What does an insurance claims adjuster do?

July 22, 2020

Insurance claims adjusters play an essential part in getting you back on your feet

An insurance claims adjuster evaluating an auto claim

Filing an insurance claim is seldom something we want to do; it usually means that something has been damaged. However, a good insurance claims adjuster can help make the process as smooth as possible and get you back on your feet in no time. But what does an insurance claims adjuster do, exactly? How do they fit into the claims process? Today, we'll answer some common questions and shed some light on this important insurance role!

Where does a claims adjuster fit into the claims process?

There are a number of scenarios in which you might have an interaction with a claims adjuster. For example, if you are involved in an auto accident and you are not at fault, you will likely have an interaction with an adjuster representing the insurance of the at-fault party.

However, for the purpose of this blog, we'll be discussing the role of an adjuster as it relates to a claim you file with your insurance. For example, if you have comprehensive auto insurance, and you have a collision with an animal and need to file a claim with your insurance carrier, you will work with one of their adjusters. 

When you call your insurance company to file a claim, you'll typically talk to a claims customer service representative. They ask questions about your claim, take necessary details, such as your insurance policy number, and record any preliminary information you can provide. Once the case has been created, it is assigned to an insurance claims adjuster. 

After being assigned the claim, the adjuster makes contact with the policyholder to let them know they're on the job and get the process moving. They act as your point of contact within the insurance company, and can answer questions about policies and coverages as needed. After they've had the initial discussion with the policyholder, they'll schedule an appointment to evaluate the claim. 

Do I have to meet with a claims adjuster in person?

Investigating and evaluating a claim is a key part of an adjuster's role in the process. This is often done in person, but doesn't necessarily have to be at your home. For example, if your vehicle is in working condition and is safe to drive, an adjuster may be able to meet you at your place of work. If your vehicle doesn't work, or isn't safe to drive, they'll have to travel to wherever it is currently being stored. Similarly, property claims, like a roof damaged by hail, will require an in-person inspection and evaluation.

However, in some cases, an in-person meeting isn't necessary. For example, if your vehicle is capable of driving safely, some carriers have preferred service shops that can perform the inspection on behalf of the insurance company. In this case, the adjuster would help put you in contact with the shop, but wouldn't need to schedule a separate meeting. 

Additionally, with the rise of mobile technology, many insurance carriers have apps policyholders can use to take photos of the damage and submit them. In this case, the adjuster usually sends you the app information and provides instructions for use. Not only can this help save policyholders time, it can speed the process of the entire claim up. 

How does a claims adjuster evaluate a claim? 

During the appointment, the adjuster performs a variety of tasks in order to evaluate the claim. They'll discuss the incidents surrounding the claim with you, gather additional information, and take photos and videos where necessary. In some cases, an adjuster may need to conduct further research after the visit, depending on how much information is available beforehand. For instance, they may need to examine a police report, speak with an expert, or, in some cases, speak with other parties involved (in an accident for example). In the event of a personal injury or liability claim, they may have to interview witnesses, third-parties, and potentially review medical records.

In general, though, claims adjusters are experts in their own right. They are well versed in the types of losses and damages that are usually involved in a claim. Auto insurance claims adjusters know their way around vehicles, and have a firm grasp on standard repair practices and costs. Property insurance claims adjusters understand how a home is put together, and understand the processes contractors use to repair one.

Their job is to provide a fair evaluation and ensure that the policyholder is able to return their property to like kind and quality as quickly as possible. For this reason, adjusters do their best to complete their estimate and issue a check on the spot whenever possible.

There are, however, occasions where the adjuster will write the check to the repair shop directly, or in the case of a property claim, to the contractor. This largely depends on the specific circumstances of the claim and can vary from company to company. When filing a claim, make sure to speak with the claims customer service representative or the adjuster to find out how the claim will be paid and to whom it will be addressed. 

What happens if the adjuster misses something?

While claims adjusters call upon extensive training and experience to perform an accurate estimate of repair and replacement costs, it is certainly possible for unforseen costs to arise. That's why it's important to remember that the claim isn't necessarily finalized just because an initial payment has been issued. 

For example, let's say you were recently in a car accident. The adjuster performed their inspection, and determined it would cost $1000 to repair your front bumper. However, once the mechanic began the repair process, they found out that their was a small puncture in the radiator caused by the accident, and it needs to be replaced. Of course, this is going to cost more for additional parts and labor.

The extra cost to repair the radiator is called "Supplemental Damage" and it is not as uncommon as you might think. In such a case, the claims adjuster would review the new information and estimate from the shop, ensure that it is a covered loss, and issue additional payments to cover the costs. 

An insurance claims adjuster and a policyholder discussing a claim

When you’re filing a claim, great customer service is essential. Since 1896, Germania Insurance has been the Insurance Texans Trust for great coverage and outstanding customer service. But don’t take our word for it! Hear what our customers have to say

For more information about our insurance products, request a free quote online, or reach out to one of our trusted agents today!

Read more: Want to learn how technology is changing the way claims are handled? Check out our blog!

by Geoff Ullrich

About the Author

Geoff Ullrich is a writer and Content Marketing Strategist at Germania Insurance.

What do you want to read more about? For suggestions, questions, or content-related inquiries, contact us at content@germaniainsurance.com!

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