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  • Writer's pictureRobert Schuerger II

What Does an Insurance Adjuster Do? Everything One Should Know

The question on many people's minds is: What does an insurance adjuster do? Typically, a claims adjuster settles and investigates claims, and it's a big business.


In fact, the insurance industry is booming because people will always have accidents or natural disasters and will need help claiming those issues and getting money to fix the problem.


If one wants to become a claims adjuster, they must have a high school diploma, take courses, and pass a licensing exam for their state. Typically, insurance adjusters receive on-the-job training to understand potentially questionable claims and investigate claims thoroughly.


Though insurance companies always hire adjusters, it might not be wise to work solely with them for personal injury and property claims. In fact, a lawyer might be the best solution, and Schuerger Shunnarah Trial Attorneys goes to war for Cincy! Learn more about insurance adjusters below!


What's an Insurance Claims Adjuster Do?

What's an Insurance Claims Adjuster Do?


A claims adjuster typically works in the insurance industry, determining the insurance company's liability. This will help them calculate an appropriate settlement amount. They usually handle various insurance claim types, from personal injuries after a car accident to property damage from a storm. Likewise, claims adjusters can inspect businesses, homes, and automobiles for evaluation.


Insurance adjuster positions are widely available, and they often feature benefits, including health insurance. However, it's crucial to know what they do.


Claims adjusters have different duties based on the employer. Regardless of where they might work, they require an in-depth knowledge of what the insurance company covers for its customers. The primary responsibilities consist of:

  • Verifying that an insurance policy exists for the damaged property or injured person

  • Gathering information and evidence relating to the case, such as witness statements and police reports

  • Investigating personal injury or damage accidents

  • Investigating questionable claims

  • Compiling reports of the findings

  • Consulting with specialists, including lawyers, physicians, architects, and engineers

  • Negotiating settlements

  • Authorizing payments

Overall, the claims adjuster investigates insurance claims and works for the insurance company, not the customer. They make sure the company doesn't pay more than necessary, often offering low-ball settlement amounts to protect the business's assets.


The Types of Insurance Claims Adjusters


Insurance claims adjusters work in various settings, and it's important to know if one is dealing with staff, independent, or public adjusters. Here are the types of insurance claims adjusters:


Independent Adjuster

Generally, independent adjusters are contractors and self-employed, so they might deal with various insurance companies. It's easy to become a claims adjuster on an independent scale

Traditionally, insurance claims adjusters work as the independent adjuster deals with catastrophe claims, traveling to the area after an emergency or major weather event. Therefore, the independent adjuster is more objective when approaching the cases because they have no bias toward the company or client.


Staff Adjuster/Company Adjuster

A staff or company claims adjuster will work full-time for one insurance company, which is much different than independent adjusters. They are typically a salaried employee, so they receive continuing education credits and benefits.


Plus, staff adjusters often work on claims relating to personal auto claims and property damage. Though auto insurance claims are their bread and butter, they could manage different claims as needed. There's more emphasis for a person to become a claims adjuster like this because it generally pays well.


Public Adjuster

Public adjusters work primarily for the policyholders. They help business owners and individuals file the insurance claim if the insurance company proposes an unfair settlement amount. Likewise, they'll assist with calamity cases because the settlement will generally be higher.


Like independent adjusters, a public adjuster is self-employed and is an independent contractor in most cases.


Typically, company adjusters don't work nights or weekends, but independent and public adjusters might.


How an Adjuster Settles Claims


Claims adjusters will settle insurance claims, meaning they must review the incident to figure out how much the policyholder can receive. Here's a more high-level overview of what the claims adjuster does:

  • Investigate the Claim - An adjuster investigates to determine the cause of the claim and see who the at-fault party was and whether it's covered.

  • Review Damages - The adjuster must examine the physical damages and might go into the field to check a vehicle or home to better understand the problem.

  • Calculate the Payout - Once the adjuster considers the evidence, they'll determine how much it would cost to fix things.

  • Settle the Claim - The adjuster will resolve the claim, which is based on the insurance policy and legal obligations of the insurance company.


The Work Environment of a Claims Adjuster


Claims adjusters may work in an office setting, from home, or in a hybrid (work/office) environment. However, this depends on the employer, their role, and the claim itself. When a claims adjuster investigates, they will likely travel to conduct the investigation, especially whenever the claim involves property damage.


Should One Work with the Claims Adjuster at an Insurance Company?


After experiencing a loss, there are things to do to ensure the process runs smoothly when dealing with insurance adjusters. Generally, It's wise to keep full records of the emails and written communications between the claimant and the insurance company. Don't rely solely on verbal promises or assurances.

If one isn't happy with the settlement amount, it might be wise to hire an independent claims adjuster or even a lawyer. They will want to see the documentation.


Likewise, it's crucial to open a line of communication between the insurance company and the client. Ask questions about the claims process to know what to expect. Likewise, tell the adjuster when and how to be contacted to speed things up and avoid "phone tag."


Differences Between an Insurance Attorney and a Claims Adjuster


The victim's interest is in competition with the claims adjusters' interest. Even if one pays the premiums every year, the insurance company wants to spend as little as possible for any damages. After filing a claim, the claims adjuster will be around to assess everything and devalue the suit whenever possible. Likewise, they will report a recommendation for settlement compensation to the company.


An adjuster is a licensed professional and has extensive training in preparing insurance claims and estimating fair replacement/repair costs. They're often brought in at the beginning and charge on a contingency fee basis, paid with the funds recovered (if they are an independent or public adjuster).

If it's a staff adjuster, they will evaluate the insurance policy, prepare the claim, and estimate damages, but they will do so in a way that lowers the settlement amount.


An attorney will offer many of the same services as adjusters, but they are unbiased. Therefore, they'll negotiate with the insurer and file lawsuits against it if necessary.


While some states don't allow public adjusters to negotiate, Ohio does include this practice. However, adjusters are more limited as to what they advise or offer the policyholder and might reject the claim altogether if they don't feel they'll get a fair offer.


The insurance company might act in bad faith or not provide adequate coverage. If that happens, an attorney is crucial to move forward. Most people start with an adjuster and then hire an attorney later. However, it's generally best to work with a lawyer from the beginning and before speaking to the insurance company or one of its adjusters. They can help answer questions such as How do insurers value an injury claim?


Why Hire an Attorney to Deal with the Insurance Company

Why Hire an Attorney to Deal with the Insurance Company


An insurance claims adjuster could be deceptive and might bargain with one's life or ability to live. The company is in control and pleasant when a victim files a claim, but the adjuster's goal is to reduce the value or prove there's nothing to pay out.


They're highly trained in the art, and injured people aren't up to bargaining because they're trying to heal. Typically an insurance adjuster requests for medical records and exams. Therefore, it's generally better to hire an attorney to work with the insurance company.


Understanding of Negligence Law

Accident lawyers are trained negotiators, similar to claims adjusters. They know how liability law works in Ohio. The adjuster will likely try to deny the claim, saying that the victim caused more than 50 percent of the damage. Premises liability claimants will usually face the same defense. Therefore, it's ideal to work with a personal injury lawyer.


They know that Ohio is a comparative negligence state. If the victim is less than 50 percent responsible for the claim, they have a right to compensation. Schuerger Shunnarah Trial Attorneys will ensure they get what they deserve.


Get the Maximum Amount of Damages

Victims who have been badly injured or who have suffered injuries that might create issues for the rest of their lives require full compensation, and it's nearly impossible to get that from claims adjusters. They work for the insurance company and aren't there to help the claimant.


Why Choose Schuerger Shunnarah Trial Attorneys to Go to War for Cincy


Instead of working with an insurance adjuster, it's best to hire Schuerger Shunnarah Trial Attorneys. This law firm deals with personal injury claims every day and will fight the insurance company and the claims adjuster.


Victims deserve compensation, and Schuerger Shunnarah Trial Attorneys goes to War for Cincy. Please request a free consultation today!

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