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Insurance Claims

  1. Aggregate Limit
  2. Benefit Period
  3. Claims Adjuster
  4. Concurrent Causation
  5. Expected Loss Ratio
  6. Waiting Period

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Claims Adjuster: Definition & Meaning

Updated: February 6, 2023

Sometimes when working at or operating a business, there are going to be unforeseen circumstances that happen. A lot of times, taking out different types of insurance policies helps to mitigate some of the costs that can occur. But who does this? Who ensures that any claims that get filed are filed appropriately?

For example, let’s say that you have business property insurance to help in case there is damage to your property? What happens when you file a claim? An insurance claims adjuster is one of the people that is going to ensure everything goes smoothly.

Keep reading to learn more about claims adjusters, how they work, what they take care of, and more!

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    • A claims adjuster is someone who investigates certain insurance claims to determine the extent of liability.
    • Claims adjusters can handle several different areas of an insurance policy. Some of the most common include property claims with damage to structures and liability claims where personal injuries are involved.
    • They can be independent claims adjusters or they can work directly for a specific insurance company.
    • There are certain guidelines when it comes to licensing that claims adjusters must follow. This depends on continuing education and licensing requirements.

    What Is a Claims Adjuster? 

    A claims adjuster is someone that helps investigate certain insurance claims. They do this to ensure that claims are accurate and to determine a company’s potential liability. Clemens adjusters can handle several different types of insurance claims to ensure they’re handled correctly. 

    These can include things like liability claims that involve third-person property damage or personal injuries. They can also handle things like property claims if there has been damage to property or structures. 

    Each case that a claims adjuster reviews involves an investigation process to ensure everything is accurate. They will likely interview potential witnesses, speak with the claimant in question, and inspect an involved property. As well, there might also be a need to research certain records, like medical or police records. 

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    How Do Claim Adjusters Deal With Claims?

    When you take out an insurance policy, it is designed to provide added peace of mind should an unforeseen circumstance happen. So, if something happens, it’s important to ensure all relevant details are accounted for and that what happened is actually covered under the policy. 

    A claims adjuster helps to verify the insurance claims and determine the fairest amount for a settlement if there is one. Plus, they can handle any number of claims and the specific type doesn’t really matter. For example, it could be from property damage or a personal injury. 

    But with property damage claims, there are some specific roles and responsibilities the insurance adjuster will look into. They do this so the investigation is as detailed as possible. 

    So what do they do when they investigate? There is always a possibility of inspecting the damage, speaking to witnesses, and talking to property owners. As well, they might look into police records or medical records depending on the specific type of claim. 

    For example, let’s say that a homeowner files an insurance claim because a big tree has fallen on their car. After the homeowner files the claim, the claims adjuster will investigate the situation. 

    They would interview the homeowner to get more information and any witnesses who may have seen what happened. As well, they will make a physical visit to the property to inspect it and determine the extent of the damage. By doing this, the claims adjuster can obtain an estimate of what the costs might be to repair the property that’s been damaged. 

    Once they complete their investigation, they will then submit documentation to the insurance company. These documents will describe what happened and also include any recommendations for the claim amount. 

    Then, after everything has been filed, the claims adjuster will be able to determine the potential liability the insurance company has. 

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    Claims adjusters work for insurance companies to help determine the extent of claims that have been submitted. They undergo an extensive investigation process to help find the total cost of any liability. To do this, they will interview the person who submitted the claim and any witnesses. They will also likely visit the site where the damage happened. 

    And, if needed, the claims adjuster has the ability to research medical or police records. Claims typically range from things like property damage to personal or third-party injuries. 

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    FAQ’s About Claims Adjuster

    How Long Does an Insurance Adjuster Have to Respond?

    Every state has different rules and regulations when it comes to insurance adjusters. For example, Colorado might have different requirements compared to California. Be sure to check with your insurance provider for specific regulations.

    Can You Negotiate With an Insurance Adjuster?

    Not necessarily. However, the best thing that you can do if you have an accident or need to file a claim is to provide a detailed description. Make sure you outline any items lost or damage done. You can also get your own estimates for additional due diligence.

    Do Claims Adjusters Get Paid Well?

    Again, this also depends on the specific location of the claims adjuster. Their salary can also depend on the specific insurance company they work for and how many claims they currently work on. But, the average salary in the US is just above $50,000 per year.

    How Do I Become a Good Claims Adjuster?

    The first thing you need to do to become a claims adjuster is to achieve the minimum education level that includes hours of training. From here, you can choose your specialty and then undergo an insurance licensure examination. The more experience you have, the better you can become.

    Is Insurance Adjusting Hard?

    Insurance adjusting can often be difficult since you’re working with people who have experienced unforeseen circumstances. And, the claims process can be a time-consuming thing to take on. Yet, insurance adjusters are heavily in demand since claims will continue regardless of any economic factors.


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