Chapter 15 - Chart A
Insurance Claims Adjusting
A: The Insurance Adjuster
An adjuster is any individual who, for compensation, fee or commission, investigates and settles claims arising under property, casualty or surety contracts on behalf of either the insurer or the insured.
Types of Insurance Adjusters
- Company Adjuster - A company adjuster is an adjuster representing the interests of the insurer, including independent contractors and salaried employees of the insurer.
- Public Adjuster - A public adjuster is an independent contractor representing solely the financial interests of the insured named in the policy.
An individual may be licensed concurrently under separate licenses as a company adjuster and as a public adjuster but shall not act as a company adjuster and a public adjuster with respect to the same claim.
Duties & Responsibilities of the Adjuster
- Fiduciary Agent
- The adjuster’s professional responsibilities to the insurer are the same whether or not the insurer employs the adjuster.
- The adjuster is a fiduciary agent;
- They take care of the company’s money when adjusting a claim;
- An adjuster shall not have a personal interest in adjusting the claim.
- The adjuster should not represent interests that are adverse to those of the principal and the adjuster should not profit, or seek to profit, from an outside source as a consequence of actions for and on behalf of the principal.
- Power to Bind
- Once the adjuster is appointed, the insured or claimant has a right to assume the adjuster has the power to ascertain the amount of the loss and to settle it.
- Agreements between the adjuster and the insurer covering matters within the scope of the adjuster's authority are thus binding on the insurer.
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