Definition
An Adjuster, also known as a Claims Adjuster, is a professional involved in the insurance industry who is responsible for inspecting claims related to damages or losses. The adjuster’s primary role is to ascertain the extent of the insurance company’s liability to the insured party, if any, under the terms of its policy.
Responsibilities
- Investigating Claims: The adjuster assesses the claim to determine the authenticity and extent of loss or damage incurred.
- Recommending Settlements: Based on the investigation, the adjuster recommends settlement options to adequately compensate losses while considering the existing policy limits and terms.
- Documentation: Essential documents are collected and compiled including photographs, statements, and police reports.
- Liaising with Claimants: They maintain open communication with claimants to provide updates and clarify the settlement process.
- Expert Consultations: Where needed, adjusters may consult with outside experts such as mechanics, doctors, or forensics experts to properly assess claims.
Regulatory Background
Adjusters operate under a set of regulations that may differ by jurisdiction but generally require training and licensure. For example, in the United States, adjusters are often required to be licensed by the state’s department of insurance. Regulations are designed to ensure ethical practice and standardization across the industry. The U.S. Department of Labor offers guidelines (Source) outlining common principles and practices.
Importance
The work of an adjuster is crucial as they help ensure fair practice and legitimate compensation according to the bounds of the insurance policy while protecting the interests of the insurance company. Proper vetting by adjusters can also prevent fraud and provide a dependable claim service to policyholders.
