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What is an Insurance Adjuster?

Written by Todd Clay. Posted in Definitions Last Updated: 03/14/2011

Three different types of insurance adjusters and how they are involved in the claims process.

A Collision Repair Estimate for an Insurance Adjuster

An Insurance Adjuster works off an estimate to pay for damages.

What is an insurance adjuster and what exactly do they do?

Insurance adjusters have one of the hardest jobs in the insurance industry.  They are responsible for making sure that an insurance company’s legal obligation to their insured is satisfied by paying out legitimate claims that the insured may have.

They also try to offer an acceptable offer of repair or settlement to the insured or other party and at the same time trying to keep the cost of the claim low so that the insurance company can still make a profit.

Property Damage Insurance Adjusters

An adjuster in the field of property damage views the amount of damage done to a vehicle or other property and then assigns a monetary value to it.  Most times in the case of a car accident the damage assessment is actually done by a body shop and then they submit their estimates to the adjuster for payment.  The adjuster reviews the estimate to make sure that the damage being fixed pertains to the accident, the work being done is restoring the vehicle to the condition it was in prior to the accident and not improving the vehicle and that the prices for the parts and labor are acceptable.

The assessment of damage done to a home is similar to the way damage to a vehicle is assessed and paid.  The only difference between a vehicle and home is that most of the time it is the adjuster that comes out to assess the damage to a home — not the contractor that will be doing the work.

In the case of a theft, the adjuster is given a list by the insured of what items are stolen and they are responsible to make sure that the items are covered under the policy that the theft is being claimed under.  They also research the value of each item to compile a payment that is made to the insured for the current value of the items or replacement value, depending on the type of coverage that the insured paid for with their policy.

Bodily Injury Insurance Adjusters

A Bodily Injury Adjuster is responsible for the injuries that mostly arise out of an auto accident, in some cases it can also be a homeowner’s insurance claim in the case of an injury from negligence.   They gather medical bills, assess treatment making sure that it is relevant to the injury that the insured is accused of causing and then at the end of treatment settling the claim.  They also work on the medical bills for the insured or other injured parties that were in the insured’s vehicle at the time of the accident, if the insured has the coverage.

Settlement for a bodily injury claim is not just adding up the medical bills and making payment on them.  It also includes a monetary amount for pain and suffering that was caused by the accident.  The settlement of the pain and suffering part of the claim is where there is usually the most disagreement.  The insurance company does not want to pay out more than it has too and the person that had the injury is feels that their pain and suffering is worth more than what is offered.

If the injured party and the adjuster cannot reach an agreement through their own negotiations, legal counsel is called in and the settlement is either negotiated then or it heads to court.

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Todd Clay

Todd Clay is a former insurance agent with the largest insurance company in the United States. He earned his Bachelor’s from the University of Texas. He's worked in several fields but has specialized in insurance, financial-related information, and technology. He blogs at Car Insurance Guidebook. Connect with Tood on Google+

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