What does a Claims Adjuster do?
Published 4 min read
A claims adjuster is a professional who investigates insurance claims. They gather information and evidence to determine how much the insurance company should pay for the claim.
Claims Adjuster job duties include:
- Investigate insurance claims and determine coverage
- Examine claim forms and other documentation to determine if all required information has been provided
- Contact insureds, claimants, witnesses, attorneys, and medical providers to obtain additional information
- Review police reports, credit reports, medical records, and other documents related to the claim
- Determine if claims should be accepted or denied
- Calculate benefits payable on valid claims
- Prepare claim reports and recommendations for approval or denial
- Negotiate settlements with claimants
- Authorize payments on valid claims
- Maintain detailed records of all claims handled
Claims Adjuster Job Requirements
Most insurance companies require claims adjusters to have at least a high school diploma, although some positions may require postsecondary education, and many companies prefer applicants who have completed college coursework related to business or insurance. Many states also require claims adjusters to be licensed, and licensure generally requires the completion of an approved training program and passing an examination. Some adjusters gain experience through internships or entry-level positions with insurance companies. Many claims adjusters start their careers working for independent adjusting firms that handle claims for multiple insurance companies.
Claims Adjuster Skills
- Analytical skills
- Communication skills
- Organizational skills
- Computer skills
- Research skills
- Writing skills
- Investigative skills
- Critical thinking skills
- Problem-solving skills
- People skills
- Negotiation skills
Related: Top Claims Adjuster Skills: Definition and Examples
How to become a Claims Adjuster
There are many reasons why someone might want to become a claims adjuster. Perhaps they have a background in customer service and they want to help people through a difficult time. Maybe they like the challenge of investigating claims and working with numbers. Whatever the reason, there are a few things that anyone interested in becoming a claims adjuster should know.
First, claims adjusters need to have strong communication skills. They will be dealing with people who are often upset or angry, and they need to be able to defuse tense situations. They also need to be able to explain complex insurance concepts in plain language.
Second, claims adjusters must be detail-oriented. They need to be able to carefully review documents and contracts to look for any discrepancies. They also need to have strong investigative skills, as they may need to track down witnesses or gather other evidence.
Third, claims adjusters should be comfortable working with numbers. They will need to calculate damages and settlements, and they need to have a good understanding of statistics and probability.
Finally, claims adjusters need to have good time management skills. They often work on multiple cases at once, and they need to be able to prioritize their workload.
If you have strong communication skills, are detail-oriented, and comfortable working with numbers, then you may have what it takes to become a claims adjuster.
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