What does a Claim Adjuster do?
Published 4 min read
A claim adjuster is a professional who investigates insurance claims and determines the extent of the insurer's liability.
Claim Adjuster job duties include:
- Investigate insurance claims by interviewing policyholders, witnesses, doctors, and other relevant parties
- Examine records and compile information to determine extent of company’s liability
- Evaluate findings and recommend appropriate action
- Prepare detailed reports of findings
- Maintain accurate claim files
- Negotiate settlements with claimants and attorneys
- Keep abreast of new developments in the field of insurance claims adjusting
- Perform other duties as assigned by supervisor
1. Investigating insurance claims by interviewing policyholders, witnesses, doctors, and other relevant parties.
2. Examining records and compiling information to determine the extent of the company's liability.
3. Evaluating findings and recommending appropriate action.
4. Preparing detailed reports of findings.
5. Maintaining accurate claim files.
6. Negotiating settlements with claimants and attorneys.
7. Keeping abreast of new developments in the field of insurance claims adjusting.
8. Performing other duties as assigned by supervisor.
9. Reviewing incoming claim referrals to determine if further investigation is needed.
10. Determining if a claim should be accepted or denied based on the evidence collected during the investigation process
Claim Adjuster Job Requirements
A Claim Adjuster is responsible for investigating, evaluating, and settling insurance claims. They work with policyholders, claimants, and witnesses to gather information and determine the extent of the insurer’s liability. A Claim Adjuster must have a high school diploma or equivalent; however, many employers prefer candidates who have completed some college coursework or have a bachelor’s degree. Many states require Claim Adjusters to be licensed. To obtain a license, applicants must pass a written examination. Some states also require continuing education for license renewal. Claims Adjusters typically have several years of experience in the insurance industry.
Claim Adjuster Skills
- Investigation
- Research
- Analysis
- Interviewing
- Claim Handling
- Customer Service
- Communication
- Organization
- Time Management
- Writing
- Negotiation
Related: Top Claim Adjuster Skills: Definition and Examples
How to become a Claim Adjuster
A claim adjuster is a professional who investigates insurance claims. They work for insurance companies to determine the extent of the insurer’s liability, and they also help policyholders receive the benefits they are entitled to.
Becoming a claim adjuster requires completing high school and taking some college courses, although a bachelor’s degree is not required. Many insurers offer on-the-job training for new claim adjusters. Some states require adjusters to be licensed, and continuing education is necessary to maintain a license.
The best way to become a claim adjuster is to start working for an insurance company in another capacity such as customer service or sales. Once you have gained some experience and knowledge about how insurance works, you can then apply for an open position as a claim adjuster. Alternatively, if you have a background in investigations or law enforcement, you may be able to transfer your skills to this field.
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Related: Claim Adjuster Interview Questions (With Example Answers)