What is a car insurance adjuster?
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UPDATED: Oct 15, 2021
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When a licensed driver is involved in a car accident, the act of filing an insurance claim should occur after insurance information is exchanged at the accident site, the police have completed their accident report and all parties and vehicles have been removed from harm’s way.
A comfortable and quiet setting is always best for filing an insurance claim which can be done by phone or online.
Time is of the essence, however, and once those involved in a car accident are safe and recovering, the claim should be filed as soon as possible.
Insurance companies have different protocols, procedures and employee labels for providing a very standard product which is strictly governed by state and federal laws.
The employee classifications in this article may not be the same as in other insurance companies, but the responsibilities and results of these different types of claims adjusters would be equal.
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Claims Adjuster Responsibilities
The following tasks are handled by a claims adjuster:
- Investigating and confirming all details of the accident. A claimant may not realize the relevance of certain details. The adjuster is trained to ask certain questions in order to get to important conclusions. Co-operation and honesty is critical when speaking with a claims adjuster.
- Assessing damages – Insurance claims adjusters have different levels of qualifications and responsibilities. Very large insurance companies have more levels of adjusters with less range of responsibilities for each adjuster level.
- Settling claims and issuing payments- The claims adjuster will determine the amount of loss and issue payment to the insured or the damaged party.
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Types of Claims Adjusters
Claims departments of insurance companies have individuals assigned to take incoming claims. As filed claims initially reach the insurance company, they are managed in the following order by the appropriate level and capability of the individual claims adjuster.
Insurance companies have claims adjusters trained to screen incoming claims. These adjusters are frequently known as First Notice of Loss or FNOL adjusters. An FNOL will ask for the insurance policy number to begin the process. Anyone can file a claim as long as there is a policy number.
Car owners, damaged parties, friends and relatives may all file claims. The FNOL will ask the following in order to proceed or direct the claim to a different adjuster:
- The existence of any injuries to any person involved in the car accident.
- Date, time and location of accident.
- Police report identification number.
- Names and contact numbers of all adult parties involved.
- Insurance companies of other involved parties.
- Names and contact numbers of available witnesses.
Being prepared by having important information available for the FNOL will help to settle a claim quickly with satisfactory results.
Claims that do not involve liability issues and are covered by comprehensive or collision coverage are known as “single vehicle” claims.
Single vehicle claims require minimal investigation and some companies use their FNOL adjusters to investigate and settle single vehicle claims. The types of claims listed below are good examples of single vehicle claims:
- A collision with a deer or other animal.
- Weather damage such as wind or hail.
If the facilitator/comprehensive adjuster learns that the subject vehicle has damaged another vehicle or property and there would be a likelihood of liability, the claim is referred to a higher level of claims adjuster.
Liability Claims Adjuster
Liability claims adjusters typically do all of their work within an office environment and do not leave the office to complete their investigations and pay settlement claims. These claims adjusters typically have these responsibilities:
- Review police reports and photos.
- Take recorded statements from witnesses and drivers.
- Assign field appraisers to evaluate, assess damage and take photographs.
- Decide whether or not to issue payment and decide amount of payment for damages.
- Liability claims adjusters may authorize field appraisers to issue payment upon completion of evaluation and assessment.
Material Damage Appraisers
Material damage appraisers often have the authority given by the liability claims adjuster to issue settlement payments.
Material damage appraisers do the insurance work that requires travel to different sites; they are frequently in the repair shop consulting with repair professionals.
The responsibilities of material damage appraisers include the following:
- Photograph damaged vehicles.
- Write repair estimates.
- Determine if the cost to repair is more than the value of the vehicle and call it a total loss.
- Collect additional information requested by the liability adjuster to confirm impact points or compare vehicle damage to bodily injury reports.
Fire and Theft Claims Adjusters
Although fire and theft claims adjusters deal with fewer liability issues, this level of adjuster typically has experience equal to that of a liability claims adjuster with an additional background of criminal justice.
There is a very high incidence of fraud in fire and theft loss when it comes to auto claims.
Bodily Injury and Liability Claims Adjusters
When there is the pain, loss and medical expense of bodily injury or death, the liability is at its highest level.
Bodily injury and liability claims adjusters are the most highly trained and experienced claims adjusters in the auto insurance industry and are responsible for the most in-depth investigations.
These claims adjusters would have these professional responsibilities:
- Review medical and diagnostic reports.
- Compare all medical findings with vehicle damage reports and police reports.
- Communicate with injured person’s attorneys.
Payments from insurance companies to car accident victims are always limited to the upper amount of any car insurance policy. In order to recover damages over an insurance maximum, the injured party must take legal action.
Insurance companies are bound by state and federal laws when it comes to car insurance coverage amounts and requirements.
Although rates vary widely, many states limit the amounts that insurance companies can charge for auto policies.
Speed and efficiency along with extraordinary service is how insurance companies are able to set themselves apart from their competition.
Damage and injury claims always follow some level of suffering and loss as well as inconvenience. Car insurance claims adjusters are expected to return injured and damaged parties to their condition before an accident as well as possible without any additional trauma.
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