|
Function of an
Insurance Adjuster
You have been the victim of a car accident. You have a
damaged car and possibly injuries to yourself as well. After the responsible
party has alerted their insurance company of the incident you will soon get a
call to clarify the details of the crash from your point of view. The next call
you receive is from the insurance adjuster assigned to your case. It can be
intimidating talking to someone from the insurance company. To help you better
in your negotiations with the adjuster it is important to understand the
function of the insurance claims adjuster.
The U.S. Department of Labor’s Bureau of Labor Statistics (www.bls.gov)
describes in its
Occupational Outlook Handbook the function of
an insurance adjuster as negotiating settlements and authorizing payments. Part
of their job is to investigate insurance claims especially when there is a
question of liability or where fraud is suspected. The claims adjuster is called
to action after the insurance company they work for has sustained a loss.
A loss to an insurance company is when a policyholder submits a claim or
requests compensation for their loss in the form of a payment. The adjuster’s
job is to basically negotiate to a payout for the least amount of money
possible. They have to authorize the payment to the claimant without violating
any Federal or State laws. The more money the adjuster saves their company the
more likely it is he or she will get a bonus.
An adjuster wants the facts of the claimant’s case. The facts should allow them
to best determine whether the policyholder’s insurance policy covers the loss
and if it does how much the payment should be for the loss. Since the adjuster
deals with finding out the facts of the incident it is important for you to have
all of your factual information documented so that you can show it to the
adjuster. Having documents showing the cost of fixing the damage to your car,
the doctor’s bills and any other expenses caused by the accident are thus a
necessity.
Claims adjusters work is scheduled around processing the various claims that
they have been assigned to handle. The adjuster investigates the claims by first
interviewing the claimant and any witnesses. This is when they will call you and
the other person involved in the accident. They want to make sure the stories of
what happened match. From my personal experience
the adjuster always
requests to tape these phone calls. So remember to
think things out clearly instead of speaking quickly and maybe incorrectly while
being taped.
Next if any witnesses to the accident gave their information, to be listed on
the police report, they are called so the adjuster can again get verification of
how exactly the accident occurred. The adjuster will next contact the officer
listed on the police report if anything on the report needs to be clarified. On
down the list the claims adjuster will go. They will see if an ambulance was
called to the scene. Then the adjuster will call the hospital or physician the
victim went to for treatment to find out more information. The vehicle will be
inspected so that the adjuster can determine if it should be totaled out or if
it can be repaired.
Besides contacting the claimant’s physician or mechanic the adjuster may also
consult with other professionals. Adjusters are normally familiar with certain
car repair companies and physicians. The adjuster will then speak to their
contact asking questions such as how much a car should be worth or would cost to
repair. With the physician they will ask if the victim’s injuries are what
should be expected from that specific type of car crash.
Everything that an adjuster finds out is usually written down in some sort of
report. The information he or she has gathered will include photographs, written
statements, recorded statements and documents the claimant has sent them. The
adjuster’s next step is to use all of this information to evaluate the claim.
Evaluating the claim involves deciding if
the claim is legitimate
and if they have
all the information needed
to negotiate and settle the claim with the claimant. If you only have damage to
your vehicle from the accident if should be easier and quicker to settle your
claim with an adjuster. You will most likely get a lower level adjuster. They
will try to speedily inspect the damage and try to get the check cut right away.
If your claim involves bodily injury you will get bumped up to a senior level
adjuster. This adjuster will need to do more fact finding so it will take a
longer period of time for the claim to be settled.
The negotiating of the settlement is done by a basic
back and forth of numbers
between the adjuster and the claimant. The adjuster will probably try to get
away with a number that is a little low out of the gate. The claimant needs to
prove their number to the adjuster and if it is within the perimeters that the
adjuster is allowed to settle for that should complete the negotiations.
The role of the adjuster is to represent the insurance company involved in the
claim by finding out the facts and then using them to negotiate a settlement. If
you have been in an accident and have filed a claim you will deal with a claims
adjuster. It can be intimidating if you do not understand their function but
with the understanding of the nature of the adjuster’s work you should feel
confident and able to negotiate your claim.
Disclaimer: This article is for information purposes. It should not be
interpreted as a recommendation to buy or sell any insurance product, or to
provide financial or legal advice. This information is provided for information
purposes only.
^Top
    |
