Posted by: jmwilsonmga | April 17, 2012

Answering and Advising Your Clients : Insurance Claims Adjusters FAQs

When a loss occurs, your insured is faced with many different questions – how to report their loss, how the process will work, and how they can remedy their situation (whether it is getting back to work or getting the necessary repairs completed on a business, home or vehicle).   One of the loss-related topics that we, the JM Wilson Claims Department, are frequently asked about is Insurance Claims Adjusters.

What is an adjuster’s role?  What do they do?

An adjuster generally contacts your insured 24-48 hours after being assigned a claim.

A claims adjuster’s role is to investigate and resolve claims for the insurer.  This involves interpreting the policy, investigating a loss, deciding if the policy covers the loss and the amount to pay.  The investigation covers many steps including: conducting interviews, taking photos, collecting physical evidence, obtaining police and medical reports, and (if needed) sworn statements or recordings.

Once the investigation is completed and authorized, the adjuster makes the payment promptly.  The amount reflects items such as deductibles or liens that must be paid.

Are there different types of adjusters?  Do they work differently?

There are three classes of insurance claims adjusters:

  • Staff Adjusters– Employed by an insurance company or self-insured entity.
    • Each company will assign a staff adjuster to the loss to assess the damage.  Our companies will work directly with your insured and use the policy guidelines to settle all claims.
  • Independent Adjusters– Independent contractors hired by the Insurance Company.
    • If it is deemed necessary, these independent third-parties hired by your insured’s insurance company will review the damage.
  • Public Adjusters– Employed by the policy holder.
    • A public adjuster will assess the claim, the same as a staff or independent adjuster would, however they are hired by your insured and represents their rights during property settlements.  Public adjusters are paid through the claim’s settlement.  They will require the insured to pay 10-15% of what the insured receives as the settlement.

How can I best advise my clients when they ask me about adjusters?

If you have a major loss reported to you, please contact our claims department, or advise your insured to contact us, before signing any contracts.  While there are times that a public adjuster can be helpful, we encourage you and your clients to check with our claims department first.  This could be an opportunity to save your client that 10-15% of their settlement costs.  We are here to help you and your clients – making the claims process easy for you.

Have questions for our Claims Experts?  Please contact us at claims@jmwilson.com or 800-964-1126.

About the Author : Jessica Garcia, Claims Supervisor

Jessica joined the J.M. Wilson Team  in 2007 and currently serves as Claims Supervisor.  She handles all claims and claims communication with our agents; additionally she works on the Wellness Initiatives at J.M. Wilson. Jessica loves helping her insureds through a smooth claims process and getting them back to their daily routines and life prior to their loss.   In her free time, Jessica enjoys listening to music, reading, teaching BodyPump and Cycling fitness classes, and spending time with her family and friends.

Connect with Jessica on LinkedIn!

Disclaimer :  This article is for informational purposes only.  There is no legal advice being suggested or proffered.  The author assumes no responsibility or liability for the actions taken or not taken by the readers based upon such information.  This article is the opinion of the author and is not supported or endorsed by J.M. Wilson.  It should not be relied upon and may contain inaccuracies or content may have changed over time, contact your underwriter for the most current and accurate information.  Any comments or responses are the opinions of their authors.  Content on this site is believed to be covered under Fair Use.

Copyright 2012 J.M. Wilson Corporation


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