Insurance Claims Help

If your home has been damaged by fire, water, or weather, one of the many things you will need to do is to talk to a insurance claims adjuster. If you’ve ever wondered what being a insurance claims adjuster is like, how to become one, and how the job is done, read the following information.

What do insurance claim adjusters do?

Typically, insurance claims adjusters work for an insurance company, but there are also public adjusters available who can offer a second opinion on your insurance claim if you are unhappy with what your insurance company is offering. Either way, claims adjusters inspect, investigate, and evaluate damage from insurance claims and determine how much the damage is worth, whether the insurance company should accept the damage claim, and how much money the insurance company should pay out to the policyholder.

The major difference between a staff adjuster working for an insurance company and a public adjuster is in whose interests they are representing. If you are adjusting on behalf of an insurance company, one of your goals is to try to limit the amount of money that the company has to pay out. More money not paid to policyholders means more money kept by the company, and more money kept by the company means more profits. Therefore, it is likely that an insurance company’s adjusting will undervalue your claim at least somewhat, as it is in their best interests to do so.

On the other hand, a public adjuster does their adjusting on behalf of the policyholder. This means that a public adjuster will be more likely to find questionable or ambiguous claims in favor of the policyholder, and they will make sure that every last eligible loss is claimed so that the client gets as much money as possible.

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Duties of Insurance Adjusters

Insurance claims adjusters have duties including:

  • Determining whether the insurance policy covers the claim
  • Investigating and evaluating insurance claims
  • Confirming that claims are not fraudulent
  • Making an estimate of how much money the insurance company should pay for the claimed loss
  • Negotiating settlements
  • Authorizing payments

How a Claims Adjuster Evaluates a Claim

Claims adjusters for homeowners insurance must be familiar with the costs of housing, construction, and repair in order to be able to make an appropriate estimate of the value of a claim. Insurance adjusters will inspect your home or business for property damage after a claim and determine the insurance company’s liability.

An insurance adjuster will talk to the claimant and collect information about the claim, such as photos or videos showing the damage that your home and personal property has sustained. They may also consult with other professionals, like construction workers or builders, who can provide an expert evaluation of a claim. Staff adjusters working for insurance companies will add all the information they have gathered to your claim file and prepare a report for the claims examiners, and the examiners will then approve or deny the claim. Once this is done, the claims adjuster can negotiate a settlement with the policyholder.

A claims adjuster may also work for an independent company. These are known as public adjusters. Public adjusters are hired by a claimant to make an independent evaluation of an insurance claim. You may choose to hire a public adjuster if you don’t think the insurance company will give a fair value for your claim, or if you’ve already received a settlement offer that you think is too low. Claims adjusters who work on behalf of insurance companies always have to balance the true value of a claim against the pressure to save the company as much money as they can, while a public adjuster tries to get the highest amount of compensation possible for the claimant.

Are claims adjusters in demand?

The Bureau of Labor Statistics projects that employment of claims adjusters, appraisers, examiners, and investigators will decline 6 percent between 2019 and 2029. This is largely because it is expected that technology will be able to automate some of the tasks that adjusters and similar workers currently perform, for example by computer software automatically evaluating photographs of damaged property and calculating an estimated claim amount. It is also expected that the process of data collection and processing will get faster, thereby improving efficiency and making workers more productive.

On the other hand, the frequency and severity of natural disasters like floods and fires are expected to increase in the coming decades, which may provide an opportunity for increased demand for claims adjusters and employment growth in this field.

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How do you become an insurance claims adjuster?

In order to become an entry-level insurance claims adjuster, typically at least a high school diploma is required, though some positions may require a bachelor’s degree or related work experience.

As a new insurance adjuster, you would typically start working on small claims and be supervised by someone more experienced as you learn the ropes. As you gain experience, you would start to be assigned larger and more complex claims.

Licensing to Become an Insurance Adjuster

Each state makes its own rules about requirements to become an insurance adjuster; some have very few requirements, some require education or successful completion of a licensing exam. In some cases, adjusters are required to complete a mandatory number of continuing education credits per year in order to renew their license. Continuing education credits can be earned through attendance at classes or workshops, writing articles for industry publications, or giving lectures and presentations.

In the state of Indiana, staff adjusters working at insurance companies are not required to obtain a license; they are allowed to work under the company license instead. Public adjusters, however, who work for independent companies, must meet several requirements:

  • Be at least 18 years old
  • Be a resident of Indiana
  • Be determined to be reliable and trustworthy and to have a good reputation
  • Not have committed any act that would result in denial, suspension, or revocation of a public adjuster license
  • Have passed the written public adjuster exam
  • Submit the required forms, application, and fees for a license
  • Have proof of a $10,000 surety bond for the state of Indiana within the past six months

In Indiana, public adjuster licenses are issued for each calendar year. The state does not require pre-licensing education, however.

What skills are required to be an insurance adjuster?

Communication skills

An insurance adjuster needs to get information from a variety of people in the course of their work, including claimants, witnesses, and experts. Insurance adjusters must be able to gather the information they need through proper communication skills.

Math skills

Insurance adjusters need to be able to properly calculate an estimate of what the company owes for the claim.

Interpersonal skills

An insurance adjuster will need to meet with people who have suffered recent stressful and possibly traumatic experiences and may be understandably emotional, upset, or scatterbrained. It is important for insurance adjusters to be empathetic and sensitive to the client’s emotional state while also being firm and focused enough to extract the necessary information.

A detail-oriented personality

Adjusters need to carefully review documents, insurance policies, and damaged property to determine the insurance company’s financial obligation. In this industry, small details can lead to large differences in financial outcomes, so an adjuster will need to be focused and accurate.

Analytical skills

Insurance adjusters must consider all the evidence they have gathered through the course of their investigation to determine whether the insurance company has an obligation to pay the requested claim, and if so, how much.

How much does an insurance claim adjuster make?

According to the Bureau of Labor Statistics, as of May 2019, the median annual wage for claims adjusters and related workers in the insurance industry was $66,790. The lowest 10 percent had a salary of less than $41,100, while the highest 10 percent were paid more than $100,400 per year.

The median annual wages for claims adjusters, examiners, and investigators were highest for those working in government, followed by direct insurance carriers, agencies, brokerages, and other insurance-related activities.

Insurance claims adjusting is generally a full-time job, but adjusters rarely work the typical 9 to 5. Schedules can vary and be irregular since adjusters frequently have to be available for evening and weekend appointments with clients.