UMHToday 
If you’ve ever filed an insurance claim after an accident, natural disaster, or theft, you’ve likely encountered an insurance adjuster. But what exactly does an insurance adjuster do, and why are they so important in the insurance claims process? Whether you’re dealing with property damage, auto insurance claims, or health-related claims, understanding the role of the adjuster can help ensure you get a fair and timely settlement.
In this guide, I’ll explain what an insurance adjuster is, their responsibilities, the types of adjusters you might encounter, and tips for working with them to make the claims process as smooth as possible.
What Is an Insurance Adjuster?
An insurance adjuster is a professional responsible for investigating, evaluating, and settling insurance claims. They work on behalf of the insurance company to determine how much the company should pay the policyholder for the damages or loss covered under their policy. The adjuster’s main job is to assess the extent of the damage, verify the validity of the claim, and negotiate a fair settlement between the insurer and the policyholder.
Insurance adjusters are critical to the claims process because they serve as the link between the insurance company and the policyholder. Their assessment and recommendations directly influence how much money you receive to repair or replace the damages.
Types of Insurance Adjusters
There are several types of insurance adjusters, each working under different circumstances or for different parties. Let’s break down the three main types:
1. Staff Adjusters (Company Adjusters)
A staff adjuster, also known as a company adjuster, is an employee of the insurance company. Their primary responsibility is to protect the financial interests of their employer while ensuring that claims are settled fairly. Staff adjusters typically handle a wide range of claims, from home and auto insurance to business insurance.
- Pros: They have a deep understanding of the company’s policies and processes, which can speed up the claims process.
- Cons: Since they work for the insurance company, their priority is often minimizing the payout, which may not always align with the policyholder’s best interests.
2. Independent Adjusters
Independent adjusters work as contractors for insurance companies. They are hired when the insurance company needs additional manpower or expertise, especially during natural disasters or large-scale events when claims volumes are high. Like staff adjusters, independent adjusters are tasked with assessing the damage and determining an appropriate settlement on behalf of the insurer.
- Pros: They often have more flexibility and experience handling diverse claims, especially during emergencies.
- Cons: Since they are still hired by the insurance company, their loyalty may still be to the insurer, not the policyholder.
3. Public Adjusters
Public adjusters are hired by the policyholder, not the insurance company. Their role is to advocate for the policyholder and ensure they receive a fair settlement based on the terms of their policy. Public adjusters are particularly useful in complex claims or cases where the policyholder believes the insurance company’s offer is too low. Because they work for you, a public adjuster is motivated to secure the highest payout possible.
- Pros: They work solely for the policyholder and have the expertise to maximize the claim settlement.
- Cons: Public adjusters charge a fee, usually a percentage of the settlement (typically around 10-20%), which will reduce the amount of money you ultimately receive.
Responsibilities of an Insurance Adjuster
Regardless of the type of adjuster you’re working with, all adjusters generally follow a similar process when evaluating claims. Their responsibilities include:
1. Investigating the Claim
Once a claim is filed, the adjuster will contact you to discuss the details of the incident and schedule a visit to inspect the damage. During this investigation, they may do the following:
- Conduct interviews with you and any witnesses to understand what happened.
- Inspect the damage to property, vehicles, or other assets.
- Request any relevant documentation, such as receipts, medical records, or repair estimates.
- Take photographs, videos, and measurements to document the extent of the damage.
2. Evaluating the Damage
After gathering all the necessary information, the adjuster will assess the value of the claim based on the insurance policy. This involves determining the cost of repairs, replacements, or any medical bills related to the claim. They will also review your insurance policy to ensure that the damage or loss is covered.
The adjuster may consult experts, such as contractors or mechanics, to get estimates for repairs or replacements. They will then compare these estimates with industry standards and the limits of your policy.
3. Negotiating the Settlement
Once the adjuster has evaluated the damage and reviewed your policy, they will offer a settlement amount. This is the sum of money the insurance company is willing to pay to cover the damages or losses. If the initial offer doesn’t fully cover your expenses, you may need to negotiate with the adjuster.
In this stage, it’s important to remember that you can dispute the adjuster’s findings if you feel the settlement is too low. This is where having a public adjuster or your own estimates for repairs can be valuable.
4. Finalizing the Claim
After agreeing on a settlement, the adjuster will issue the payment, allowing you to begin repairs or replacement. In some cases, the adjuster may provide a partial payment upfront, with the remaining balance paid after repairs are completed.
How to Work Effectively with an Insurance Adjuster
Filing an insurance claim can be stressful, but knowing how to work effectively with your adjuster can make the process smoother. Here are some tips for working with an insurance adjuster:
1. Be Prepared with Documentation
Gather all the necessary documents before the adjuster visits. This might include receipts, repair estimates, photos of the damage, police reports, and medical records. The more information you have, the easier it will be for the adjuster to assess your claim.
2. Be Honest and Thorough
When discussing your claim with the adjuster, be as honest and thorough as possible. Provide a detailed account of the incident and any damage or loss. Hiding information or exaggerating the claim could hurt your chances of a fair settlement.
3. Ask Questions
If you don’t understand something during the claims process, don’t hesitate to ask the adjuster for clarification. Insurance policies and claims can be complex, so make sure you’re clear about what’s covered and what isn’t.
4. Get Multiple Estimates
If you disagree with the adjuster’s estimate for repairs or replacements, consider getting independent estimates from contractors or specialists. This can help you negotiate a better settlement if the initial offer is too low.
5. Consider Hiring a Public Adjuster
If the claim is large or complex, or if you feel the insurance company is not offering a fair settlement, consider hiring a public adjuster. They can help advocate on your behalf and ensure you receive the maximum settlement possible.
Conclusion
Insurance adjusters play a crucial role in the claims process by investigating, evaluating, and settling claims. Whether you’re working with a staff adjuster, an independent adjuster, or a public adjuster, understanding their responsibilities and how to work with them effectively can make the process smoother and more transparent.
When you file a claim, make sure to document everything, stay honest, and ask questions. If needed, don’t hesitate to seek outside help from a public adjuster to ensure you get the compensation you deserve. With the right approach, you can navigate the insurance claims process with confidence.
FAQs About Insurance Adjusters
1. How long does it take for an insurance adjuster to process a claim?
The time it takes to process a claim depends on the complexity of the claim, the type of insurance, and how quickly you provide the necessary information. For smaller claims, it can take a few days to a couple of weeks. Larger or more complex claims may take longer.
2. Do I have to accept the insurance adjuster’s first offer?
No, you don’t have to accept the first settlement offer. If you believe the offer is too low, you can negotiate or provide additional documentation to support a higher settlement amount.
3. What should I do if I disagree with the adjuster’s decision?
If you disagree with the adjuster’s assessment or settlement offer, you can request a review of your claim, provide additional estimates, or hire a public adjuster to advocate on your behalf.
4. Can a public adjuster help me get more money for my claim?
Yes, public adjusters work for the policyholder and can often help secure a higher settlement by thoroughly reviewing your claim, negotiating with the insurance company, and ensuring that all damages and losses are accounted for.
5. How much does a public adjuster cost?
Public adjusters typically charge a fee based on a percentage of the final settlement amount, usually ranging from 10% to 20%. This fee is deducted from the settlement, so it’s important to weigh the cost against the potential benefit of hiring one.
