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Insurance Claims Adjuster School 101.1
What is Claims Adjusting?
On
my first deployment to a major hurricane I was a nervous green horn. I didn’t
have enough confidence to make a decision and so I asked questions—lots of
them.
That
was good. Never be afraid to ask questions—lots of them. That’s how you learn. Especially
in the insurance world—there is no dumb question.
Policy language can be confusing and can be interpreted differently. So, if it’s your first day on the job or you’ve been at it for thirty years, if you have a question, ask. Don’t be ashamed to ask. And when you ask too many, and it’s time to cut the umbilical cord, they’ll let you know. They did me. The long hours and endless flow of questions fired at my inside handler finally wore on his nerves until he blurted out:
Policy language can be confusing and can be interpreted differently. So, if it’s your first day on the job or you’ve been at it for thirty years, if you have a question, ask. Don’t be ashamed to ask. And when you ask too many, and it’s time to cut the umbilical cord, they’ll let you know. They did me. The long hours and endless flow of questions fired at my inside handler finally wore on his nerves until he blurted out:
You’re an
adjuster—adjust.
I continue to ask questions—lots of them.
I don’t think he realized the
wisdom of his words that day. I’ve forgotten his name, but still remember his
words. It remains some of the best advice I’ve been given regarding adjusting
even after all these years.
You may do the same things over and over, but no claim should be considered a brainless cookie-cutter exercise. Consider each and every claim as having its own unique set of circumstances and adjust each scenario against policy guidelines, and then, make a recommendation accordingly. As an adjuster you’re paid to give recommendations.
You may do the same things over and over, but no claim should be considered a brainless cookie-cutter exercise. Consider each and every claim as having its own unique set of circumstances and adjust each scenario against policy guidelines, and then, make a recommendation accordingly. As an adjuster you’re paid to give recommendations.
Kind of
like CSI
Sometimes the human element
gets involved and things get a little hairy. You may hear someone tell you that
old crack in the drywall resulted from a tree hitting the roof. Perhaps.
Perhaps not. Your job is to gather evidence and determine what direct physical damage
was related to the insured peril. And also, just as important—damage not related
to the insured peril—especially damages claimed by insured as resultant damage.
We’ll get into that, in more detail later.
Remember, adjusting, in a nutshell is to let the carrier know if they need to write a check and if so; why, and how much. You are the eyes and ears of the carrier. You are to see what happened. Listen to what the Insured said happened. And document this through photos, sketches and written word. Generally the carrier is the check writer, and they will hold the final decision regarding what gets paid.
An official statement you can make might sound like this:
Remember, adjusting, in a nutshell is to let the carrier know if they need to write a check and if so; why, and how much. You are the eyes and ears of the carrier. You are to see what happened. Listen to what the Insured said happened. And document this through photos, sketches and written word. Generally the carrier is the check writer, and they will hold the final decision regarding what gets paid.
An official statement you can make might sound like this:
“I
do not have authority to extend or deny coverage.”
But, I usually say something like:
“It’s
not my check book, so your carrier will make the final coverage decision. If it were my check book…I’d be fishing right
now.”
This statement basically says
the same thing, but in a way they’ll remember—which keeps you off the hook. And the insured is less likely to get confused
and say you promised them a big fat check.
Well, that’s all for today.
What questions do you have
about how to get an insurance claims adjuster job? Or insurance claims adjuster
training?
I read you correspondence and
try to answer as quickly as possible.
Doug Spurling
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