Many people ask us what it’s like to have a career as an insurance claims adjuster. What many of them don’t realize is that there are many different types of claims adjuster. In this article, we describe many of the different claims adjuster careers. Maybe one of them is right for you.
In its broadest sense, a claims adjuster is responsible for investigating insurance claims to determine the extent of an insurance company’s liability. They assess the damage or loss, negotiate settlements, and authorize payments to policyholders. Some of the specific tasks that an insurance claims adjuster may perform include:
Investigate claims:
An adjuster reviews the details of the insurance claim, interviews witnesses, and inspects the damaged property to determine the cause and extent of the loss.
Evaluate damages:
The adjuster assesses the damage to the property and calculates the cost of repairs or replacement.
Verify policy coverage:
The adjuster reviews the insurance policy to determine the scope of coverage and the policy limits that apply to the claim.
Negotiate settlements:
The adjuster negotiates with policyholders, contractors, and other parties to settle claims within the limits of the policy coverage.
Authorize payments:
The adjuster authorizes payments to policyholders and service providers, such as contractors, for repairs or replacements.
Report findings:
The adjuster prepares reports detailing their findings and recommendations for the insurance company and other stakeholders.
Although the specific tasks are different, these roles and responsibilities are usually common for the various types of adjusters. Now we will explore the roles and roles and responsibilities for several of the top of claims adjuster specialties:
Workers Compensation Claims Adjuster
A Workers Compensation Claims Adjuster is responsible for investigating and evaluating claims made by employees who have been injured or become ill due to their job. They work for insurance companies, self-insured employers, or third-party administrators and their primary role is to determine whether the claims made by the employee are valid and should be approved or denied.
The following are some of the typical responsibilities of a Workers Compensation Claims Adjuster:
Investigating the claim:
The adjuster will gather information from the employee, employer, witnesses, and medical professionals to determine the extent of the injury and whether it was work-related.
Reviewing medical records:
The Workers Compensation Claims Adjuster will review medical records and reports from the employee’s treating physician to evaluate the extent of the injury and the treatment required.
Determining coverage: The adjuster will review the person’s insurance policy to determine whether the injury or illness is covered by workers’ compensation insurance.
Calculating benefits:
If the claim is approved, the adjuster will calculate the benefits owed to the employee based on the severity of the injury and the state’s workers’ compensation laws.
Negotiating settlements:
In some cases, the adjuster will negotiate a settlement with the employee. This often involves a lump-sum payment in exchange for giving up the right to future benefits.
Communicating with stakeholders:
The adjuster will communicate with the employee, employer, and medical professionals throughout the claims process to keep them informed of the status of the claim and to answer any questions they may have.
Overall, a Workers Compensation Claims Adjuster plays a critical role in ensuring that employees who are injured or become ill due to their job receive the benefits they are entitled to under workers’ compensation insurance.
Construction Defect Claims Adjuster
A Construction Defect Claims Adjuster is responsible for investigating and evaluating claims made by property owners or contractors alleging defects in the construction of a building or structure. They work for insurance companies, self-insured employers, or third-party administrators and their primary role is to determine whether the claims made by the property owner or contractor are valid and should be approved or denied.
The following are some of the typical responsibilities of a Construction Defect Claims Adjuster:
Investigating the claim:
The adjuster will gather information from the property owner or contractor, the builder or developer, and any other relevant parties to determine the extent and nature of the alleged construction defect.
Reviewing documents and reports:
The Construction Defect Claims Adjuster will review plans, specifications, construction contracts, building codes, and other documents related to the construction project to determine the cause and extent of the alleged defect.
Evaluating damages:
The adjuster will evaluate the property damage caused by the alleged construction defect and determine the cost of repairs or replacement.
Determining coverage:
The adjuster will review the insurance policy and determine whether the construction defect is covered by the insurance policy.
Negotiating settlements:
In some cases, the adjuster will negotiate a settlement with the property owner or contractor, which involves a payment in exchange for resolving the claim.
Communicating with stakeholders:
The Construction Defect Claims Adjuster will communicate with the property owner or contractor, the builder or developer, and any other relevant parties throughout the claims process to keep them informed of the status of the claim and to answer any questions they may have.
Overall, a Construction Defect Claims Adjuster plays a critical role in ensuring that property owners or contractors who allege construction defects receive the benefits they are entitled to under their insurance policy.
Homeowners Insurance Adjuster
A Homeowners Insurance Adjuster is responsible for investigating and evaluating claims made by homeowners who have suffered losses or damages to their property. They work for insurance companies, self-insured employers, or third-party administrators and their primary role is to determine whether the claims made by the homeowner are valid and should be approved or denied.
The following are some of the typical responsibilities of a Homeowners Insurance Adjuster:
Investigating the claim:
The adjuster will gather information from the homeowner, witnesses, and any other relevant parties to determine the cause and extent of the damage or loss.
Evaluating damages:
The adjuster will evaluate the property damage or loss caused by a covered peril and determine the cost of repairs or replacement.
Determining coverage:
The adjuster will review the insurance policy and determine whether the damage or loss is covered by the insurance policy.
Negotiating settlements:
In some cases, the Homeowners Insurance Adjuster will negotiate a settlement with the homeowner, which involves a payment in exchange for resolving the claim.
Communicating with stakeholders:
The adjuster will communicate with the homeowner throughout the claims process to keep them informed of the status of the claim and to answer any questions they may have.
Liaising with contractors and repair companies: The adjuster may work with contractors and repair companies to evaluate the damage and estimate the cost of repairs or replacement.
Overall, a Homeowners Insurance Adjuster plays a critical role in ensuring that homeowners who have suffered losses or damages to their property receive the benefits they are entitled to under their insurance policy.
General Liability Adjuster
A General Liability Adjuster is responsible for investigating and evaluating claims made by third parties who have suffered bodily injury or property damage due to the actions of an insured party. They work for insurance companies, self-insured employers, or third-party administrators and their primary role is to determine whether the claims made by the third party are valid and should be approved or denied.
The following are some of the typical responsibilities of a General Liability Adjuster:
Investigating the claim:
The adjuster will gather information from the injured party, witnesses, and any other relevant parties to determine the cause and extent of the bodily injury or property damage.
Evaluating damages:
The adjuster will evaluate the bodily injury or property damage caused by the insured party and determine the cost of repairs or compensation.
Determining coverage:
The adjuster will review the insurance policy and determine whether the bodily injury or property damage is covered by the insurance policy.
Negotiating settlements:
In some cases, the adjuster will negotiate a settlement with the injured party, which involves a payment in exchange for resolving the claim.
Communicating with stakeholders:
The adjuster will communicate with the injured party and any other relevant parties throughout the claims process to keep them informed of the status of the claim and to answer any questions they may have.
Liaising with legal counsel:
The adjuster may work with legal counsel to evaluate the claim and determine the appropriate course of action.
Overall, a General Liability Adjuster plays a critical role in ensuring that third parties who have suffered bodily injury or property damage due to the actions of an insured party receive the benefits they are entitled to under the insurance policy.
Auto Claims Adjuster
An Auto Claims Adjuster is responsible for investigating and evaluating claims made by policyholders who have been involved in automobile accidents or have suffered losses or damages to their vehicles. They work for insurance companies, self-insured employers, or third-party administrators and their primary role is to determine whether the claims made by the policyholder are valid and should be approved or denied.
The following are some of the typical responsibilities of an Auto Claims Adjuster:
Investigating the claim:
The adjuster will gather information from the policyholder, witnesses, and any other relevant parties to determine the cause and extent of the damage or loss.
Evaluating damages:
The Auto Claims Adjuster will evaluate the property damage or loss caused by the accident or other covered event and determine the cost of repairs or replacement.
Determining coverage:
The adjuster will review the insurance policy and determine whether the damage or loss is covered by the insurance policy.
Negotiating settlements:
In some cases, the Auto Claims Adjuster will negotiate a settlement with the policyholder, which involves a payment in exchange for resolving the claim.
Communicating with stakeholders:
The adjuster will communicate with the policyholder throughout the claims process to keep them informed of the status of the claim and to answer any questions they may have.
Liaising with repair shops:
The adjuster may work with repair shops or other service providers to evaluate the damage and estimate the cost of repairs or replacement.
Overall, an Auto Claims Adjuster plays a critical role in ensuring that policyholders who have suffered losses or damages to their vehicles receive the benefits they are entitled to under their insurance policy.
Bodily Injury Claims Adjuster
A Bodily Injury Claims Adjuster is responsible for investigating and evaluating claims made by third parties who have suffered bodily injury due to the actions of an insured party. They work for insurance companies, self-insured employers, or third-party administrators and their primary role is to determine whether the claims made by the third party are valid and should be approved or denied.
The following are some of the typical responsibilities of a Bodily Injury Claims Adjuster:
Investigating the claim:
The adjuster will gather information from the injured party, witnesses, and any other relevant parties to determine the cause and extent of the bodily injury.
Evaluating damages:
The adjuster will evaluate the bodily injury caused by the insured party and determine the cost of medical treatment, lost wages, and other damages.
Determining coverage:
The Bodily Injury Claims Adjuster will review the insurance policy and determine whether the bodily injury is covered by the insurance policy.
Negotiating settlements:
In some cases, the adjuster will negotiate a settlement with the injured party, which involves a payment in exchange for resolving the claim.
Communicating with stakeholders:
The Bodily Injury Claims Adjuster will communicate with the injured party and any other relevant parties throughout the claims process to keep them informed of the status of the claim and to answer any questions they may have.
Liaising with legal counsel:
The adjuster may work with legal counsel to evaluate the claim and determine the appropriate course of action.
Overall, a Bodily Injury Claims Adjuster plays a critical role in ensuring that third parties who have suffered bodily injury due to the actions of an insured party receive the benefits they are entitled to under the insurance policy.
Field Property Claims Adjuster
A Field Property Claims Adjuster is responsible for investigating and evaluating claims made by policyholders who have suffered property damage to their homes or businesses due to covered events such as fire, flood, or storm damage. They work for insurance companies, self-insured employers, or third-party administrators and their primary role is to determine whether the claims made by the policyholder are valid and should be approved or denied.
The following are some of the typical responsibilities of a Field Property Claims Adjuster:
Inspecting the property:
The adjuster will visit the property and conduct a thorough inspection to assess the damage and determine the cause of the loss.
Evaluating damages:
The adjuster will evaluate the property damage caused by the covered event and determine the cost of repairs or replacement.
Determining coverage:
The Field Property Claims Adjuster will review the insurance policy and determine whether the property damage is covered by the insurance policy.
Negotiating settlements:
In some cases, the adjuster will negotiate a settlement with the policyholder, which involves a payment in exchange for resolving the claim.
Communicating with stakeholders:
The adjuster will communicate with the policyholder throughout the claims process to keep them informed of the status of the claim and to answer any questions they may have.
Coordinating with repair contractors:
The adjuster may work with contractors or other service providers to evaluate the damage and estimate the cost of repairs or replacement.
Overall, a Field Property Claims Adjuster plays a critical role in ensuring that policyholders who have suffered property damage due to covered events receive the benefits they are entitled to under their insurance policy.
Liability Claims Adjuster
A Liability Claims Adjuster is responsible for investigating and evaluating claims made by third parties who have suffered bodily injury or property damage due to the actions of an insured party. They work for insurance companies, self-insured employers, or third-party administrators and their primary role is to determine whether the claims made by the third party are valid and should be approved or denied.
The following are some of the typical responsibilities of a Liability Claims Adjuster:
Investigating the claim:
The adjuster will gather information from the third party, witnesses, and any other relevant parties to determine the cause and extent of the bodily injury or property damage.
Evaluating damages:
The adjuster will evaluate the bodily injury or property damage caused by the insured party and determine the cost of medical treatment, lost wages, and other damages.
Determining liability:
The adjuster will determine whether the insured party is liable for the bodily injury or property damage.
Determining coverage:
The adjuster will review the insurance policy and determine whether the bodily injury or property damage is covered by the insurance policy.
Negotiating settlements:
In some cases, the adjuster will negotiate a settlement with the third party, which involves a payment in exchange for resolving the claim.
Communicating with stakeholders:
The adjuster will communicate with the third party and any other relevant parties throughout the claims process to keep them informed of the status of the claim and to answer any questions they may have.
Liaising with legal counsel:
The adjuster may work with legal counsel to evaluate the claim and determine the appropriate course of action.
Overall, a Liability Claims Adjuster plays a critical role in ensuring that third parties who have suffered bodily injury or property damage due to the actions of an insured party receive the benefits they are entitled to under the insurance policy.
