The insurance adjuster is seldom, if ever, mentioned in a policy of insurance. The strict wording of the third party liability policies set the obligation to prove a claim that entitles the insured to defense or indemnity of a claim against the insured by an injured third party. Over a century ago insurers determined that to properly deal fairly and in good faith with their insureds, an insurance claims professional was needed to thoroughly investigate claims made against the insured, work with the insured and a third party claimant to resolve claims without litigation, and properly protect the interests of the insured.
...moreAdjusting liability insurance claims requires skill, patience, knowledge of insurance, basic knowledge of tort and contract law, and knowledge and experience as an investigator. To properly and effectively perform the duties of a liability claims adjuster, he or she must be capable of effectively dealing with the following basic obligations:1.To understand the law of torts as applied in the state where the adjuster works.2.To understand the law of contracts as applied in the state where the adjuster works.3.To understand sufficient medical terminology to be able to evaluate claims of injury.4.To understand the costs to repair or replace damaged real or personal property.5.To understand how to read and apply the terms and conditions of a liability insurance policy to a particular fact situation developed by his or her investigation.6.To understand how to thoroughly investigate all claims assigned.7.To conduct an investigation of every claim assigned fairly and in good faith with an intent to find coverage for the loss presented by the insured.8.To be able to effectively, fairly and in good faith negotiate with claimants and lawyers to resolve bodily injury or property damage claims asserted against an insured.9.To ascertain that the insurer pays promptly all claims the insurer owes under the contract.10.To resist, and recommend against payment of all claims the insurer does not owe under the contract of insurance. In the United States, the average adjuster is a 22-year-old graduate of a liberal arts college who has little or no training sufficient to allow him or her to fulfill the obligations imposed on them as a representative of an insurer. Much to the chagrin of insurance claims professionals some modern insurance companies are willing to give the title “adjuster” or “claims representative” to a recent college graduate who has no education or training in insurance, tort law, contract law, investigation, claims handling, or negotiation. These insurers, unconcerned with the need for insurance claims professionals, simply hire a person to be an adjuster, provide no training, and send them out to deal with the public with only the assistance of a claims supervisor who may only have two years-experience.This Compact Book of Adjusting Liability Claims- Third Edition is designed to provide the new adjuster with a basic grounding in what is needed to become a competent and effective liability claims insurance adjuster. It is also designed to work as a refresher for the experienced adjuster.The liability claims adjuster quickly learns that there is little difficulty with a claimant (the person alleging bodily injury or property damage against a person insured) if the claim is paid as demanded. The insured may be unhappy if the claimant’s claim is paid as presented since most do not believe they did anything wrong or fear an increase in premiums charged for subsequent policies. Of course, holding a claimant down to what he or she asks for, is not adjusting. Rather, it is, simply acceptance of an extortioner’s demand which may or may not be reasonable.
(show less)