Who represents the insured in the investigation of an insurance claim? is the question policyholders normally ask. Have you ever filed an insurance claim before? Or do you want to file a claim and they want to know if you’ll be properly represented? The insurance claim process is an easy process, but it can take a long time for it to be paid to the policyholder. During the insurance claim process, there is always an agent that is assigned to the policyholder.

Who represents the insured in the investigation of an Insurance Claim?

I know it might not seem like it, but it is the claim adjuster that represents the insured, which is the customer or policyholder in an insurance claim. In this article, we are going to answer the question and consider how our adjuster does so exactly.

Who represents the insured in the investigation of an insurance claim?

An adjuster is responsible for representing the customer, who is also the policyholder, in an insurance claim. But in every sense of it, the adjuster is not representing the customer. They are there at the direction of the company to lower the claim settlement the customer makes. The sooner you realize that the claim adjuster is not your friend, the easier it will be to negotiate and obtain your claim.

How do we know that adjusters are puppets of the insurance company? This is because they always try to lower your settlement amount so that the company does not have to pay much. making them be a representative of more of the insurance company than you, the insured, or the customer. That being said let’s take a look at what an insurance adjuster is below.

What is a Claim Adjuster?

The claim adjuster is the person that investigates insurance claims to determine the extent of damage and liability to the insurance company. They simply review each case by speaking to the claimants and interviewing witnesses to get the full story of the incident. They usually tend to give you an offer that is below the settlement that you demanded after they are done adjusting.

How do Claim Adjusters work?

As I have mentioned above the claim adjuster is a representative of the company sent to represent the claimant. To do this they need to properly investigate and carry out several activities to determine the actual figure that they think the insurance company should pay as claim settlements. To do this they follow the below process:

  • They properly inspect the damages that are insured to the property which is insured.
  • Reviewing the police report is also another process they go through.
  • Interview eyewitness is by speaking with them about the incident.
  • Finally, they talk to property owners and present a settlement figure after their investigation is done.

What do insurance investigators ask from claimants?

After filing your claim, the insurance adjuster does not just take your word for it; they need certain information to carry out their investigation. Therefore, the law awards the insurance investigators ask of claimants:

  • An overview of the incident Claimants’ interview/statement
  • Documentary evidence
  • Physical evidence
  • Insurance policy statement
  • Statements of witnesses
  • A survey of the area
  • Obtaining contextual information
  • Complete information about your loss.                                                                Depending on the incident that occurred, these are basically the questions that will be asked by your insurance adjuster or investigator.

How long does an Insurance Claim Investigation take?

An insurance claim investigation takes about a month after the company has acknowledged that a policyholder has filed a claim. Once the insurance company is done investigating the claim, then a settlement offer is made to the policyholder. If the policyholder prefers, he or she may accept the first offer made or play the negotiation game.

In different states, there are different time frames allowed for insurance companies to investigate insurance claims. Most states in America allow up to a month of investigation before they are mandated to quit investigation and pay settlements. In the UK, insurance companies are allowed up to three months to investigate claims and pay settlements.

How to negotiate a settlement with an Insurance Claim Adjuster

As I have mentioned above, the insurance claim adjuster is the one representing you in your claim. In the real sense, he is actually representing the interests of the insurance company. They simply want you to reduce your settlement claim so that they can pay you as little as possible and not spend much money. However, you have the right to decline the offer and negotiate a better offer once it is made to you.

To negotiate, do not accept the first offer made to you. Even if the first offer is worth the damage that you incurred, Another method of negotiating is to simply have a minimum and maximum amount in mind and negotiate around it. If that doesn’t work, play the emotional card by emphasizing the emotional damage the incident caused. Following the steps correctly will just get you the claim settlement you want.

Frequently Asked Questions

How do insurers investigate claims?

The insurance company sends an adjuster to properly investigate the incident that occurred and fine-tune the claim. It is the work of the adjuster to investigate the claim based on evidence gathered from the accident scene records and interviews. Once it is all said and done, a settlement figure will be presented to the policyholder.

Who accesses insurance claims? Who represents the insured in the investigation of an Insurance Claim?

It is the work of a loss adjuster to access and properly investigate everything about an insurance claim. They are responsible for establishing the cause of the accident and all the nitty gritty.

What does an insurance investigator do?

An insurance investigator basically investigates the claim by accessing a range of factual information, including the claimant’s background. The incidents, the weaknesses, and every other piece of information about the claim

Who processes the claims for insurance?

It is the insurance company that is responsible for processing the claim. Claims are processed through the insurance company’s in-house claims processing department.

What does a claim handler do?

The claim handler can also be referred to as an insurance investigator or a loss adjuster. They are responsible for managing a claim from start to finish by investigating everything possible.


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