of insurance adjuster, they are contracted to manage various insurance claims. 

Staff Adjusters

When a policyholder suffers damage, one of the first things they do is call their insurance agent. The agent then puts the policyholder in contact with a staff adjuster. Staff adjusters are hired on a full-time basis by insurance companies to handle any and all types of insurance claims. Their position applies to any type of tangible or intangible assets. They investigate, evaluate, and settle claims for the insurance company they work for. In some cases, staff adjusters are allowed to award the claim to the insured directly by writing a check. Real estate adjusters are sent to the policy holder’s home to investigate the cause of the damage, the expense, and the amount of compensation accurate for the damage.

Independent Adjusters

The independent adjusters are called independent because they do not have a long time employment contract with insurance companies. They usually work for third-party companies that are specialized in homeowners insurance or other types of insurance claims. Independent adjusters are hired on an as-needed basis by insurance companies to determine and investigate claims. They outsource the claim to the claim-handling company that they work for as well as the adjustment process. Once the claim is investigated and evaluated. That report is given to the policyholder who then presents it to the insurance company their policy is from. Independent adjusters are considered more objective than staff adjusters as they are not bound to the insurance company, therefore they can make a fairer evaluation. Insurance companies appeal to them to ease their workload, to get a more specialized adjuster in cases of rare and uncommon insurance claims.

Public Adjusters

The public adjusters are contracted by the policyholder and not by the insurance company. They never represent the insurance company. Policyholders appeal to public adjusters when they want their own evaluation of the damage suffered during an event and they help them file the claim for the insurance company. In case a staff or independent adjuster that comes on the behalf of the insurance company determines a compensation amount that is considered too low by the claimant, they can contract a public adjuster. Because of their complete objectivity towards the insurance company, public adjusters can help policyholders save a lot of money by making sure that the insurance company awards the entire amount that they are due under the policy in question.

image of a real estate dictionary page

Have a question or comment?

We're here to help.

*** Your email address will remain confidential.
 

 

Popular Insurance Terms

Type of policy with premiums that are fully paid up within a stated period. For example, a 20-payment life insurance policy has 20 annual premium payments, with no further premiums to be ...

Defined contribution pension plan in which employer contributions are set under a collective bargaining agreement. It usually covers the employees of a number of firms and is administered ...

Amount of loss that insured pays in a claim; includes the following types: Absolute dollar amount. Amount the insured must pay before the company will pay, up to the limits of the policy. ...

Form of stock ownership that permits the stockholder to select a beneficiary to receive the stock upon the death of the stockholder. The stockholder retains all rights of stock ownership ...

Endorsement to the special multiperil insurance (smp) policy that provides all risks damage coverage for personal property. There are special limitations on amounts of coverage for furs, ...

Decision in the absence of a plaintiff or defendant at the specified court time. ...

Employees participating in and covered under an employee benefit insurance plan. ...

Provision for known claims due but not paid, known claims not yet due, and provision for incurred but not reported (IBNR) claims. The critical problem facing a casualty insurance company is ...

Value of loss resulting from loss of use of property. For example, a fire damages the structure of business premises and the business loses customer income until it can reopen. The loss in ...

Popular Insurance Questions