The inner workings of the auto insurance industry are mysterious to the average customer. On one hand, insurance sales are typically handled by an insurance agent or brokerage company. On the other hand, a car insurance claim is usually handled by either an in-house insurance adjuster who works directly for the insurance company, or in some cases, an independent claims adjuster.
What is a claim? A claim is when a policy holder experiences a loss, damages or injury, and reports it to his or her insurance company in order to seek compensation. It is the job of the claims adjuster to investigate the claim. Car insurance claims are regulated on both a state and federal level, so there are many laws about how a claim must be handled.
Insurance adjusters perform a number of duties as part of their job, which is to investigate the car insurance claims assigned to them. Upon receiving a claim, the first thing an adjuster does is to investigate coverage. Once proper coverage has been confirmed, then the insurance adjuster will examine the claim for fraud indicators. If proper coverage cannot be confirmed, then a coverage investigation will be opened.
An insurance adjuster will contact the policy holder as soon as a claim is reported against the policy. If the customer cannot be reached by phone, then a letter will be sent to the policy holder's mailing address. Insurance adjusters investigate damages (property and injury), determine the value of the loss, negotiate settlements, and make payments to the policy holder and claimants, when appropriate.
A professional insurance adjuster must be able to deliver good customer service. Customer who have experienced an auto accident will be concerned with how their vehicle will be repaired, and how they will get around while their vehicle is in the shop. The adjuster may act as a liaison between the repair shop, the insurance company and the customer, assisting with repairs and assuring that a proper estimate is written and approved for payment. The adjuster may also assist the customer with arranging a rental vehicle or moving the damaged vehicle from a tow yard to a repair facility.
Investigating liability is an important part of the insurance adjuster's job. Adjusters will interview the driver of the insured vehicle, the driver of the other vehicle and any witnesses during the course of their investigation. Adjusters will also order the police report, if one is available, and investigate both the scene and damages to ensure that there is consistency and accuracy. After an insurance adjuster has completed the investigation, he or she will complete a final analysis of the car insurance claim, explaining all of the findings and recommendations.