Insurance Claim Adjustment

Receive the insurance claim assignment from the insurance company and review the details of the policyholder's filed claim.

Initiate contact with the policyholder to acknowledge receipt of the claim and discuss the claim process.

Investigate the claim by collecting evidence, such as photos from the scene, police reports, and witness statements. This step may also involve interviewing the policyholder and any involved parties.

Assess the damage to policyholder's property or possessions. This may include consulting with professionals or specialists for evaluations or quotes.

Review the insurance policy details to determine the coverage applicable to the claim and identify any exclusions or limits.

Prepare a detailed claim report which includes the assessment of the damage, investigation findings, coverage determination, and a recommendation for settlement.

Based on the assessment and policy details, determine the claim settlement amount and communicate the decision to the policyholder.

Address any concerns or negotiations from the policyholder, and finalize the resolution of the claim either through payment, repair, replacement, or denial as per policy terms.

Ensure all steps of the claim process are thoroughly documented, including the rationale for settlement decisions, and file these documents appropriately as per company policy.

Conduct a follow-up with the policyholder to ensure that the resolution is satisfactory and to answer any additional questions.

Claims adjusters should regularly update their knowledge of policy changes, new laws, and industry best practices through continuing education.

Adjusters must handle all claims ethically, ensuring fairness to the policyholder while also protecting the interests of the insurance company.