24 X 7    CALL : 1-888-331-5263

What Part Does The Claims Adjuster Play In The Claims Process?

What Part Does The Claims Adjuster Play In The Claims Process?

After someone has filed a personal injury claim with an insurance company, that claimant does not speak with the insurer. Instead, that particular claimant, like all claimants communicates with the claim’s adjuster.

The Adjuster’s First Tasks, After Being Assigned A Given Claim:

The adjuster needs to get the answer to a few specific questions. For instance, the insurer expects the adjuster to learn whether or not the defendant in a third-party claim carried some form of insurance. If so, how much money could the defendant’s insurance company pay on that claim?

Sometimes a policy holder makes a first party claim. In that case, the adjuster would need to learn the extent of the coverage provided by the customer’s/claimant’s policy. In addition, a smart adjuster would check to see if that same policy covered any associated expenses.

The remaining tasks that must be tackled by adjusters, those that are working on an assigned claim:

Investigate the details associated with an assigned claim. Assess the amount of damage caused by the reported accident. While performing that particular task, adjusters frequently snap pictures of the damage. A personal injury lawyer in Lakewood, can serve as the claimant’s primary means for contacting the insurance company. Determine who should be held responsible for the accident and obtain a copy of the police report.

Interview any witnesses that have been named by the plaintiff or the police in the police report. Seek out the plaintiff’s hospital records, if the plaintiff spent time in the hospital. Consult with experts, in hopes of finding an expert that would be able to refute one or more of the plaintiff’s claims. Prepare a damage report, which must be given to the insurer.

Work with all those that have been asked to complete the repairs that were sought by the claimant/plaintiff. Negotiate with the plaintiff/claimant, or with the plaintiff’s lawyer. This task could eat-up a good deal of the adjuster’s time. The 2 sides must keep exchanging offers until they reach an agreement, or until it becomes apparent that the 2 sides have reached a stalemate.

If the 2 sides do reach an agreement, then the adjuster becomes charged with the job of arranging for payment of the claim.

The adjuster’s goals

All adjusters hope to uncover some evidence that can allow the insurance company to question the veracity of the claim that has been presented to that same company. In other words, each of them wants to limit the amount of money that the insurer must pay to the claimant.

By the same token, every adjuster’s move, reflects the insurer’s desire for a quick settlement. Adjusters’ actions demonstrate their desire to please their boss, the insurer. That insurer wants the claim settled just as soon as possible.

Enter your keyword