Explaining the Need for Liability Claims Adjusters
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The insurance adjuster is seldom, if ever, mentioned in a policy of insurance. The strict wording of the third party liability policies set the obligation to prove a claim that entitles the insured to defense or indemnity of a claim against the insured by an injured third party. Over a century ago insurers determined that to properly deal fairly and in good faith with their insureds, an insurance claims professional was needed to thoroughly investigate claims made against the insured, work with the insured and a third party claimant to resolve claims without litigation, and properly protect the interests of the insured.
Adjusting liability insurance claims requires skill, patience, knowledge of insurance, basic knowledge of tort and contract law, and knowledge and experience as an investigator. To properly and effectively perform the duties of a liability claims adjuster, he or she must be capable of effectively dealing with the following basic obligations:
- To understand the law of torts as applied in the state where the adjuster works.
- To understand the law of contracts as applied in the state where the adjuster works.
- To understand sufficient medical terminology to be able to evaluate claims of injury.
- To understand the costs to repair or replace damaged real or personal property.
- To understand how to read and apply the terms and conditions of a liability insurance policy to a particular fact situation developed by his or her investigation.
- To understand how to thoroughly investigate all claims assigned.
- To conduct an investigation of every claim assigned fairly and in good faith with an intent to find coverage for the loss presented by the insured.
- To be able to effectively, fairly and in good faith negotiate with claimants and lawyers to resolve bodily injury or property damage claims asserted against an insured.
- To ascertain that the insurer pays promptly all claims the insurer owes under the contract.
- To resist, and recommend against payment of all claims the insurer does not owe under the contract of insurance.
In the United States, the average adjuster is a 22-year-old graduate of a liberal arts college who has little or no training sufficient to allow him or her to fulfill the obligations imposed on them as a representative of an insurer.
© 2021 – Barry Zalma
Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost
equally for insurers and policyholders. He also serves as an arbitrator or mediator for insurance related disputes. He practiced law in California for more than 44 years as an insurance coverage and claims handling lawyer and more than 52 years in the insurance business. He is available at http://www.zalma.com and email@example.com.
Mr. Zalma is the first recipient of the first annual Claims Magazine/ACE Legend Award.
Over the last 53 years Barry Zalma has dedicated his life to insurance, insurance claims and the need to defeat insurance fraud. He has created the following library of books and other materials to make it possible for insurers and their claims staff to become insurance claims professionals.
Go to the podcast Zalma On Insurance at https://anchor.fm/barry-zalma; Follow Mr. Zalma on Twitter at https://twitter.com/bzalma; Go to Barry Zalma videos at Rumble.com at https://rumble.com/c/c-262921; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg; Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/ Read posts from Barry Zalma at https://parler.com/profile/Zalma/posts; and the last two issues of ZIFL at https://zalma.com/zalmas-insurance-fraud-letter-2/ podcast now available at https://podcasts.apple.com/us/podcast/zalma-on-insurance/id1509583809?uo=4