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Chapter 15: Insurance Claims Adjusting

I.
The Insurance Adjuster
- Types of Insurance Adjusters
- Duties & Responsibilities of the Adjuster
Print Chp. 15*
II.
The Claims Filing Process
- Duties of the Insured
* Proof of Loss
* Special Requirements
- Duties of the Insurer
* Claims Investigation
* Claim File Documentation of Events
- Standards for Acknowledgment of Pertinent Communications
* Acknowledgment of Notices of Claim
* Answers of Inquiry from Insurance Department
* Replies to Other Pertinent Communications
* Provisions of Assistance to First Party Claims
- Standards for Prompt Investigations; Fair & Equitable Sett. Applicable to all Insurers
* Investigation of Claims
* Offers of Settlement
* Denial of Claims
* Records of all Denied Claims
* Notice of Necessary Delay in Investigating Claims
* Liability of Others
* Denial of Claims for Failure to Exhibit Property
* Separation of Claims
* Time for Payment of Claims
* Notice of Applicable Time Limitations
* Avoidance of Payment
* Unreasonable Travel


III.
Adjusting Losses
- Property Losses
* Determining Value & Loss
* Claim Settlement Options
* Payment and Discharge
- Liability Losses
* Types of Liability Losses
* Claim Settlement Options
IV.
Adjusting Automobile Losses
- Standards for Prompt, Fair & Equitable Settlements Applicable to Automobile Insurance
- Adjustment of Partial Losses
- Adjustment of Total Losses
V.
Basic Claims Handling Activities
- Adjusting Claims
- The Adjuster's Investigation
* Critical Evidence
* Fact Evidence
* Official Reports
* Unofficial Reports
* Medical Reports
* Documentary Evidence
* Visual Evidence
* Verification Evidence
* Expert Evidence
- The Evaluation Process
- Negotiation of Settlement
- Alternative Dispute Resolutions
* Appraisal Clause
* Arbitration Clause
* Competitive Estimates
* Mediation
- Settlement Options/Releases
- Types of Adjuster Reports
- Dealing with Coverage Disputes

VI.
Vehicle Parts & Construction
- Body
- Substructure
- Mechanical

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