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An insurance adjuster is a professional who evaluates insurance claims to determine the insurance company's liability under the terms of an owner's policy.

What is an Adjuster in Insurance?

In the realm of insurance, an adjuster plays a critical role in the claims process. This professional is responsible for inspecting the damage, determining the cost of repairs or replacement, and establishing how much the insurance company should pay. For example, if a business experiences a fire, an insurance adjuster would visit the site to assess the damage, review the policy details, and calculate the amount of loss. This ensures that the insurance company fulfills its obligation as per the policy while fairly addressing the claims made by the policyholder.

Key components of an Adjuster:

  • Assessment of Damage: The adjuster’s primary task is to evaluate the extent of damage. This involves a thorough inspection and sometimes requires the adjuster to have specialized knowledge of various fields like construction, mechanics, or medicine.
  • Policy Review: Adjusters must thoroughly understand the insurance policy’s terms and conditions to interpret coverage accurately. This includes knowing what the policy covers, the limits of coverage, and any deductibles that apply.
  • Claim Valuation: After assessing the damage and understanding the policy terms, the adjuster must calculate the financial value of the claim. This valuation must be fair, justified, and in line with the policy stipulations.

Types of Adjusters

Staff Adjusters

Employed directly by an insurance company, these adjusters handle claims for their employer only.

Independent Adjusters

These are freelance professionals who work as contractors for multiple insurance companies. They are typically called in when the volume of claims is high, such as after a natural disaster.

Public Adjusters

Hired by claimants, public adjusters work on behalf of the policyholder to negotiate claims with the insurance company. They aim to obtain a favorable settlement for the claimant.

Catastrophe Adjusters

These adjusters specialize in handling claims related to major events like hurricanes, earthquakes, or floods. They often travel to disaster sites and deal with a large volume of claims.

Exclusions and Limitations

While adjusters play a fundamental role in the claims process, there are limitations and exclusions to their services. For example, adjusters cannot resolve issues that are outside the coverage of the policy, such as claims for damages that are excluded under the policy terms. Additionally, public adjusters’ fees are subject to state regulations and might vary, which can affect their availability and effectiveness.