A Public Claim Adjuster: Policyholder’s Rights

A public adjuster or Public Claim Adjuster is an expert claims controller/claim adjuster, who promotes the rights of the policyholder in negotiating and reviewing a claim with his insurer. Claims adjusters work independently with the insurer’s claims department to assess the insurer’s policyholder’s claim against the insurer’s policy limit. In some states, it is illegal for an insurer to pay the public adjuster’s fees.

A public claim adjuster can be employed by his/her own company, a private claims management company, or a government agency such as a Medicare or Medicaid program. The claims adjuster also has the authority to work independently if he/she is not employed by an insurance company. In the case of a small business, an insurance company may hire a claims adjuster to perform the same job but at a reduced rate. Some claims adjusters charge their own fee.

If you are a policyholder, you should contact the claims adjuster’s agent to discuss the issue. Do not file a claim against your policy with the public claim adjuster unless you have obtained the correct insurance estimate from your insurer. An insurer’s estimates are available from the office of the claims manager or claim adjuster and are usually free. Make sure that you have obtained a policy estimate before filing a claim against your policy.

When the claims adjuster’s assistant receives your claim against your policy, the adjuster will review it with the insurance claims department, which has jurisdiction over the case. Once the adjuster receives the required information, the adjuster will make an initial evaluation of the policy owner’s claim against the insurer’s policy. If the adjuster determines that you are eligible for compensation under the terms of your policy, the adjuster will notify the insurer about your claim.

At this point, the adjuster will either accept or reject your claim based on the information received from you. If the claim is rejected, the adjuster will contact the insurer.

If the adjusted accepts your claim, your insurance company will reimburse you for your claim expenses from the total of your policyholder’s claims history, including the cost of premiums, plus any other costs of the adjuster’s services, including his/her fees, expenses, and living expenses if hired outside of your state. If applicable. The adjuster will report this amount to you on a claim form and file a claim form with the Insurance Claims Division of the Department of Insurance. Within thirty days after accepting the claim.