Confessions of an insurance claims adjuster
When you file an insurance claim, you put your trust in a claims adjuster to help you get back to normal. But have you ever wondered what the experience is like from the other side? Bankrate asked New York-based Scott Congiusti, assistant vice president of claims for HUB International insurance brokerage, to take us behind the scenes of a claims adjuster’s life.
Understanding the process that an adjuster goes through to settle your claim could help you be more prepared for your own loss experience. You may be better able to provide an adjuster with the information and documentation needed to help move your case along. The insights shared by Congiusti might even help you head off misunderstandings before they happen.
A lot in common with being a cop
I was working as a police officer in New Jersey when I fractured my back in an off-duty accident. During my recovery, I started looking at what I could do in the private sector and took a job with Allstate, handling automobile claims. It was a good mental fit because I like figuring things out and I function best under high stress. A mundane, sedentary job would drive me nuts. Strangely enough, a lot of insurance claim adjusters have a criminal justice degree; they just might not like shift work or carrying a gun.
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Powered by Coverage.com (NPN: 19966249)
Coverage.com, LLC is a licensed insurance producer (NPN: 19966249). Coverage.com services are only available in states where it is licensed. Coverage.com may not offer insurance coverage in all states or scenarios. All insurance products are governed by the terms in the applicable insurance policy, and all related decisions (such as approval for coverage, premiums, commissions and fees) and policy obligations are the sole responsibility of the underwriting insurer. The information on this site does not modify any insurance policy terms in any way.
Every day starts with the hotline
You come in every day and you have a list of automobile claims assigned to you from the insurer’s 24-hour hotline. If I was lucky, I’d have two or three, but it was usually more. Still, I had more information from the hotline than I did in law enforcement, where somebody would call and say, “There’s a fight in progress,” but you didn’t know what caused it or how many people were involved.
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Camera required, other gear optional
Absolutely the most important tool for a claim adjuster is a digital camera, cell phone or tablet to capture photos. You also need a lengthy tape measure and maybe a moisture meter to detect standing water behind walls or under floors. In a catastrophe, you need protective gear and a ladder in case you have to climb on a roof. And regardless of technology, I still carry a notepad, because depending on where you are, it’s not always practical to carry a $2,000 tablet around with you.
Adjuster styles differ by insurance types
Insurance claims adjusting is different when working for a publicly traded, stock-held insurance company versus working for a mutual insurer where the policyholders own the company. Stock-owned companies are a little more black and white on procedures, because they are typically large and have thousands of adjusters in the field. With mutuals, the policyholder is also a shareholder, so they tend to be a little more flexible. I wouldn’t say one is better or worse than the other. They both get to the same place, just from slightly different angles.
Everybody needs their car claim done ‘now’
How are we perceived by the customer? Typically, you are the answer to their call for help. With an automobile claim, they might need a rental car or body-shop estimate, so it’s more immediate, whereas with someone’s home it is very, very personal — you are going to be in their house. But at the end of the day, you are seen in this positive light as the person who’s going to make their life good again.
The rarer the claim, the greater the appeal
The least frequent claims are probably the most interesting, just because they are different. But they are also the most disruptive to the policyholders, so they tend to be the most difficult. House fires, for example, are pretty rare — you don’t get a full house-burns-to-the-ground claim very often. They are very tragic, very personal. There’s a lot of emotion involved, so they are probably the most difficult to deal with on the homeowner side.
The one claim no adjuster can ever fix
On the auto side, absolutely the worst claims are fatalities. I’ve dealt with quite a few of those. There’s nothing you can say or do to make it better. I can pay them $10 million on a policy or buy them a new car or build them a new house, but it’s never going to replace the person who passed away. It’s never going to fix it, and you’re often left with this sense that you didn’t do enough, because you can’t.
Toughest part about being an adjuster?
The hardest part of my job? That’s easy: living on call. For the last eight years of my career, my cellphone has only been off when my two children were born and anytime I am on an airplane. Otherwise it’s either on silent or just on, period. My wife’s used to seeing my phone ring at 2 or 3 in the morning and me waking up and going to get my laptop. It seems to be a recurrence every single Christmas Eve.
By now, I am used to it; my family’s used to it. But for somebody coming from a typical 9-to-5 job, it can be very hard to adjust to. The trade-off for me is, I don’t work shifts anymore. Being awakened at 2 a.m for half an hour is so much better than working midnight to 8 a.m. and trying to sleep when everybody else is outside enjoying the sunshine.
Adjusters know that dealing with damage is stressful, and it is their primary responsibility and goal to help you get back to normal. Staying in contact with your adjuster, asking questions and keeping detailed records could help you move through the claims process as quickly and smoothly as possible. Being patient and kind can go a long ways towards making the process easier for you and the adjuster assigned to your claim as well, especially in the event of a large scale loss.
Frequently asked questions
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Whether or not you get to choose a claims adjuster depends on how the loss situation is approached. After you file a claim with your insurance company, you are typically assigned a company adjuster to your case. In some cases you may be able to request a second opinion from another company adjuster or manager, or you can opt to hire your own adjuster, which is called a public adjuster. Public adjusters are not employed by the insurance company and third parties used to help settle claims on behalf of policyholders, but you are generally responsible for paying the costs associated with their work on your claim. It’s also worth noting that your adjuster could change in some circumstances, such as widespread hurricane damage, due to the company dealing with multiple losses.
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It’s important to understand that there are three primary types of claims adjusters: company adjusters, public adjusters and independent adjusters. Company adjusters are employed by the insurance company and work on its behalf to settle claims filed by policyholders. Public adjusters are licensed to work independently on behalf of policyholders and are not employees of the insurance company. Independent insurance adjusters, on the other hand, are somewhere in between. Similar to a company adjuster, an independent adjuster works on behalf of the insurance company, but unlike company adjusters, they are not employees of the company. They are hired on a contract or as-needed basis and are generally utilized when an insurance company needs more adjusters on a temporary basis, like when the company is dealing with a high number of claims after a catastrophic storm.
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How an insurance adjuster gets paid depends on the type of adjuster they are. Company adjusters are typically on a fixed salary from the insurance company and may also get an annual bonus, such as profit sharing. Independent adjusters usually work on a fee schedule, meaning the amount of the claim payout directly impacts how much they earn — they are typically hired by corporations. And lastly, a public adjuster can charge a flat rate, an hourly rate or work on a fee schedule — it is up to the adjuster to determine how they get paid. A public adjuster is usually hired by the general public and the insured is responsible for their payment.
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Sometimes, an insured disagrees with an adjuster’s decision or the claim payout amount. In general, insurance adjusters are honest but mistakes can be made. When this happens, here are steps you can take.
- Gather evidence to support why you think their decision was wrong. For example, if you feel that your claims check for your totaled car is less than it should be, gather several quotes for the actual cash value amount of the same or similar vehicle that was damaged to show that your payout amount is disproportionate to the average.
- Review your insurance policy to make sure you understand how the coverage works and what deductible applies.
File an appeal with your insurance company. - Be patient and persistent; it can take time for an insurance company to review your situation. Stay in constant contact with your company and don’t miss any paperwork deadlines.
- Legal action is a last resort. If you are unhappy with the final decision, you may be able to file a complaint with the state’s insurance commissioner’s office and take the matter to court or mediation. Going to court can be time-consuming and expensive, so consider getting a second legal option before pursuing this option.
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