Claims adjusters investigate insurance claims
by interviewing the claimant and witnesses, consulting police and hospital records, and
inspecting property damage to determine the extent of the company’s liability. In the United Kingdom, Ireland, Australia,
South Africa, the Caribbean and New Zealand the term loss adjuster is used. Other claims adjusters who represent policyholders
may aid in the preparation of an insurance claim. Classes
Claim service representatives. In the two first instances, and the fourth,
the adjuster operates on behalf of the insurer. Adjusters may handle “property claims” involving
damage to buildings and structures, or “liability claims” involving personal injuries or third-person
property damage from liability situations, such as motor vehicle accidents, slip and
falls, dog bites, or alleged negligent behavior. Some adjusters handle both types of claims
and are known as “Multi-Line” adjusters. Also “All Lines Adjusters” may handle “any”
type of claim already identified and also include professional liability, Hospital Professional
Liability, Excess Liability, Physicians and Surgeons Liability, Aircraft Liability/Hull,
Inland Marine, Ocean Marine, Boiler and Machinery, as well as various types of Bond Losses. Public adjusters work exclusively for the
policyholder. This means there should be no inherent conflict
of interest when it comes to advocating on the policyholders behalf to the insurance
company. An independent adjuster could be working for
multiple insurance companies or self-insured entities. If licensed by state authority they represent
pinnacle of property loss knowledge in their field; whether it be residential, vehicular,
marine, etc. An adjuster will frequently verify that coverage
applies through an insurance policy, investigate liability for the damages caused, and make
compensation to the injured person based on their emotional or physical property damages. Specific duties include:
Notifying the insurer of a covered loss as defined under the policy of insurance
Responding to claims in a timely manner Filing paperwork
Communicating with policy holders Investigate liability
Assess damages Research, detail and substantiate each aspect
of the claim, including building damage, contents, and extra living expense claims. Prepare a detailed damages report based on
monthly updated insurance cost software for the purpose of making an offer of settlement
to the insured. If needed for specialty cost coding, negotiate
with product/service providers on time and cost of repairs for the purpose of making
an offer of settlement to the insured. Ensuring accurate procedures
Protect the interest of the insurance company the adjuster represents, when dealing with
claimants. Computer skills with a high degree of proficiency. Some states now require adjusters disclose
to claimants whose interest specifically independent, staff and public adjuster represent, before
they proceed with the policyholder. Always check your local chapter of Licensed
Public insurance adjusters, or state agency, in order qualify an adjuster is properly licensed
and in good standing. Some of the state chapters are AAPIA and NAPIA. In Florida, the chapter is FAPIA. IEA conducts certified online classes for
people. The Insurance Institute of America also provides
training leading to professional designations. Some states accept the Associate of Claims
designation, and will waive the licensing examination, and grant a license by the state
insurance commission. Some insurance carriers, and independent adjusting
companies provide in house training certified by the state insurance commission. The must be pre-approved by the licensing
division. An adjuster license is issued to those that
pass the requirements. Education
Many insurance companies prefer their claims adjusters to have a 4-year college degree
preferably in business related fields. In the past, high school graduates have become
claims adjusters by promotion from within the claims department. Since there are no college majors for claims
adjusters, many states require a state certification in order to practice as an adjuster. States also require that a certain number
of continuing education credits for claims adjusters are earned each year in order to
maintain their license. This continuing education is achieved by attending
seminars and online training from different claim adjuster educational resources. There are also professional designations that
have become prevalent among claims adjusters; for example, The American Institute for Chartered
Property Casualty Underwriters awards the Chartered Property and Casualty Underwriter
designation to experienced underwriters. Florida is one of the few states in the United
States that has created specific designations for the licensing of insurance claims adjusters. The Accredited Claims Adjuster Designation,
created by statute in coordination with Polk State College in 2002, allows an individual
to obtain the Florida All Lines Independent or Company license, without taking the state
licensing exam. In some instances, such as with collapse insurance,
courts have been involved in order to predicate a reasonable understanding of the guidelines
of the policy in question. The meaning of terms such as “collapse” have
undergone rigorous constitutional assessment. This leads to some ambiguity between what
the law says and what is enforceable by modern mandates. The idea of “Structural Integrity” may not
always be a universally understood term, but several articles have been published on the
topic which suggests the field is evolving toward a continuity in terminology. For those interested in the claims adjustment
field, in-depth study of legal principle is a necessity. Most states require licensed adjusters to
continue their education through a ‘continuing education’ requirement. Florida requires 24 hours of CE every two
years. Texas Department of Insurance,Continuing Education
Requirements:http:www.tdi.state.tx.uscontineducindex.html Working conditions
Claims adjusters work long hours including work nights and weekends. Their work is appointment based and must revolve
around the needs of clients. Staff adjusters are those who work for a specific
insurance company and usually have a company provided office from which to work. Independent and public claims adjusters often
work from home. They receive their work assignments daily
by fax machine, email, or by checking into a designated website. Staff adjusters receive their assignments
when they arrive at the office first thing in the morning. In the case of a severe natural disaster such
as floods or tornadoes, or other catastrophe, independent and public adjusters travel to
the area to supplement local adjusters. Often this requires the incoming adjuster’s
presence in the field for days to weeks at a time. Catastrophe adjusters may spend days to weeks
in a hotel or RV near the field of operations. Husband and wife teams often enjoy this type
of work as it allows them to work and travel together to different parts of the country. Adjusters should become familiar with the
reimbursement rules for each company with whom they work and track all expenses used
in the line of work. Keep your receipts for everything as virtually
all expenses, while deployed in the field, are tax deductible. A good computer program or bookkeeping system
is recommended. Computer skills are essential, including keyboard
skills. Most insurance companies store all documentation
digitally. A digital camera is highly useful in documenting
claims visually. Estimates, including auto and property losses,
are prepared on computers connected to a corporate network. Laptop computers, pad, and other technologies
make claims adjusting easier and consume less time. However, claims adjusting also requires a
level of physical strength and stamina. Property adjusters, for example, are often
required to operate a 50-pound ladder and must stand, walk, kneel, crawl, and perform
other physical demands as they investigate damaged property. References