How do insurance adjusters calculate claims?


Quick Answer

An insurance adjuster investigates the details of a claim by talking to the insured party to get his version of events, contacting the insurer, requesting and reviewing all documentation in the case and investigating the plaintiff before determining the amount of the settlement offer. The adjuster often makes a first offer that is a percentage of what he believes the final value to be. The plaintiff can accept this offer or continue negotiations.

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Full Answer

The adjuster tries to get the same facts that the plaintiff's attorney has available to make a case on behalf of his client. A plaintiff deals with an adjuster as a representative of the insurance company on which the claim had been made. The adjuster, in turn, investigates not only the present claim but the history of the plaintiff and any other claims he may have made. The adjuster also requests to see documentation, such as police reports, medical bills, medical history, present earnings or proof of property damage, if applicable.

After acquiring all the documentation and evidence that the adjuster deems necessary, he carefully examines this information, Such a task is mainly to look for inconsistencies in the plaintiff's claim, such as in claims based on physical ailments that may have been previously present or false loss-of-income claims.

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