You probably don’t spend much time thinking about claims adjusters – until you need one. When that happens, you might become very curious about claims adjusters, what they do and how their work will impact your insurance claim. To give you some insight, here’s an inside look at the day-to-day work of an auto adjuster.
The Role of Claims Adjusters
A claims adjuster, also called an insurance adjuster, is responsible for determining appropriate compensation for a claim. This can be a very complicated task involving the following steps:
Step 1: Check the type of coverage in place.
To do this, claims adjusters compare the details of the insurance policy to the type of claim you’ve submitted. For example, if your claim is for damage to someone else’s car, they’ll check to see that you have property damage liability coverage. On the other hand, if your claim is for damage to your own car, they’ll check to see if you carry collision insurance.
Step 2: Verify the amount of coverage – also known as your policy limits.
For example, if you’ve been involved in an accident that caused $75,000 of medical treatment for another person, they’ll need to know the bodily injury liability limit on your policy. They can only pay claims up to your policy limit.
Step 3: Decipher what happened, and who was at fault, if it matters.
In addition to examining the claim, adjusters may talk to witnesses and read police reports. In this way, claims adjusters are similar to other types of investigators. Hawaii is considered a no-fault state, which means that your insurance company will pay covered claims up to the personal injury protection benefits (“PIP”) limit, for you and your passengers’ injuries, regardless of who is at fault.
Step 4: Determine the value of the claim.
Claims adjusters assess the amount of damages incurred – either for property damage, bodily injury or liability. If the claim involves damage to your vehicle, they determine what can be repaired and what must be replaced, and how much this will cost. They may send the information to an appraiser for an estimate. The value of the claim will also depend on the policy limits as discussed in step 2.
Step 5: Coordinate your defense in the event of a lawsuit.
If you are sued, your claims adjuster will hire an attorney and help coordinate your legal defense. When the facts of the case are known, the claims adjuster will play an integral role (along with attorneys) in determining if the lawsuit should be litigated or settled. If there is a settlement, your adjuster will explain the process and facilitate the paperwork.
Step 6: Help get you back to normal.
Claims adjusters may also help with other matters, such as arranging for temporary transportation. They may contact third parties to set up repairs. They talk with the insured and answer any questions that arise. They may also pay bills related to your claim.
Step 7: Evaluate subrogation potential.
Although Hawaii is a modified no-fault state, this doesn’t mean carriers don’t investigate fault. In certain cases, they may pursue wrongful injury or subrogate for property damage claims. Successful subrogation can be beneficial to you, by eliminating your deductible and protecting your policy standings and credits.
Working with a Claims Adjuster
Having a claim can be stressful, but a claims adjuster can help you through the process. Plan to communicate frequently, ask questions and use your adjuster as a resource. The claims adjuster is there to resolve your claim as fairly and efficiently as possible.
