Insurance Claims Adjusters: Everything You Need to Know

Here's a guide on what to expect during visits from insurance adjusters and how to maximize your pay-out when an adjuster assesses your claims.
Written by Liliana Pina
Reviewed by Carrie Adkins
If you’ve ever filed an insurance claim, you almost certainly worked with an insurance adjuster to document the extent of damage done and determine the monetary amount your insurance company will provide for repairs.
While many insurance adjusters work directly for an insurance company as a member of their staff, you may also have the option of utilizing an external adjuster. Effectively, insurance adjusters are the claim settlement experts that you work with
following an accident
or emergency event.
Here's everything you need to know about what to expect from an insurance claims adjuster, how to
maximize your pay-out
, and how to ensure that you select the best
car insurance
and plan for your needs.

What is an insurance adjuster?

Insurance adjusters, also commonly referred to as insurance claims adjusters, function as the representative for your insurance company when you make a claim.
Insurance adjusters are responsible for inspecting property damage and assessing your insurance policy to determine how much your insurance company will pay you in the event of a covered emergency of event.
While insurance adjusters mainly conduct their jobs in person by visiting homes, there are also occasions where a phone call can suffice.

Types of insurance claims adjusters

Though many insurance claims adjusters are employed directly by an insurance company, there are also options to have outside adjustors conduct the same service in some circumstances.
The type of insurance adjuster you utilize may slightly alter the claims process, so it's important to know the three main types of insurance adjusters.
Staff: A staff insurance claims adjuster works for only one insurance company and responds to their claims exclusively. You do not have to worry about paying them because they are employed by the insurance firm.
Independent: An independent insurance claims adjuster works for multiple insurance companies or third-party administrators. When attempting to utilize an independent adjuster, you must first evaluate how much you are paying and to whom, as this varies by company and/or contact.
Public: In general, public insurance claims adjusters work directly on behalf of policyholders and work to serve your best interest. According to
Forbes
, a typical fee for a public insurance adjuster is 20% of the insurance settlement. People typically hire these claims experts because they're often able to reassess the situation and increase your reimbursement amount from your insurance.
Though there are pros and cons to each type of insurance adjuster, it is important to consider your options before signing a contract with an insurance company.

Making an insurance claim

Working with an insurance adjuster is a necessary component to
filing a claim
and receiving insurance benefits, but there are additional steps you must take to ensure that you receive the maximum reimbursement possible.
Here's a step-by-step process for correctly and efficiently managing your insurance claim.
Step 1: Make your claim. When confronted with an accident or emergency event, it's important to contact your insurance company as soon as possible so you can begin the process of receiving reimbursement for any damages done. Before making the phone call, make sure you document the current condition of the insured item as well as any necessary repairs.
Step 2: Prepare for the visit. Make sure you have any appropriate documentation necessary on hand and receipts for any money spent on repairing damages covered by your insurance policy. Your insurance company will reimburse you for these amounts.
Step 3: Insurance adjuster evaluates the damage. Though this step is typically conducted in person, there are instances where a phone call also works. Many companies have been making adjustments to satisfy COVID-19 guidelines.
For a home insurance claim, when arriving at your home, an insurance adjuster will take note of the state of the household before and after the damages made and may even give you an idea of how much your reimbursement will be. However, any verbal discussions about reimbursement amounts are not official until a written agreement is received. After this, the insurance adjuster will submit a report on your claim.
Step 4: The insurance company issues you a reimbursement amount. After reviewing the provided evidence and the notes of the insurance adjuster, your insurance company will issue you a reimbursement amount. The length of this process varies by company and circumstance, but should occur relatively soon after the insurance adjuster visit.
Step 5: Dispute or accept the offer. If you agree with the offer presented to you, you can accept it and go about receiving and utilizing the funds. If you would like to dispute the offer because you feel like you are entitled to more monetary compensation, you must present your case for why you deserve a higher reimbursement.
At this stage, people will typically hire a public insurance claims adjuster to assess their plan and work to maximize their profits. Be sure to thoroughly read the offer, as any discrepancies can influence the amount of money you receive.

Final tips

Now you're a master of the insurance claims process. Congratulations! Here are some additional tips and tricks to ensure that you receive the maximum reimbursement possible:
Assess your plan and become an expert: While it's important to note that insurance claims adjusters are experts in their field, you must also be an expert when it comes to your coverage.
Knowing your rights will empower you and ensure that you're always receiving the benefits you agreed upon when the contract was signed. Companies are required by law to act in good faith when it comes to upholding their policies and previous agreements, so be sure to hold them accountable.
Keep comprehensive records of everything: According to the
Consumer Financial Protection Bureau
, it's essential that you document every single step of the insurance claims process.
This includes photo and/or video evidence of the damages for which you are seeking reimbursement, written documentation of any relevant conversations with members of your insurance firm, and the case number associated with your claim and/or insurance account.
Read the fine print: This step is absolutely essential. When it comes to both your insurance policy and your reimbursement offer, you must be sure to understand each term and condition to make sure you are selecting an appropriate plan and are receiving the proper benefits.
Insurance policies vary in terms of what they cover and how much money they are willing to reimburse for certain issues, so having this information accessible will limit any coverage surprises.

FAQs

What does a claims adjuster do?

Simply put, claims adjusters assess damages in the event of an insurance claim to determine how much money the company needs to pay out.

Do claims adjusters work from home?

Most claims adjusters will come to your house or car to assess damages, but in some situations, claims adjusters will only need photos of damages.
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