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 guaranteed investment contract in which the interest rate credited is tied to an external index such as the United States Treasury Bond Index. ...

Instrument that uses noncombustible substances such as carbon dioxide to deprive a fire of oxygen, thereby extinguishing it. ...

Insured losses that have occurred but have not been reported to a primary insurance company. These types of claims have a tremendous effect on a reinsurance treaty, which may be showing a ...

Organization of over 300 property and casualty insurance companies whose mission is to investigate fraudulent claims and bring to justice those making such claims. ...

one in which the amount and frequency of payment may fluctuate. ...

Stated fixed payment for maternity costs regardless of the actual costs. ...

Type of health maintenance organization (HMO) that issues contracts to independent physicians. These physicians are paid a per visit fee for seeing an HMO member or are paid an annual fixed ...

Same as term Floater: coverage for property which moves from location to location either on a scheduled or unscheduled basis. If the floater covers scheduled property, coverage is listed ...

Actions not allowed between a trust and a disqualified person under the employee retirement income security act of 1974 (erisa). The disallowed actions are designed to prevent a conflict of ...

Popular Insurance Questions