What Does a Liability Claims Adjuster Do, How Do They Help Claimants Injured On The Job?

Liability claims adjusters play a vital role in the insurance industry and are critical in determining fault. These specialized adjusters help individuals and businesses navigate the complex world of liability claims. Their responsibilities are multifaceted and dynamic, requiring a blend of analytical skills, negotiation abilities, and customer service.

text written on a wall that says Claims Examiner

Claim Investigation

The day of a liability claims adjuster often starts with a review of pending claims and a quick prioritization of tasks. One of the primary responsibilities of a claims adjuster is to investigate claims thoroughly. This entails gathering information from various sources, including police reports, witness statements, photos, and medical records. Adjusters may also need to visit accident scenes or interview involved parties. This investigative phase is critical in determining liability and assessing the extent of damages.

For example, if an auto accident claim is being handled, the adjuster might review accident reports, speak with both drivers involved, and assess the damages to the vehicles. They may also contact any witnesses to the accident, the hospital for medical records, and repair shops for repair estimates. This investigative process helps establish the facts surrounding the claim. It may take several days or possibly weeks to gather all of the necessary information.

Policy and Coverage Analysis

Claims adjusters must have a deep understanding of the insurance policies they work with. They will meticulously review the insurance policy of the insured party to determine the extent of coverage for a particular claim. For example, in a liability claim involving property damage, the adjuster will review the policy to verify the property damage coverage limit and assess whether the specific cause of damage is covered.

Negotiation and Communication

Clear and effective communication skills are crucial for liability claims adjusters. Adjusters often need to negotiate with claimants, policyholders, and other involved parties to reach settlements. This involves discussing the findings of the investigation, the coverage limits of the policy, and the settlement amount. Negotiations can be challenging, as they require finding a fair and agreeable solution for all parties involved.

Documentation

A significant part of an adjuster’s role is to document every aspect of a claim thoroughly. This documentation serves as a legal record and ensures that all actions and decisions are well-documented. Adjusters write reports summarizing their findings and detailing their communication with claimants, policyholders, and other relevant parties.

For instance, if a liability claim arises from a slip and fall incident in a retail store, the adjuster would document the incident, the conditions of the store, any security camera footage, and all conversations with the injured party, witnesses, and the store’s management. An adjuster will need to be detail oriented when it comes to documenting a claim.

Client Meetings

Liability claims adjusters occasionally need to meet with clients or insured parties to discuss the claim in person. This could be at the claimant’s residence, a medical facility, or at the claims adjuster’s office. These meetings are essential for gathering additional information, discussing the progress of the claim, and addressing any questions or concerns the claimant may have.

For example, in a personal injury claim, the adjuster may meet the claimant at their home to understand the extent of their injuries and assess any home modifications that may be necessary as part of the settlement.

Legal Consultation

Depending on the complexity of the claim, liability claims adjusters may need to consult with legal experts within their organization or engage external legal counsel. Legal input is invaluable when claims are complex, there are disputes, or potential litigation.

For instance, in a liability claim involving a construction accident, the adjuster may consult with an attorney to navigate the intricate legalities surrounding workers’ compensation and third-party liability.

Administrative Tasks

There are several administrative tasks that come with the job of a liability claims adjuster. Some of these tasks include updating claim files, managing emails, scheduling follow-up actions, and ensuring that all documentation is up-to-date and organized.

Ongoing Training and Professional Development

The field of insurance is continually evolving, with new laws, regulations, and technologies emerging. As such, liability claims adjusters invest time in ongoing training and professional development to stay current with industry changes. This may involve attending workshops, webinars, or in-house training sessions.

The job of a liability claims adjuster can be rewarding as the adjuster works to make the claimant’s life whole again after a work related injury. The adjuster provides individuals with the support needed to rebuild their life after an unexpected injury. Their work requires a unique blend of investigative, analytical, and interpersonal skills.

The foundation to becoming a liability claims adjuster starts with the Accredited Claims Adjuster (ACA) training from Educational Services & Consulting. As candidates earn their ACA designation and refine their skills initially learned through ESC’s comprehensive training program, they can pivot into the liability claims adjuster world.

For more information on how to get started with your 6-20 ACA designation and join this growing field, we invite you to call our Clermont, Florida office at 1-800-309-2459 or read more about the accredited claims adjuster designation process on our website. Beyond our ACA courses, we have partnerships with other companies that offer additional training for adjusters to continue learning the proper ways to handle claims and continue growing in their career.

A huge benefit to enrolling with Educational Services & Consulting is the opportunity to bypass the Florida State exam. Individuals who pass our 6-20 ACA final exam will be exempt from taking the state of Florida exam. In Florida, once you earn your 6-20 accredited claims adjuster designation, you can apply to the state for your all-lines adjuster license. This will enable you to work on home insurance claims, auto and RV insurance claims and property insurance claims. You would have the flexibility to work as a staff claims adjuster or an independent insurance adjuster.

Even if you move out of the state of Florida or your practice takes you out of state, Florida has a reciprocity agreement with other states within the U.S. Individuals who obtain their Florida license are eligible to work in 34 of the 37 states across the U.S. that require an adjuster license. We invite you to call us at 1-800-309-2459 for more information.

Information in this blog post is for informational purposes only and is subject to change at any time.

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