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Insurance adjuster roles types

Understanding Insurance Adjuster Roles Types

By Eli Goins · Published: · Updated: · 2 min read

Public adjusters specialize in first-party property claims. It is typical that insurers tend to adjust claims in ways that benefit the themselves (to minimize the payouts). The basis for loss adjustment in some complex property damage claims involves judgment and interpretation. Different judgement calls can make thousands of dollars of difference in recovery to the insured.

It is always a good idea to employ the services of an experienced Public Adjuster to make the judgments and interpretations that favor the insured, and to have a forceful advocate in its dispute with the insurer. While Public Adjusters are not supposed to practice law, they skate at its edges. Experienced Public Adjusters are good at interpretation of property insurance policies that they know the ins and outs where insureds can maximize their recovery.

The following are some functions or tasks that public adjusters can perform for clients

  • Assist in the gathering of photos, documents and evidence needed
  • Assist in the completion of needed claim paperwork, often required by the policy
  • Explain and interpret insurance provisions (policy)
  • Coordinate and arrange for inspections of damaged property and loss location
  • Negotiate with the insurance claims adjuster
  • Advocate for the policyholder
  • Remove or minimize the hassle and drama of dealing with the insurance company or its adjusters
  • INSURANCE COMPANY STAFF ADJUSTERS

Employees of an insurance company who are tasked with handling claims filed by policyholders. These adjusters that are employed by the insurance company and are on the insurer’s staff are often referred to as staff adjusters.


INDEPENDENT INSURANCE ADJUSTERS (IAs)

Independent adjusters are adjusters that work for firms that offer claims adjusting services to insurers for a fee, based on time and expense or a sliding scale. For some insurance companies, they fill the role of staff adjusters. Other carriers may use both staff, independent adjusters or CAT adjusters.


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THIRD PARTY ADMINISTRATORS (TPAs)

TPAs are firms with Independent Adjusters that handle claims from insurers or from self-insured (corporate) clients. TPAs refer to large independent claims services providers that span a large geographic scope and may have hundreds or even thousands of employees spread over a large geographic area.

Others may be smaller “Mom & Pop” firms. They may range in size from single-person to independent adjusting firms with a handful of claims handlers to a few administrative staff.

Resources:


IA & TPA Firm

IA Firm

Finding a PA Firm

Frequently asked questions

What are the types of insurance adjusters?
The article describes four main roles. Staff adjusters are employees of the insurance company. Independent adjusters (IAs) work for firms that adjust claims for insurers for a fee. Third party administrators (TPAs) are firms with independent adjusters handling claims for insurers or self-insured clients. Public adjusters work for the policyholder. Some carriers also use CAT adjusters.
What is a staff adjuster?
A staff adjuster is an employee of an insurance company who is tasked with handling claims filed by policyholders. Because they are on the insurer's payroll, their employer is the insurance company, not you. Some carriers rely on staff adjusters, while others use independent adjusters or CAT adjusters, or a combination.
What is an independent adjuster?
An independent adjuster (IA) works for a firm that offers claims adjusting services to insurers for a fee, based on time and expense or a sliding scale. For some insurance companies, IAs fill the same role as staff adjusters. Either way, the adjuster is paid through the insurer, not the policyholder.
What is a third party administrator (TPA)?
A TPA is a firm staffed with independent adjusters that handles claims for insurers or for self-insured corporate clients. Large TPAs are independent claims services providers that span a wide geographic area and may employ hundreds or thousands of people. Others are smaller 'Mom & Pop' firms, ranging from a single person to a handful of claims handlers.
What does a public adjuster do?
A public adjuster specializes in first-party property claims and advocates for the policyholder. Typical tasks include gathering photos, documents, and evidence, completing required claim paperwork, explaining and interpreting policy provisions, coordinating inspections of the damaged property, and negotiating with the insurance company's claims adjuster. The goal is to make the judgment calls and interpretations that favor the insured and maximize recovery.

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