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What is the role of an insurance claims adjuster?

For a lot of people, their interaction with members of the insurance industry often starts and stops with their broker. They help you find the policy that best fits your situation, provide ongoing service, and often act as an intermediary with your insurance company if the time comes when to make a claim.

Insurance companies want to make it as easy as possible for you get back to normal after an unexpected loss, while also performing due diligence to ensure all parties interests are being considered. If you make a claim, you’ll be assigned a claims adjuster, sometimes called an insurance adjuster, a claims specialist, or a claims representative.  Regardless of the title, the adjuster is generally going to be your primary point of contact once the claims process begins – though at DPM Insurance Group, we’re always here to help make sure you have a positive experience while you navigate the claims process.

Basically, an adjuster is responsible for everything from verifying your policy and coverage terms and conditions to making arrangements for repair quotes and car rentals, investigating the accident or damage, gathering any reports and necessary documentation, assigning liability or fault, and determining your settlement.

Here are some of the things an insurance claims adjuster may do to help you get from filing your claim to receiving a settlement:

  • Make the initial arrangements. The adjuster will contact you and provide you with information about your claim, including your claim number, their contact information, repair and rental schedules (when applicable), and whether you will pay a deductible.
  • Investigate the accident or claim details. The adjuster will interview you to get your statement about the events that lead to your car or property damages. They may also review any police statements, injury reports, hospital or medical records, and any other details that will help them understand the extent of your loss. In complex cases they may do this in person, but in most cases, they can get this information over the phone. If necessary, they will interview witnesses, consult experts, and contact third party insurers. This information is collected to determine liability (or fault), assess the situation, and ultimately determine the amount of your settlement.
  • Review all documentation and expenses. An adjuster will review your policy terms and conditions, your degree of liability, the cost of repairs, medical expenses, lost income, living expenses, and any other expenses incurred to determine your settlement.
  • Determine your settlement. Your adjuster will calculate your settlement and present the amount to you. You can discuss the settlement value with your adjustor if you need clarification, if you feel expenses have been missed, or if you are expecting costs that haven’t been billed yet. Be prepared to present this information and documentation to your adjuster.

From the insurance company’s perspective, adjusters also play an important role in preventing insurance fraud, which is estimated to cost Canadian consumers over $1 billion a year. Fraud can range from exaggerated claims to the deliberate staging of accidents or damage. Both end up costing honest policyholders by leading to increased premiums for everyone. During their investigation, adjusters will look for anything that raises concern about possible fraudulent activity – and that shouldn’t be taken personally. It’s simply part of their duties.

In short, insurance adjusters have an important role, helping you with the claims process and negotiating a fair settlement for all parties involved in a loss.

At DPM Insurance Group, we’re hear to help you navigate the insurance process at all its stages, whether that’s finding the best policy to fit your situation or collect on a claim. If you’re interested in reviewing your current policies, or would like a no obligation quote, click here to find the office most convenient for you: https://dpmins.com/locations/


Source: Economical


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