UPDATED: Mar 13, 2020
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An adjuster or claims adjuster is a salaried employee of your insurance company who assists the policyholder with a claim.
The adjuster will be the policyholder’s primary line of communication with the insurance company. The adjuster will investigate the claim, assess the damages, then determine how much the policyholder is owed.
The specific role of an adjuster may vary from company to company. With many companies, however, the adjuster can assess a damaged vehicle for technical issues to determine cause and effect after an accident.
Sometimes, the adjuster will keep the policyholder informed throughout this process. In other cases, the policyholder is kept in the dark, and the adjuster is free to do his or her work until delivering the final payout to the policyholder.
Types of Auto Insurance Adjusters
There are several types of claims adjusters. Those that are usually involved in auto insurance claims, however, typically fall into one of the following categories:
Property Claims Adjusters: Property claims adjusters assess the damage caused to other vehicles, structures, or other property during an accident.
Liability Claims Adjusters: Liability claims adjusters are used to assess personal injuries and other third party damage after an accident, including hospital bills, lost wages, and other expenses that the at-fault driver may owe to the injured party.
Multi-Line Adjusters: Multi-line adjusters can handle all aspects of claims adjustment. These adjusters are particularly common in the auto insurance industry.
What Do Claims Adjusters Do?
Claims adjusters perform a variety of roles to ensure the auto insurance claims process goes smoothly.
First, the adjuster will ensure the incident was covered under your current auto insurance policy.
Then, the adjuster will investigate who is to blame for the accident (if anyone).
Finally, the adjuster will ensure appropriate compensation is paid to all parties involved, including any coverage for car repairs, medical bills, lost wages, property damage, emotional or physical damage, and more.
Throughout this process, the adjuster will be in communication with the policyholder and any other parties involved. The adjuster might check the police report and talk to the police to determine the truth behind the accident. The adjuster will check the vehicle and analyze the damage.
The adjuster may also talk to a certified repair shop to determine how much the repairs should cost.
If there’s no evidence of wrongdoing and the adjuster has no other concerns, then the adjuster will plug all of the above information into a formula, then deliver the final payment to the policyholder (assuming the policyholder is owed payment).
What Do Adjusters Look For?
Adjusters are salaried employees of your insurance company. Their goal is to protect their employer’s interests while ensuring your claim is closed as quickly as possible.
With that in mind, adjusters receive special training in how to detect fraud. You might claim damage to your vehicle was from a hit and run, for example, when it’s actually from you scraping your car against the wall of your garage.
Adjusters know what certain types of damage look like. They understand the difference between a fender bender caused by a vehicle and a fender bender caused by backing into a pole.
Adjusters will also look for pre-existing damage to your vehicle. Your insurance company will not cover pre-existing damage after an accident. Furthermore, certain pre-existing damage may preclude you from making future claims. If you failed to repair your brakes and then got into an accident because your brakes didn’t work, then your insurance company might deny your claim.
The adjuster will take all of this into consideration when processing your claim. Ultimately, the goal of the adjuster is to pay you the lowest amount they are legally required to pay on your claim.
Claims adjusters play a crucial role in the insurance industry, protecting the interests of the insurer while ensuring policyholders receive fair treatment.
A good claims adjuster ensures your claim is dealt with in a timely, efficient, and fair manner.
Remember, however, that the adjuster’s goal is to protect his or her employer (the insurance company). The adjuster wants to close your claim as quickly as possible while paying the least amount of money legally permitted based on the terms of your policy.