In insurance, what does a "claims adjuster" do?

A claims adjuster plays a crucial role in the insurance process by reviewing and assessing claims to determine the validity and extent of the payments that should be made to policyholders. When a claim is filed, the adjuster investigates the circumstances surrounding the claim, which may involve gathering evidence, interviewing witnesses, and coordinating with other professionals such as medical experts or accident reconstruction specialists.

The adjuster evaluates the policy to determine whether the claim is covered, and if so, they will establish how much compensation is warranted based on the details of the incident and the insurance policy terms. This role is essential for ensuring that claims are handled fairly and that payouts align with the coverage promised to the insured. The role requires both analytical skills to assess damages and a thorough understanding of insurance policies to make informed decisions.

While processing payments and refunds, inspecting properties for underwriting, and developing policy language are important tasks within the insurance industry, they fall under different job functions and responsibilities that do not directly relate to the primary duties of a claims adjuster.