The Difference between a Claims Adjuster & an Underwriter

The Difference between a Claims Adjuster & an Underwriter
••• David De Lossy/Photodisc/Getty Images

Claims adjusters and underwriters are both important within the framework of an insurance company. However, their roles and the type of work that they do are quite different with regard to involvement with the insurance process and interaction with insured policyholders.

Type of Work

Simply describing the type of work claims adjusters and underwriters perform for insurance companies demonstrates major differences. Underwriters review application materials for an insurance policy, determine the risks associated with offering an individual or business policy, and prepare the terms and conditions of the insurance policy. Adjusters investigate claims by policyholders to review the basis of a claim, negotiate settlements with policyholders and authorize payments when applicable.

Timing

The timing of the involvement of the adjuster and underwriter in the insurance policy also denotes a significant difference. Insurance underwriters are involved before a policy is purchased and in place. They decide whether the provider will even issue a policy and under what terms. Claims adjusters, on the contrary, only enter the picture when you have insurance in place and are in need of a claim resolution.

Risk Management

One way to characterize insurance is a process of risk transfer from the policyholder to the insurer. Underwriters and adjusters have different roles with regard to the insurer's risk management. Underwriters typically use various data and metrics to consider the risks in offering a policy and what rates justify issuance. Adjusters more often deal with the payout side of insurance and have to weigh the risks of paying out too much on settlements and alienating customers.

Service Effect

Insurance is an intangible service-driven industry. Customers buy insurance to avoid major financial devastation from a covered event. Underwriters and adjusters each have customer service responsibilities, but in distinct ways. Underwriters perform a more subtle, up front and behind the scenes type of service by reviewing applications for coverage and putting together policies. Adjusters have more direct customer service responsibilities, especially in the early 21st century where retaining customers is critical to long-term viability. Adjusters need to communicate consistently with customers during a claim and accurately process claims and payouts.