The role of an Insurance Adjuster is to determine the amount of loss coverage that the company is accountable for. They investigate, analyze, and calculate the amount of damage claimed in order to establish an accurate settlement payment that would both satisfy the client’s needs and protect the company from unnecessary or excessive loss.
Insurance Adjusters usually work as part of the staff of an insurance company or as independent Adjusters. Companies often hire Insurance Adjusters when they have a reason to suspect that their client, or the claim they filed, is involved in some form of insurance fraud. Should an Insurance Adjuster determine that a claim is part of a fraud, through analysis and examination, the case will usually be settled by a court of law.
These professionals mostly work with claims related to property or vehicle damage, although health related claims are not uncommon. When dealing with these claims, Insurance Adjusters visit and investigate the scene of the accident to determine its cause, interview witnesses and experts to collect further information, and evaluate the policy contract to verify the extent of the coverage granted.
Here’s a non-exhaustive list of common tasks Insurance Adjusters are required to complete.
- Examining claims to determine insurance coverage:
- Determining the cause of the accident;
- analyzing all possible variables;
- interviewing claimants, witnesses, and other relevant parties (e.g. Police Officers, Physicians, or other experts); and
- verifying the veracity of the information collected.
- Assessing damages caused to a property:
- Apprising the value of damaged property;
- estimating the value of the losses; and
- calculating an appropriate settlement payment.
- Reviewing reports (e.g. medical records, medical bills, or property damage reports) related to the claim:
- Estimating the cost of all damages caused; and
- verifying that the policy covers all damages.
- Authorizing or denying a settlement payment based on findings.
- Negotiating a settlement with the claimant:
- Explaining the policy contract and what it covers to the claimant;
- trying to find a settlement that benefits both parties; and
- suggesting a litigation process if negotiations prove futile.
- Investigating suspicious claims:
- Analyzing records and evidence to validate the veracity of a claim;
- determining if insurance fraud is at play; and
- referring cases of fraud to the company and the corresponding legal authorities.
- Writing legal and investigatory documentation based on findings:
- Presenting reports to the insurance company;
- collecting information to be presented as evidence in a court of law if necessary; and
- presenting testimony and reports as evidence in a court of law when necessary.
- Visiting scenes of accidents.
- Inspecting damaged property to appraise losses.
- Interviewing medical personnel and witnesses, and working alongside other experts.
- Calculating the value of damages suffered by the claimant.
- Analyzing the insurance policy to determine the extent of coverage.
- Investigating cases of suspected fraudulent claims.
- Writing reports based on findings.
- Preparing documentation to be presented in a court of law as evidence.
- Negotiating settlements with claimants.
The average Insurance Adjuster salary is $59,707 per year or $31 per hour. This is around 1.8 times more than the Median wage of the country. Entry level positions start at $42,000 while most experienced workers make up to $84,000. These results are based on 7 salaries extracted from job descriptions.
- Outstanding mathematical, statistical, and numerical skills:
- Appraising losses involved in a claim;
- working with long and complex spreadsheets; and
- calculating settlement payment arrangements.
- Exceptional communicational and interpersonal skills:
- Communicating in a clear manner in order to create strong and communicative relationships with customers and coworkers;
- communicating regularly with medical experts and other specialists to collect reports based on examinations;
- having a friendly and appealing personality to engage in positive interactions with clients; and
- listening carefully and understanding clients’ inquiries in order to be able to assess and resolve any issues promptly.
- Strong analytical skills:
- Possessing a detail-oriented approach to analysis;
- examining damages and losses involved in a claim;
- reviewing long and complex medical and expert reports; and
- analyzing all losses for a company involved in a claim.
- Excellent time management and organizational skills:
- Being capable of taking on several tasks at the same time;
- being able to work in a dynamic, fast-paced environment; and
- being able to work both independently and as part of a team.
- Good computer skills:
- Using specialized software to calculate losses and their value; and
- using word processors to write reports and documentation.
- Problem-solving and decision-making skills:
- Identifying cases of fraud and resolving problems in a timely manner; and
- authorizing or denying a claim based on findings.
- Being resourceful, energetic, driven, structured, and displaying a strong desire to take initiative.
Entry-level jobs as an Insurance Adjuster often require applicants to have completed a secondary education, as well as possessing a bachelor or associate’s degree in Business Administration, Economics, Risk Management, Engineering, Mathematics, or Statistics. However, most employers in this field care more about the candidate’s experience in related areas. Applicants with at least 2 years of previous work experience in the type of claims they will be working with (e.g. Construction for property claims, Mechanical Engineering for vehicle claims, or hospital work for health claims) will have an advantage during the selection process.
Furthermore, all Insurance professionals in Canada are required by law to be properly licensed to do their job. Each province and territory has a designated entity in charge of issuing these licences. Applicants must be licensed to work in the province or territory where they reside. British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, and Quebec each have their own regulators tasked with, among other things, issuing the necessary licences that all professionals working in Insurance need to have. New Brunswick, Prince Edward Island, Nova Scotia, Newfoundland & Labrador, and the Northwest Territories are all under the jurisdiction of the National Superintendent of Insurance.
Insurance Adjusters usually work the standard 9-to-5 office hours, on a Monday through Friday basis. However, in some cases they might be required to work extra hours to complete examinations and reports. The work of an Insurance Adjuster is both office and field-based. The nature of their job requires them to travel to the scene of accidents, visit the premises of the claimant, inspect locations, and interact with various experts. Therefore, most Insurance Adjusters are required to possess a valid driver’s licence in order to get around to these places. Office work for an Insurance Adjuster consists in analyzing the information they have gathered, doing the necessary calculations, as well as preparing reports and documentation.