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by Ken May

            As far as jobs are concerned in the insurance industry, being an auto claims adjuster is about the most stressful one. Before I became the principal at Ken May Insurance Services, I worked on the company side and had the pleasure (if you’re an insurance geek) and opportunity to witness the various departments and job duties within an insurance company. In fact, part of my job as a program manager was to coordinate and oversee the claims, underwriting, customer service, program development, and marketing departments all the while trying to manage successful auto insurance products in six states and keeping within the budget. This was fascinating to me but the one job that I would have to think long and hard about before signing up would be as an auto claims adjuster.

            I learned that in many cases, it’s all about price to many consumers at the time of purchase but it becomes all about coverage when a mishap occurs and a claim needs to be filed. In other words, many people want a discounted price when they buy a policy but expect over-the-top coverage when they have a claim. Woman with stacks of files

           So what exactly does an auto claims adjuster do? First, they have to evaluate a claim to see if the insurance company needs to pay on it and if so, how much. In a case where two or more vehicles are involved in an accident, they have to determine what percentage each party to the claim was responsible. When they walk into the office each morning, they will typically have anywhere from 100 to 160 claims on their desks that they are working on.

            Other daily duties include interviewing claimants and witnesses, inspecting photos of the vehicles involved in the loss, obtaining and reviewing police reports, negotiating with other claims adjusters from other companies, work with attorneys on both sides, obtain reports and interview physicians, and work with other third party vendors which become part of the claim. And remember, this process is for each claim though some claims are easier or more difficult than others. Some companies employ Field Adjusters who conduct scene investigations, go to court when needed, conduct remote interviews of parties involved in a claim, and sometimes end up commiserating with someone who just suffered a devastating loss. The in-house adjuster must work closely with the field adjusters to get the right facts and to make the right decisions involving how much each party was at-fault which will affect any payouts. And did I mention that in most cases, the adjusters are forced to deal with people who are extremely emotional and impatient?

            Another job that the adjuster has is to be on the lookout for any fraudulent activity. Some car owners, body shops, and even attorneys seem to think that trying to defraud an insurance company is an acceptable practice. In some large urban markets, fraud rings and staged accidents are rampant. I’ve been told that about 25% of your auto insurance premium is due to the costs of insurance fraud (another 25% is due to uninsured motorists).

         Claims Adjuster   How does an auto claims adjuster handle such a stressful and demanding job? No, the answer is not alcohol (most of the time). An adjuster must be an expert on time management or be buried in additional claims. The adjuster must know how to effectively prioritize his or her daily functions. The adjuster must set reasonable expectations as to how many activities can be realistically and effectively processed in a day. An adjuster simply cannot waste time or procrastinate or will soon be out of a job.

            It is often said that it is during the claims process when the true value of an insurance company comes to light. So the next time you start getting heated because your assigned adjuster hasn’t gotten right back to you by phone, please remember that he or she is following a complicated process, coordinating many parties to the claim, negotiating with other carriers and attorneys, determining whether or not there is coverage, and juggling over 100 files sitting on his or desk. With that in mind, you may have a greater appreciation of just what the adjuster is doing for you. And if you don’t understand a part of the process, ask the adjuster or call your agent.  

Posted 5:15 PM

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