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Do You Know Who Does What in Your insurance Claim?

Par Nathan Guss|5 min|août 2023

The claims process is complex and involves many professionals. Here’s an overview of what they do.

When disaster strikes your home, the aftermath can be overwhelming. You need to know who you can count on as you try to get back to your normal life. Knowing who does what for your insurance claim can save you time and give you peace of mind.

Several key players are involved, and each professional plays a specific role. Here’s a look at insurance agents and brokers, claims adjusters and public claims adjusters.

The Claims Adjuster

After you report damages to your insurer, you’ll speak with a claims adjuster. He or she guides you through the claims process and is your go-to person for any questions.

Tasks

  • Identify urgent actions and the experts needed post-disaster to secure your property
  • Explain the various steps of the claims process to you
  • Coordinate the cleaning, repair or replacement of your assets
  • Authorize the purchase of replacement items
  • Oversee the payment or reimbursement of living expenses, such as temporary housing
  • Prevent fraud
  • Present and negotiate settlement offers based on damage assessments and policy terms

Although claims adjusters represent the insurance company, they’re bound by a code of ethics. They both look out for the insurance company’s interests and ensure that you are compensated based on the terms of your policy. They’re trained to assess situations impartially so that you receive a fair settlement.

Learn more about claims adjusters’ code of ethics.

The Public Claims Adjuster

While claims adjusters work for the insurance company, you’re the one who hires and pays the public claims adjuster. He or she takes care of most of the work that you would otherwise do when filing a claim. This streamlines the claims process and ensures you receive an accurate settlement that reflects the damages and your policy’s terms.

Tasks

  • Create an inventory of lost and damaged property
  • Handle claims paperwork
  • Keep you informed about your file’s status
  • Help you make good decisions
  • Serve as the point person between you, the insurer, witnesses, experts, etc.
  • Take care of negotiations with your insurance company

Not every home disaster calls for a public claims adjuster. Whether you should hire one depends on your budget and the extent of damages, among other factors.

Learn more about when to hire a public claims adjuster.

Should I call my insurance agent or broker?

There’s no need to call either professional when filing a claim. Their role is to help you select, purchase update or renew an insurance policy.

Here’s what they each do and how they’re different from each other:

  • Insurance brokers help you find the best insurance for your needs. They don’t work for just one insurance company. Instead, they look at many different policies from different companies, trying to find a policy that best fits your needs. You don’t pay them directly. They earn a commission from the insurance company when you buy a policy.
  • Insurance agents, on the other hand, work for a single insurance company. They can educate you about that company’s insurance policies. Agents earn a salary and, at times, a commission from the insurer they work for.

Here’s the breakdown of who does what:

  • If you’ve just experienced a disaster, your first call should be to your insurance company. They’ll assign you a claims adjuster who can help you with your claim and answer all your questions.
  • Need help with tasks, such as drawing up an inventory of losses or negotiating your settlement? Hiring a public claims adjuster might be the answer.
  • There’s no need to reach out to your insurance agent or broker when filing a claim. Get in touch with him or her when you need to renew or modify your policy.

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