What Do Insurance Claims Adjusters Do?

by Dan Tromblay, CLU, ChFC, FLMI, CDEi | Apr 28, 2020

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What do insurance claims adjusters do? from the insurance experts at WebCE

Insurance claims adjusters can have several job titles, such as claims specialist, claims representative, independent claims analyst, etc., but all insurance adjusters do similar work. Insurance adjusters are always needed since accidents and disasters occur year-round. This makes being an insurance adjuster a great option for someone considering an insurance career.

What Do Insurance Adjusters Do?

So — what do insurance adjusters do? All insurance adjusters have similar goals: to settle insurance claims. But the daily routine and specific responsibilities can vary, depending on the type of insurance adjuster.

Types of Insurance Adjusters

There are three main types of insurance claims adjusters:

  • Staff claims adjusters work exclusively for a specific insurance firm. Staff adjusters are usually salaried employees who receive benefits including health insurance, retirement plans, and continuing education training. Staff adjusters respond only to claims for the insurance
  • Independent claims adjusters work as contract employees, often for several different insurance firms or third-party administrators. Independent adjusters often work with catastrophe insurance claims and subsequently have to travel to areas impacted by tornados, hurricanes, earthquakes, or other major natural disasters. Insurance companies often hire independent adjusters if they do not have an in-house adjuster of their own in the area.
  • Public claims adjusters are usually contract workers (but can also be salaried) who work directly on behalf of insurance policyholders, as opposed to working for the insurance company. Public adjusters are employed to help individuals or businesses file their insurance claims if their insurer proposes a settlement that seems insufficient. It’s a public adjusters job to help the policyholder obtain the highest possible settlement from their insurer.

Staff adjusters are able to enjoy a 40-hour-week, 9-to-5 job, but independent adjusters and public adjusters have more flexible schedules. Independent adjusters and public adjusters can sometimes work well over 40 hours a week during a busy season but fewer hours during less busy seasons.

How Insurance Adjusters Settle Claims

After an insurance claim is filed, the insurance company calls in either their own staff adjuster or an independent adjuster to handle the claim. This always involves some degree of investigative work, and all insurance claims adjusters — whether staff adjusters, independent adjusters, or public adjusters — spend a large amount of their time on investigative work.

Insurance adjusters begin by preparing a claim file including information about the incident provided by the claimant and from the adjusters own investigation. During their investigation, insurance adjusters collect information and details about the incident in order to work out what happened. For example, if an adjuster is investigating a car accident, they may gather photos of the damage, photos of the accident scene, police reports, and witness statements.

In some cases, they may even include testimony from relevant experts or expert sources, such as accountants, architects, construction workers, engineers, lawyers, and physicians, etc., depending on the specific case.

Different types of insurance claims adjusters have different goals, as we discussed above. Staff adjusters and independent adjusters are working on behalf of the insurance company and so are looking out for the company's best interests. Public adjusters, meanwhile, try to get the highest possible settlement on behalf of the claimant, as public adjusters are paid a percent of the settled claim.

How to Become an Insurance Claims Adjuster

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If you want to become an insurance claims adjuster, now may be the perfect time. Insurance claims adjusters are in high demand. While the need for adjusters remains steady, a large number of claims adjusters are at retirement age and are leaving the industry.

In order to be an insurance adjuster, you need a high school diploma or equivalent GED. Depending on your employer, you may also need an associate’s degree or bachelor’s degree, but these aren’t required to receive your insurance adjuster license.

Auto damage adjusters sometimes have experience working in auto repair or a relevant nondegree award or certification. Many community colleges and vocational schools offer auto repair programs where students can learn how to estimate the cost of repairing damaged vehicles.

Important Qualities for Insurance Adjusters

There are several personal qualities and skills that can be helpful for professionals working as insurance claims adjusters. These qualities include:

  • Analytical skills. Claims adjusters must evaluate whether their employer (the insurance company) is obligated to pay a claim and, if so, how much they should pay. There are typically several factors to consider when making these decisions that make analytical skills an important asset.
  • Communication skills. Insurance claims adjusters are required to reach out to and communicate a number of individuals ranging from claimants to witnesses, police, experts, and more. It's important to know how to communicate with different groups as well as what questions are important to ask. Claimants may also be upset or emotional, so it's important for claims adjusters to be understanding but also firm about the company's policies.
  • Detail oriented. Claims adjusters are required to carefully review many documents, photographs, and scenes in-person to determine how the insurance company will address the claim. Even small details can have large consequences.

Receiving Your Insurance Adjuster License

Depending on what state you live in, you may have to complete an insurance licensing course and pass a licensing exam. If your state requires insurance claims adjusters to have a license, then your focus should be on obtaining your home state’s license.

Even if you work in a state not requiring an insurance adjuster license, many insurance professionals want to be able to work in states requiring licenses. Adjusters can receive a DHS (Designated Home State) license, which means, if an adjuster resides in a state not requiring a claims adjuster license, they can designate another state as their “home” state and receive that state’s license. This qualification can then be used to work in other states.

If your state requires a license or if you’re obtaining a DHS license, you will likely need to complete continuing education (CE) credits each year to maintain your insurance adjuster license. Check to see what your state requires to maintain your license and what CE is required.

If you have a good work ethic and enjoy investigative work and negotiating, a career as a insurance claims adjuster may be a great choice. If you need to take a licensing exam and aren’t sure where to start, WebCE offers online prep courses and study tools for the insurance adjuster license exams in Texas, New York and Florida with more to come.

WebCE’s interactive, online adjuster licensing courses for Texas and Florida also satisfy the adjuster requirements for 30 other reciprocal states, and you can obtain your insurance adjuster license without ever stepping foot in a classroom or testing facility.

Insurance Adjuster Exam Prep  Exam Prep Company Solutions