When you make a claim with your insurance, your claim will be assigned to an adjuster, who will act as your point of contact with the insurance company. They will determine if your policy provides coverage for your claim.
Claim adjusters work to verify your insurance claim, conduct investigations to determine liability, and calculate settlement amounts.
The Job of the Adjuster
The first thing your adjuster will do upon reviewing your claim is determine whether or not your policy covers the loss. If your policy covers the damages you are claiming, they will then investigate the details of your claim.
They assess the claimed damage and decide who is at-fault for the loss that has occurred. This assessment may include the inspection of the damaged property, the gathering of evidence, and the documentation of the scene.
To investigate further, adjusters may conduct interviews. They may interview eyewitnesses, obtain police reports, and hospital records. Additionally, they may talk with other professionals such as accountants, architects, construction workers, lawyers, and physicians. These professionals may be able to provide further insight into your claim. Finally, they negotiate settlement claims.
There are several different types of insurance adjusters. Typically, those that handle small personal claims are full-time employees of the insurance company you are making a claim against.
If your claim is complex or has a significant monetary value, the insurance company may hire an independent adjuster. Whom, although not a full-time employee, will have the best interest of the insurance company in mind. Insurance companies may also turn to independent adjusters if they do not have a claims office in your area.
The third type is a public adjuster. They work for the claimant, not the insurance company. Public adjusters typically handle cases involving large losses or those where the claimant and insurance agent can’t reach a compromise. Usually, these adjusters work for a percentage of your settlement, similar in nature to an attorney’s contingency fee.
However, adjusters cannot give you legal advice, they may only tell you how the facts of your case apply to your policy.
Adjusters are not Attorneys, but Attorneys can be Adjusters
There are instances where an insurance company may hire an attorney to negotiate your claim with you. In some cases, if you file a claim against a government agency, they may also employ an attorney to negotiate your case with you.
However, an attorney acting as an adjuster has no more legal power than a regular insurance adjuster.
Negotiating with the Insurance
When negotiating your case, you should stick to the facts. Keep your personal history on a “need to know” basis. It is vital that you only converse about topics relevant to your case; as insurance adjusters will use your words against you to reduce your settlement.
Negotiating with a Government Entity Adjuster
Typically large cities or state governments will have their own claims adjustment offices. If you make an insurance claim against a government employee, your case will be assigned to an adjuster employed by that government entity. These cases are typically settled in the same manner as those involving private parties. However, if your claim goes to litigation, the judge or members of the jury will be frugal in the damages award, as these damages are paid using public money. As a result, you can expect to receive approximately 10-25% less in settlement than you would have received in a claim against a private entity.
Peak job performance requires adjusters to settle cases as quickly and inexpensively as possible. Further, they may receive upwards of 100 new cases each month. Additionally, adjusters have no special training in areas pertaining to law or medical treatment. Therefore, it is likely that you know much more about your case than the insurance agent, giving you an advantage when negotiating your claim.
Insurance adjusters have imposed limits on the amount of settlement they can offer you. The limits are based on how much experience they have settling cases. Those with very little experience have limits of $5,000-$10,000, whereas experienced adjusters have a range of $10,000-$20,000.
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