Victims of personal injury situations can find themselves with a lot of concerns that they must address. For example, depending on the extent of the injury, it may no longer be possible to work or even function as before. There may even have been property damage that needs to be taken care of, which is another headache.
Typically, getting the expected compensation will depend on successfully filing an insurance claim. Of course, this means that the limits of coverage will depend on what the applicable insurance policy offers. In some cases, there are multiple defendants, which means there may be more than a single insurance company at play.
One of the most important roles is that of the insurance adjuster, which will be the focus of today. The idea is to provide all the fundamental details of what an adjuster does, alongside other valuable insights.
What Is an Insurance Claims Adjuster?
A good place to start is by explaining what an adjuster is. Effectively, this is the person who will determine the extent of liability that the insurance company has in the matter. Depending on the kind of policy at play, an insurance company's adjuster could investigate structural damage, auto accidents, personal injuries, third-party property damage, and more.
This will involve a series of tasks, arguably the most important of which is communicating with the claimant, alongside doing research, interviewing witnesses, and doing whatever inspections may be relevant to the matter. Schuerger Shunnarah Trial Attorneys can help with questions such as what if the claims adjuster denies coverage for my injury?
What Types of Insurance Adjusters Are There?
The way claims adjusters work will depend on what umbrella they fall under. There are effectively three different types of adjusters to keep in mind. There may be company, independent, or public adjusters involved in a given matter.
As the name implies, independent insurance adjusters work on a contractual basis. Typically, there will be third-party administrators or multiple insurance firms that will rely on the services they provide. While it's not impossible to see one dealing with standard claims, an independent adjuster will most often be seen where there is an emergency or there are severe weather events such as natural disasters.
In fact, they have become so closely associated with these duties that some people have resorted to calling them "catastrophe claims adjusters."
These adjusters work on behalf of those who have insurance policies. They will assist in filing the claims, particularly if the settlement amount proposed does not seem to be a fair one. Under normal circumstances, public adjusters are not members of staff, instead being hired on a contractual basis.
Company or Staff Adjusters
Unlike independent and public adjusters, the company variant is employed full-time as a staff member of a single firm. Therefore, they will be entitled to the typical benefits that salaried employees receive. This also means that their response is limited to claims that fall under the company they work for. Home and personal auto claims are prominent examples.
Positions Outside of the Insurance Industry That Are Comparable
The properties of the job are not too far removed from other jobs out there, with the key differences being that some of them are not in the same industry. Some of the similar occupations are:
Appraisers and Assessors
Insurance policy clerks
Different Responsibilities Claims Adjusters Take on
A claims adjuster must ensure that there is an intimate knowledge of exactly what the employer offers to customers. Be that as it may, the actual duties that they have may vary from one place to the next. Even so, here are some of the primary responsibilities that would not be abnormal to see:
Authorizing payments to customers or taking a leading role in settlement negotiations
Doing investigations into personal injury accidents or property damage that may have occurred
Putting the required evidence for a case together, which may include witness statements and police reports
Investigating claims that may seem to have a questionable nature
Ensuring that there is an insurance policy in place that covers the damaged property or the injured person in the claim
Going through consultation sessions with different types of specialists including best personal injury lawyers, engineers, architects, physicians, etc., to collect valuable data on the claim.
Compiling the required reports to detail findings from any investigations carried out
Day-to-day Work of an Insurance Claims Adjuster
As you can see, much of what an insurance claims adjuster will be doing is investigative, and because the job is a key determining factor in how claims are handled, it's no surprise. After an insurance claim has been filed, the insurance adjuster will pretty much immediately be called in to handle the whole process. Schuerger Shunnarah Trial Attorneys can answer questions like how do insurers value an injury claim?
They are expected to do whatever is legally acceptable and necessary to ensure that they accurately work out what took place so that they can strike the balance for a fair settlement price. Some of the essential pieces of information needed to do this successfully include:
Property damage or incident photographs and videos
Statements from the different parties involved in the accident
Bear in mind that depending on the type of insurance adjuster, the goal may be different. For example, since a public adjuster is working on behalf of the claimant, the idea is to get the highest possible amount paid out. However, a staff adjuster will have the company's best interests at heart, meaning that the idea is to pay as low an amount as possible or even to avoid having to pay altogether.
Demand for Adjusters for Different Types of Insurance Claims
Believe it or not, this is one of the most stable career paths out there. A big part of that is because the demand for the role is consistently high. In fact, it's one of those special roles that remains in high demand even when there is a recession happening.
A big part of this is simply the nature of how insurance works. If there are natural disasters, adjusters need to be called in to assess the damage. Bear in mind too that customers can be individuals or businesses.
How Do Insurance Claims Adjusters Become Qualified?
While there are more in-depth explanations out there that cover things at a granular level, fundamentally there are three steps that someone would need to take to become a claim adjuster.
The first is completing the required course of education for the job. The floor may be lower than people would think, considering that there are many claims adjusters out there who have nothing more than a high school diploma. Nevertheless, some take their education to the next level, getting an undergraduate degree.
Being licensed is arguably more important than the education element. States will typically require a license for this kind of job, which will usually come with taking and passing a licensing exam. However, there are some cases in which the aspiring adjuster need only complete mandatory paperwork and pay a set fee. There will usually be a background and criminal record check completed.
Experience is the final essential piece of the puzzle. As is the case in other industries, many adjusters will start with an internship or at the entry-level. This allows them to be around more experienced persons who can help with knowledge development in areas such as negotiation, quotation, and medical terms.
The Experience of Working with a Claims Adjuster for Personal Injury Claims
As indicated before, where the interests lie will depend on the type of adjuster it is and which party did the hiring. Typical circumstances will see the insurance company of the negligent party either use an in-house or contracted adjuster, meaning that the best interests of the victim will not be the priority.
This is why victims are often advised to hire their own adjuster. Independent adjusting firms are a good place to start. When a claim involves property damage or injury, getting a proper settlement is not something to be taken for granted.
Health insurance is often not enough to cover injuries suffered, and even if it were, the negligent party should be the one responsible for handling these kinds of costs.
Preparing for Negotiations with Insurance Adjusters
An accident victim needs to prepare adequately to deal with an insurance adjuster hired by the other party, considering the obvious conflict of interest. The best way to win this battle is by having the necessary and correct information on hand.
This can include photographs, videos, expense statements, valuations, witness contact details, medical records, etc. As far as cost estimates are concerned, it's best to get them done independently of the adjuster. Attorney guidance and support are typically recommended for negotiations.
Talk to an Experienced Houston Personal Injury Attorney Today!
While the priority after an accident should be on getting the victim whatever compensation is needed to return to a sense of normalcy, many adjusters will simply be on a mission to minimize the payment obligation of the insurance company.
The best way to fight against this is to retain the services of a seasoned Houston personal injury lawyer who will go to war for you! Schedule a free consultation with Schuerger Shunnarah Trial Attorneys today!