A liability adjuster works for an insurance company and investigates when an insured party or third-party beneficiary files an insurance claim under a policy. He or she tries to figure out if the circumstances are covered by the policy. The liability adjuster represents the insurance company in legal actions if the claim is denied or if the company needs to try to recoup a policy payout from another responsible party.
Insurance companies specialize in risk management. They make money when people buy policies and pay the premiums, but they never have to use the insurance company for a claim. When an insurance company has to pay out on a claim, on the other hand, they lose the investment gamble and their profits suffer. A liability adjuster is a field investigator for an insurance company. He is the person in charge of ensuring that the company only has to pay legitimate claims that fall within the policy’s exact terms.
A contract between a company and the person paying the premiums is known as an insurance policy. Because insurance is a calculated risk, the policy’s terms are critical in protecting the company’s profitability. Insurance companies will only pay a claim if it is covered by the contract’s terms. Between the time an insured party files a claim and the time the company accepts or denies the claim, there is always a lag. The liability adjuster is in charge of managing that time frame and determining whether or not the company should pay.
A liability adjuster is assigned to a case when a person calls his insurance company to file a claim. The adjuster looks into the claim by gathering information from the insured party and, in some cases, visiting the scene of the accident. He creates an investigation file in which he records everything he learns about the case. Some people try to defraud insurance companies by lying about the details of an accident or other loss incident; adjusters try to determine whether a claim is legitimate or not.
A liability adjuster must determine not only whether the insured party’s account of the loss is accurate, but also whether the loss is covered. An adjuster must be well-versed in the various types of insurance coverages used in his field. If he works on homeowners insurance policy claims, for example, he must understand the legal parameters of the coverages that are typically included in those policies.
After determining whether a claim should be paid or denied, the liability adjuster must take the steps necessary to close the case. This could include authorizing a check or representing the company in a mediation, arbitration, or court trial to defend his decision to deny the claim. In addition, the adjuster is in charge of pursuing reimbursements from responsible parties or their insurance companies.