Who Handles an Insurance Claim?
Who Handles an Insurance Claim?
When you make an insurance claim to your insurance carrier, the claim is routed directly to the appropriate handling party. Depending on the insurance carrier, your claim may be routed to a regional adjuster or a remote adjuster. Either way, that adjuster will be the one making coverage decisions for your property.
Before we dive deeper into who handles your claim, it's important to clarify what a claim is. You can also check out “When to File a Claim” here.
A claim, put simply, is a request for compensation. This request is based on the policy you hold with your insurance carrier. You are notifying the carrier that you suffered a loss and by the terms of the policy, the insurance carrier owes you compensation for the loss. Remember that the insurance carrier is only liable based on the terms you agreed to when you signed up for a policy, and that insurance policies are written to compensate you in specific circumstances.
The adjuster should reach out to you to introduce themselves and ascertain more information about your situation. If it is reasonable that the carrier is liable to compensate you for a loss, then they are required to investigate it.
The adjuster will either inspect your loss themselves or hire an outside party to conduct an inspection. Following an investigation into your claim, the adjuster should communicate the carrier’s coverage determination or amount with a reasonable timeframe. Remember, that the carrier’s determination is never final - but they can only make changes when you provide them with the necessary information to do so.
Who doesn’t handle your claim?
Oftentimes, policyholders assume that the party who sold the policy or arranged it, will be the ones who investigate claims. This is not so, underwriters and agents specifically focus on the policy arrangement, not claims. Claims will also be handled by the claims division of whichever party backs the policy.
Does the insurance adjuster represent me?
The insurance adjuster represents the carrier. They should act in good faith to compensate you for your loss, but ultimately they do not work for you or represent you, and principally represent the insurer’s interest. If you are in disagreement with your insurance carrier's decision on your claim, make sure to clarify the carrier's reasoning for their decision and provide any information that could assist the carrier’s adjuster in revising the coverage decision.
When dealing with an insurance carrier in the context of an insurance claim, it can be very helpful to involve a professional to represent your interests. A public adjuster serves as an adjuster to prove your loss, estimate your loss, and ensure the carrier properly compensates you. If you are interested in involving a public adjuster in your ongoing or potential claim, engage us here.
