What Is the Role of the Adjuster When You File a Car Insurance Claim?

Autos & TrucksInsurance

  • Author Laura Ginn
  • Published January 2, 2014
  • Word count 726

Once you file a car insurance claim, your insurance provider normally assigns it to a specialist known as an adjuster. From there on out, the adjuster is the person who will work on your claim the most, so it's important that you understand exactly what their role is as you wait for the insurance company's final decision.

Overview

Very generally, the job of an auto insurance adjuster is to make sure that the car insurance claim you filed is valid given the conditions of your policy. People sometimes file with their insurance company without reviewing their agreements, so it's not uncommon for them to want help for something beyond which they are covered. Even if the claim is valid, the adjuster still has to verify that the amount you are asking for is within the policy limits. If it's not, then the adjuster may approve the claim but not at the amount you expected.

Initial Contact

After you file your claim, the adjuster will have some basic information about your accident. The insurance company needs to make sure that all of this information is accurate, so the adjuster will contact you. Most of the time, he or she does this with a simple phone call.

As you talk, the adjuster will go over the facts you gave in your initial claim. These are often fairly clear, but the adjuster will ask questions about what happened if he or she needs to look at your situation more in depth to determine your degree of fault, if any. If needed, the adjuster will request additional documentation from you, or he or she might ask for certain permissions, such as having you release medical records.

Auto insurance adjusters try to get the big picture about accidents, so they will not limit their initial contact to just you. They also get in touch with the others involved in the incident to get their side of the story. They also look to witnesses, and if you or anyone else got hurt, they might also contact medical providers to verify the extent of injuries and the value of the medical services received.

Field Work

In addition to getting on the phone and talking with people directly or indirectly related to the accident, an auto insurance adjuster also has to consider the physical evidence involved in your claim. This isn't necessarily because the adjuster doesn't believe you--it's simply that the insurance company knows that perceptions are not always accurate, especially in the heat of the moment of an accident. He or she often visits the accident scene. The adjuster might take pictures or measurements, or he or she might sketch out what is at the scene in a formal diagram.

Another part of the adjuster's field work is to look at the damage done to the vehicles or other property. The adjuster once again takes pictures and documents what he sees. Often, by piecing together this evidence with the layout of the accident scene, the adjuster can make better sense of how the accident happened.

Putting It Together

Once the insurance adjuster has collected all the data he can about your accident, he takes some time to review it. He looks for discrepancies and tries to determine objectively if the accident might have been avoided. At this point, the work is a lot like putting together the pieces of a jigsaw puzzle. The ability to analyze and think critically is extremely important.

Decision Alert and Negotiation

The last thing an adjuster does is contact you with a decision about your claim. He or she might award you the full amount you asked for, but the adjuster also might decide that you are entitled to only a portion. In the worst case scenario, the adjuster will deny your claim altogether. At any rate, if you are unhappy with what the adjuster offers you, you usually can appeal. This means you go to the adjuster's supervisor or an appeals board to try to have the claim reevaluated.

Conclusion

At an auto insurance company, the adjuster is essentially a detective. He or she searches for more information and tries to corroborate what everyone has said to get an accurate picture of the accident. It is his or her analysis that determines whether your claim is approved or denied and how much compensation, if any, you get.

Wanda Thibodeaux appreciates that many drivers worry about making a car insurance claim as they fear it will raise the cost of their premiums. Find out more about making a claim and how if effects your policy at uSwitch.com.

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