A claims agent investigates and determines the extent of monetary loss resulting from an accident and negotiates the amount the insurance company will pay. There are specialty areas, including commercial lines, personal lines, and life and health adjustment. They document facts, examine estimates, and settle claims for damage to property, vehicles, and equipment. Life and health adjusters primarily deal with claims against life insurance and disability policies.
A claims agent, or claims adjuster, is an insurance professional who determines the extent of a monetary loss resulting from an accident and the amount the insurance company will pay to compensate the injured party. The agent investigates such losses to determine which party is at fault and whether the insurance company is responsible for any payment. Negotiating the amount paid is also part of the agent’s duties. There are several specialty areas for claims agents, from commercial lines adjustment to life and health adjustment.
Most claims adjusters handle property damage or bodily injury liability claims. Property claims occur when property protected by an insurance policy is damaged as a result of fire or severe weather. Liability claims occur when someone is injured or something is damaged and the insured person is at fault. A large part of a claims agent’s job is to investigate claims and determine if the loss is the result of something covered by the insurance policy and if the loss is the result of actions taken by the insured.
The claims agent will document the facts of an accident by taking photos, recording statements, and measuring things like tire marks. The agent will also examine the estimates to repair or replace the damaged property and determine if the estimates are within normal ranges. An adjuster will often need to examine medical bills submitted by an injured party.
There are several types of claims adjusters. Commercial lines adjusters handle property damage and business liability claims. A personal lines claims agent handles auto and home insurance claims. Life and health adjusters process death, disability and disability medical claims.
Commercial lines adjusters settle claims for damage to office buildings, business vehicles, and business equipment or machines. They also settle claims for damages, such as injuries suffered by someone while on insured property or damage to another person’s property caused by employees of an insured business. Commercial lines adjusters can also resolve claims related to workers’ compensation injuries.
A personal lines claims agent deals primarily with auto claims. Many auto claims involve accidents between vehicles; The claims agent settles claims for damage to the insured vehicle and potentially for injury to the other party or damage to the other party’s vehicle. Most homeowners claims involve damage to a home or personal property due to hazards such as lightning or fire. A homeowner’s policy also covers liability for events such as a pet injuring someone or the owner accidentally damaging another person’s property.
A lesser known claim agent is the life and health adjuster. This type of claims agent primarily deals with claims against life insurance and disability policies. In the case of a life policy, the adjuster issues settlements based on death certificates and medical records. For disability claims, the adjuster determines eligibility for benefits based on physician statements and medical records.
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