what is an insurance adjuster?
When a person with a home insurance policy experiences a loss, they will file a claim with their insurance company. The adjuster (also known as an insurance adjuster or claims adjuster) is the person who investigates that claim on behalf of the insurance company.
Insurers have to exercise due diligence when it comes to paying claims. Otherwise, they could end up paying claims that fall outside the coverage of the policy or claims that are fraudulent in nature. this would consume all the funds the insurance company needs for legitimate claims, eventually causing the company to go bankrupt. then no one would have insurance.
Reading: What is an insurance adjustor
To prevent this, insurance companies hire adjusters to investigate claims and help reach settlements that are fair to both the insurer and the insured. the adjuster communicates with the insured throughout the claim process on behalf of the insurance company.
in canada, each province and territory has its own insurance regulator. insurance adjusters are licensed by these regulatory bodies. they need to have the correct license for the province they are working in.
what does an adjuster do?
The job of a claims adjuster is hectic. When an insured person files a claim with their insurance company, that claim will be assigned to an adjuster. The adjuster will then start a claim file and collect the necessary details. they need to submit a report to the insurance company that explains everything about the claim and how much the insurer must pay to settle it. The adjuster will also look at the insurance policy to determine what parts of the claim are or are not covered.
In order to make an accurate and fair determination of the settlement amount, the adjuster needs to gather a lot of information. During their investigation, they will visit the scene of the damage, interview claimants and witnesses, review police reports, consult with relevant experts, or whatever else they need to do to get the full picture. If you’re filing a claim, the more details you can provide your adjuster, the better; It will save them time trying to track things down and they will be able to resolve your claim faster.
Along the way, the adjuster will often be able to help the insured take any necessary steps, such as obtaining repair estimates and selecting professional contractors.
Once they have completed their investigation and determined the cause of the loss and the extent of the damage, they will report all of that information to the insurance company along with a recommended settlement amount. the adjuster tries to determine the amount that covers the insured loss, no more and no less.
of course, sometimes things don’t go perfectly well; it can be difficult to find out the precise cause of a loss, or sometimes the insured disagrees with the adjuster’s settlement amount. the adjuster also functions as a negotiator. Even though they are working for the insurer, they want to make sure both parties are happy with the deal. it’s a delicate balance.
An adjuster may handle claims differently depending on the insurance company (or insurer) they work for. for example, some adjusters may be authorized to pay small claims quickly, under express settlement processes. For example, early on, many small claims can be handled using our online claims process. Larger and more complex claims still require a bit of legwork, but most zero claims in Canada are resolved within 60 days.
what is an independent adjuster?
Insurance companies often have in-house adjusters, but they also often outsource the adjustment process to independent adjusters. Independent adjusters are third parties who perform adjusting services on their own behalf. If an insurance company writes policies in an area where they don’t have an office (which is very common), they will hire an independent adjuster to handle claims coming from that area.
In addition to being self-employed, independent adjusters function in much the same way as in-house adjusters. they investigate claims, talk to claimants, file reports, and determine how much the insurer should pay to settle the claim.
the important points
An insurance adjuster works for an insurance company (or an independent adjusting firm).
When an insured person files a claim, the adjuster investigates the details of that claim to decide how much the insurance company should pay.
The adjuster also acts as the insured person’s point of contact during the claims process and negotiates the final settlement with them on behalf of the insurance company.
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