Claims Adjuster Job Description: Top Duties and Qualifications

A Claims Adjuster, or Insurance Adjuster, is responsible for surveying damages to property or investigating personal injuries to decide how much an insurance company should pay to a policyholder. Their duties include meeting with witnesses and the policyholder, reading police reports and traveling to site locations to look at damages up close.

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Claims Adjuster Duties and Responsibilities 

Claims adjusters have varying duties, depending on what type of insurance company they work for. Typical job duties may include: 

  • Investigating, evaluating and settling insurance claims
  • Determining whether the insured’s policy covers the claimed loss
  • Deciding an appropriate amount the company should pay out
  • Ensuring that claims are not fraudulent
  • Contacting claimant’s employers or doctors for additional information if the claim is questionable
  • Conferring with legal counsel when needed
  • Negotiating settlements and authorizing payments

What Does a Claims Adjuster Do?

Claims Adjusters typically work for insurance companies or insurance adjuster firms to help claimants receive the correct amount of funds in response to personal injury or property damage. They use their knowledge of their employer’s coverage options to apply claim criteria to the policyholder’s situation. Their job is to analyze the events surrounding property damage or personal injury to determine whether there’s a viable claim for compensation from the insurance company. 

They may also need to maintain frequent communications with the claimant to update them on the claim process and when they can expect an answer about payment.

Claims Adjuster Skills and Qualifications

A Claims Adjuster interviews claimants and witnesses, inspects properties and completes additional research, including reviewing police reports when necessary. Skills and qualifications that assist in efficiently completing this job include: 

  • Analytical skills to evaluate if the insurance company is required to pay the claim. Claims Adjusters must consider multiple pieces of information to carefully make a decision. 
  • Communication skills to gather information from individuals, including medical experts, claimants and witnesses. They must know the correct questions to ask to get the information they need. 
  • Attention to detail to carefully review damaged property and documents.
  • Interpersonal skills to meet with claimants and other relevant individuals who may be upset by a situation. Claims Adjusters must be able to be understanding, yet firm with the company’s policies.
  • Math skills for calculating property damage.

Claims Adjuster Salary Expectations 

The average salary for a Claims Adjuster is $59,194 per year. This information is based on 2,375 anonymously submitted salaries along with information gathered from Indeed users and current and past job listings within the last 36 months. 

Claims Adjuster Education and Training Requirements 

While a high school diploma is a minimum requirement for an entry-level Claims Adjuster position, most employers look to hire individuals with a bachelor’s degree or other insurance-related work experience. In the beginning, Claims Adjusters work on smaller claims under the supervision of an experienced employee. As their knowledge grows about the claims process, including investigation and settlements, they are assigned more complex, larger claims. 

Claims Adjuster Experience Requirements 

Licensing requirements for a Claims Adjuster will vary from state to state. While some states have minimal requirements, others require either successful completion of pre-licensing education or a passing score on a licensing exam. Public Adjusters may be required to meet additional or separate requirements. Some states don’t require a Claims Adjuster to be individually licensed; instead, the Adjuster works under the company’s license. In some states that require licenses, Claims Adjusters must also complete a specific amount of continuing education credits each year to renew their licensure. 

State and federal laws, along with court decisions, often affect what insurance policies are required to cover and how claims are handled. Claims Adjusters who work on health and life claims should stay up to date on the latest prescription drugs and new medical procedures. Adjusters who work with auto claims should be familiar with current repair techniques and new car models. To fulfill continuing education requirements, a Claims Adjuster can attend workshops or classes, write articles for claim publications or give presentations and lectures. 

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Frequently asked questions about Claims Adjusters

 

What is the difference between a Claims Adjuster and a Claims Examiner?

The difference between a Claims Adjuster and a Claims Examiner is that a Claims Examiner typically has more seniority than a Claims Adjuster and therefore has a different scope of responsibilities. For example, Claims Adjusters engage with policyholders, review damages and file claims to determine the payment a policyholder should receive for damages or injuries. 

Once the Claims Adjuster files a claim, the Claims Examiner looks over the case and compares it to the Claim Adjuster’s suggested amount of payment. This helps them decide whether the policyholder should receive that amount from the insurance company.

 

What are the daily duties of a Claims Adjuster?

On a typical day, a Claims Adjuster starts by checking their email and phone messages. They reply to time-sensitive messages from coworkers or claimants and look over their to-do list to plan the schedule for the day. Throughout the day, they review insurance claims and contact claimants to schedule a meeting and learn more about the incident. They may also ask them to send pictures or connect them with emergency personnel to verify their claims. Claims Adjusters also travel to a claimant’s home to survey property damage in the event of a house fire or natural disaster. They take pictures at the scene to review once back in the office. 

Once they compare the case to the insurance company’s payout policies they come up with a suggested sum to pay the claimant for repairs to damages or medical bill payments. They then file the claim and provide Claims Examiners with all the documents they need to confirm or deny the claim.

 

What qualities make a good Claims Adjuster?

A good Claims Adjuster is someone who seeks to find the best solutions for claimants while also adhering to the insurance company’s rules and guidelines surrounding insurance claims. They have an investigative mindset that enables them to seek out witnesses, police reports and other evidence to either support or disprove a claim. Further, a good Claims Adjuster has excellent interpersonal communication that allows them to adjust their communication to speak with insurance professionals, members of the public and claimants accordingly.

 

Who does a Claims Adjuster report to?

A Claims Adjuster typically reports to a Claims Manager within an Insurance company. They go to Claims Managers with questions regarding specific cases and to confirm what the insurance company covers in more unique cases.

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