Have you ever been in a situation where you had to submit an insurance claim? Whether it was about a small incident, a sudden pipe burst, or a phone theft, the procedure can be extremely complicated and nerve-wracking. That’s where having a licensed insurance adjuster is important.
A licensed insurance adjuster is known to offer the required assistance and support during the claims resolution process. They streamline the claims process for their clients and ensure they get the deserving compensation for the damages they endured.
In this article, you’ll explore the ways in which a licensed insurance adjuster helps in the claims resolution process.
Licensed Insurance Adjuster: Guiding You Throughout Your Claims Resolution Process
An insurance claims adjuster is a licensed individual who works with various insurance-related cases. Their main role is to establish if the claim made by you was genuine or there was any coverage involved.
The adjuster collects information with careful evaluation, estimates the damage or loss (whether it’s a property or a physical injury), and negotiates a settlement on behalf of the client. Their further roles include:
- Conducting a comprehensive investigation to understand if the claim falls under the coverage of the policyholder.
- Thorough evaluation of damages sustained due to property or personal injury.
- Negotiating with the policyholder until they agree on a compensation amount that resolves their differences in an amicable manner.
- Supervising repairs or medical attention depending on the kind of claim it is.
What are the Types of Insurance Claims Adjusters
There are three different types of insurance claims adjusters who have different purposes:
Company Adjuster:
These adjusters are hired by an insurance company. They have immense knowledge about their own company’s policies and procedures. They only deal with policyholders insured by the specific firm to ensure that the settlements meet the terms of reference set by the insurer.
Independent Adjuster:
These individuals operate under independent adjusting firms. They offer expertise and flexibility to deal with a wider number of cases from multiple insurance companies across different regions or areas.
Public Adjuster:
Public adjusters act as a policyholder’s advocate throughout the claims process. They help a policyholder understand their coverage options and negotiate settlements on their behalf. They also push for fair compensation.
What are the Responsibilities of an Insurance Adjuster in the Claims Process?
An insurance adjuster has various responsibilities in the claims process, as given below:
Analyzing Damages and Losses:
This is the most important aspect of an adjuster’s job. They thoroughly analyze the severity of the injuries or damages endured by the policyholder, whether it’s a physical injury or property damage.
For property claims, the adjuster will make site visits to determine the firsthand nature of the loss. They click photographs, shoot and record videos, measure the area, and collect essential documents, such as damage estimates.
In case of personal injury, the adjuster will read and comprehend all medical reports together with consultants and healthcare professionals. They will also consider other aspects like lost wages, future medical requirements, etc.
Claim Investigation:
To ensure they come up with an equitable settlement, adjusters perform a thorough investigation into the claims. They review every important detail relevant to the claim in various ways, such as interviewing the insured party and speaking to witnesses and other potentially involved parties,
The adjuster also examines police and accident reports thoroughly to recognize other causes of loss and verify them they were genuine.
Evaluation of Coverage:
Insurance policies don’t cover specific types of losses. That is why adjusters carefully compare specifics mentioned in a policyholder’s insurance contract against the details provided in their claim whenever necessary.
Such comprehensive knowledge about different insurance policies, including their exceptions, is applied when analyzing the extent to which the claim falls.
Negotiating Statements:
Negotiation is the next stage that involves assessment of damages arising from risks insured against in relation to those covered by the insurer.
An adjuster needs to be someone with good convincing skills. This will help them explain difficult terminologies from insurance companies properly and always help both parties involved arrive at a suitable agreement among themselves.
Offering Customer Support and Guidance:
Apart from evaluating claims, the adjuster offers customer support, which is very important for a policy holder. Policyholders communicate with them as they are usually the first contacts therefore answering queries during the claims processing time frames and also addressing their fears in a soft manner.
The adjuster explains all the claims procedures, keeping policyholders updated about their claim status and offering guidance and advice on medical care and repair choices.
Skills Required By a Proficient Licensed Insurance Adjuster
Here are some important skills that a licensed insurance adjuster needs to have:
Analytical Skills:
The uncovering of intricate details during an insurance claim is something that needs to be done by an analytic thinker. They consider all the important facts and determine the ones that are more essential, use judgment to make important decisions and find suitable solutions.
Insurance Policies and Regulations:
Adjusters should have a thorough understanding of policies along with the regulations involved. The different types of insurance coverage involve exclusions and policy terms, that will help the adjuster establish whether the claim falls within the specific scope of coverage or not.
Communication and Negotiation Skills:
To ensure effective and amicable resolution of claims, an adjuster needs to have proper communication and negotiation skills. They interact with multiple people, including customers, witnesses, service providers, and various other individuals.
During such conversations, adjusters need to clearly explain confusing issues on insurance, listen carefully to complaints and make an agreement upon settlement in a professional way.
Apart from all these things, an adjuster needs to have a significant amount of attention to detail and accuracy to ensure even the slightest things don’t make any changes to the suitable compensation for the policy holder.
To Summarize
Adjusters are essential for settlement claims. They help policy holders to ensure they get the deserving amount of compensation for the damages and body injuries they have endured. Their expertise and guidance can help policy holders to avoid any uneventful situation that could lower their compensation amount.
