Legal Definitions - adjuster

An adjuster is a professional who investigates and evaluates insurance claims to determine the extent of loss or damage and to negotiate a settlement. Adjusters work to assess the facts of a claim, verify coverage under an insurance policy, and propose a fair resolution. They can be direct employees of an insurance company, independent professionals hired by an insurer, or public adjusters who work on behalf of the policyholder.

• Auto Accident Claim

  Scenario: After a minor fender-bender, Sarah files a claim with her car insurance company to cover the damage to her vehicle.

  Adjuster's Role: An auto insurance adjuster is assigned to Sarah's case. The adjuster examines photos of the damage, reviews the police report, and obtains repair estimates from approved body shops. Based on this investigation, the adjuster determines the cost of repairs and offers Sarah a settlement amount to fix her car.

  Illustration: This shows an adjuster acting on behalf of an insurance company to investigate a common auto claim and propose a settlement.

• Homeowner's Property Damage

  Scenario: A severe thunderstorm causes a tree to fall on David's roof, resulting in significant structural damage to his home. David contacts his homeowner's insurance provider.

  Adjuster's Role: An independent adjuster, hired by David's insurance company, visits his property. They meticulously inspect the roof and interior damage, take measurements, document the destruction with photos, and consult with contractors to estimate the repair costs. The adjuster then prepares a detailed report and presents a settlement offer to David, outlining the coverage for repairs and temporary living expenses.

  Illustration: Here, an independent adjuster is brought in to objectively assess complex property damage and facilitate a settlement under a homeowner's policy.

• Commercial Liability Claim

  Scenario: A customer slips and falls inside a grocery store, sustaining an injury, and subsequently files a liability claim against the store's business insurance policy.

  Adjuster's Role: A commercial claims adjuster is appointed to investigate the incident. They review security footage, interview store employees and witnesses, examine the store's safety protocols, and gather medical reports related to the customer's injury. The adjuster then evaluates the store's liability and negotiates with the customer's legal representative to reach a settlement that covers medical expenses and other damages.

  Illustration: This example demonstrates an adjuster handling a liability claim for a business, involving investigation into potential negligence and negotiation with legal parties.