Job Description

Short Description:

An adjuster evaluates and investigates insurance claims to determine the extent of coverage and liability. Their responsibilities include reviewing documentation, conducting interviews, and assessing damages to make fair and accurate claim settlements. Adjusters work closely with policyholders, witnesses, and other relevant parties to gather information and negotiate settlements within the parameters of insurance policies and regulations. Strong analytical skills, attention to detail, and effective communication are crucial for success in this role, as adjusters play a key role in facilitating the resolution of claims and ensuring customer satisfaction.

Duties / Responsibilities:

• Examine claims forms and other records to determine insurance coverage.
• Investigate and assess property damage and create or review property damage estimates.
• Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
• Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
• Negotiate claim settlements and recommend litigation when settlement cannot be negotiated.
• Analyze information gathered by investigation, and report findings and recommendations.
• Interview or correspond with agents and claimants to correct errors or omissions and investigate questionable claims.
• Prepare a report of the findings of the investigation.
• Refer questionable claims to the investigator or claims adjuster for investigation or settlement.
• Collect evidence to support contested claims in court.

Skills / Requirements / Qualifications

• Active Listening: Giving full attention to what other people are saying, taking time to understand the point made, asking questions as appropriate, and not interrupting at inappropriate times.
• Critical Thinking: Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems.
• Judgment and Decision Making: Considering the costs and benefits of potential actions to choose the most appropriate one.
• Social Perceptiveness: Being aware of others' reactions and understanding why they react as they do.
• Complex Problem Solving: Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.
• Analytical or Scientific Software: Injury Sciences EDR InSight; Insurance claims fraud detection software; Magnify Predictive Targeting System
• Computer-Aided Design CAD Software: 4n6xprt Systems StiffCalcs; ARSoftware WinSMAC; MapScenes Evidence Recorder; Visual Statement Investigator Suite
• Document Management Software: Agency Management Systems AMS 360; atGlobal Allegro; BCCORP Burkitt W5; InSystems Calligo Document Management System