Claims Adjuster

Definition - What does Claims Adjuster mean?

A claims adjuster is a person who investigates insurance claims to determine the amount an insurance company should be liable for. This usually involves conducting interviews, inspections, and a review of related documents, such as police reports and medical records.

Insuranceopedia explains Claims Adjuster

A claims adjuster plays an integral role in the insurance industry. Their responsibilities include the following: verifying the existence of an insurance contract between the insurance company and the claimant, making sure a claim is not fraudulent, interviewing the claimant and witnesses, gathering evidence leading to the damage, inspecting the damaged property or a person’s injury, evaluating the extent of the coverage vis-à-vis the damage or injury, and making a report of the incident and recommending a fair amount of settlement claim to the insurance company.

Meanwhile, other claim adjusters are also tasked to negotiate settlements and even authorize payments. If the claimant contests the outcome of the claim, the claims adjuster works with lawyers to defend their report and the insurer’s position.

Furthermore, some claims adjuster may be self-employed and available to work in the interest of policyholders who may not want to put their faith in the insurance company's claims adjuster. The former is known as a public adjuster.

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