What Is an Insurance Adjuster?
Insurance is a widely used product and often necessary to protect property and life. When an accident or incident does occur, the claim must be examined to determine the details of the loss and the amount to be paid from the policy. An insurance adjuster is a professional who handles these claims in some form or another and makes decisions on the payments to be made.
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Industry
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Insurance is purchasing financial security against a potential risk. Insurance companies hedge the types of insurance and policies against the statistics of how many claims they may have to serve against those policies. Adjusters are key in this process, because they are the agents in the field who determine the amount of the loss if any, that the insurance company will pay out to the claimant. There are several types of adjusters and ways they handle claims.
Fields of Expertise
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Insurance adjusters can specialize in several different fields. Some insurance companies have a broad spectrum of policy types, and an adjuster may have several types of claims to handle, or may be assigned to only one insurance line. In the health insurance field, adjusters determine the validity of medical claims and may deal with fraud from persons claiming permanent disability. Other fields that require experience are often geographically determined in areas such as the Gulf Coast where hurricanes are common and large numbers of property damage claims can occur at one time.
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Process
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An adjuster must examine all the details of a claim and the incident it involves. This may include examining records pertaining to the case, whether a police report or medical records. An adjuster goes out in the field when claims are property damage, and may employ techniques to re-enact an accident to determine cause and fault. Interviews with claimants, witness, and law enforcement may enter into the work.
Technology and Automating
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Certain types of claims can be done in bulk because of common occurrence, such as car accidents. These are done in claim centers, and much of the work is based on the similar incidents, compiled data, and employing trusted partner companies such as auto repair shops that agree to accept a standardized payment for particular types of claims. This can speed the process for the insured, the insurance carrier and makes the repairs occur faster. These make a position for what is called a claims examiner, which is a form of adjuster who frequently works in the office examining claims that have already been processed by reviewing them.
Specialties
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Adjusters, examiners, appraisers and investigators are all forms of this career. An adjuster typically works in the field conducting assessments and examining damage, and often must be available at all hours when a claim occurs. Examiners typically work in an office setting, conducting reviews and examining claims for discrepancies. An appraiser is in the field, assessing damage firsthand and determining value, generally in the auto insurance field. Appraisers usually do their job in the field and use laptop computers to process claims. The investigator is called in when fraud is suspected and works closely with law enforcement. Often insurance investigators must conduct surveillance and may work in a hostile environment as they are dealing with claims most often that are being disputed.
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References
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