What a claim adjuster does
A claim adjuster is the person your insurance company assigns to investigate your claim and decide how much the company will pay. They are employees of the insurance company, not neutral third parties. Their job is to verify that your loss actually happened, that your policy covers it, and to estimate the dollar amount of damage or loss.
The adjuster will contact you, visit the damaged property, review your documentation, take photographs, interview witnesses if needed, and compare your claim against the terms of your policy. They then write a report recommending a payment amount. The insurance company uses this report to issue you a check or denial.
Adjusters handle claims across all types of insurance—home, auto, business, health. The process is similar regardless of the type, though the specific details they investigate change based on what you're claiming.
Key Takeaways
- Claim adjusters work for the insurance company, not for you, so their goal is to verify the claim and control costs rather than maximize your payout.
- You have the right to hire your own independent adjuster or public adjuster if you disagree with the insurance company's adjuster or believe your claim is undervalued.
- The adjuster will ask for documentation, photos, receipts, and repair estimates, so gathering these before they contact you speeds up the process.
- You are not required to accept the adjuster's initial estimate—you can dispute it with your own evidence or hire a professional to counter their findings.
How the adjuster investigates your claim
When you file a claim, the insurance company assigns an adjuster within a few days. The adjuster will call you to schedule an inspection of the damage. During the visit, they photograph the damage, measure affected areas, and ask detailed questions about what happened, when it happened, and what you've already done to prevent further loss.
The adjuster also requests documentation: your original policy, proof of ownership (receipts, photos, bank statements), repair estimates from contractors, and any police reports or incident documentation. They may contact your contractor, neighbors, or other witnesses. If the claim involves injury, they may request medical records.
The adjuster then compares your claim against your policy's coverage limits, deductibles, and exclusions. They research the cost of repairs or replacement in your area and determine depreciation if your policy includes it. All of this goes into a written report that becomes the basis for the company's decision.
The difference between company adjusters and independent adjusters
A company adjuster works directly for your insurance company and is paid by them. An independent adjuster is a licensed professional hired by the insurance company on a per-claim basis. Both work for the insurance company, not for you. The difference is mainly in how they're employed and their experience—independent adjusters often specialize in complex claims like large property damage or business interruption.
A public adjuster is different: they work for you, not the insurance company. You hire and pay them directly (usually a percentage of the settlement they negotiate). A public adjuster investigates the claim on your behalf, prepares documentation, and negotiates with the insurance company's adjuster. You can hire a public adjuster if you believe the insurance company's offer is too low or if the claim is complex enough to warrant professional representation.
You do not need permission from the insurance company to hire a public adjuster. However, you should understand that public adjusters charge a fee—typically 5 to 10 percent of the final settlement—so the benefit must outweigh the cost.
When to dispute the adjuster's estimate
If the insurance company's adjuster offers a settlement you believe is too low, you have options. First, review the adjuster's written report carefully. Look for errors in the damage description, missing items, or depreciation calculations that seem wrong. Request a copy of the report if you haven't received one.
You can then submit your own evidence: additional photographs, contractor estimates that are higher than the adjuster's, receipts showing the original cost of damaged items, or informed opinions. Send this in writing to the insurance company's claims department, not just to the adjuster.
If the disagreement persists, you can request that the insurance company assign a different adjuster to review the claim. Some policies also include an appraisal clause, which allows you and the insurance company to each hire an appraiser to evaluate the damage independently. If the two appraisers disagree, they select a third appraiser, and the majority decision is binding on both sides.
What happens after the adjuster submits their report
The adjuster's report goes to the insurance company's claims department. A claims manager reviews it and decides whether to approve the settlement, request more information from the adjuster, or deny the claim. You will receive written notice of the decision, including the amount approved (if any) and the reason for any denial or reduction.
If the company approves the claim, they issue a check. The check may be made out to you alone, or to you and your contractor or mortgage lender (depending on your policy and the type of claim). If the check is made out to multiple parties, all must endorse it before it can be deposited.
If the company denies or significantly reduces the claim, you have the right to appeal or file a complaint with your state's insurance commissioner. You can also pursue a lawsuit, though this is expensive and time-consuming. Many people hire an attorney or public adjuster before reaching this point.
Red flags in the adjuster's process
Be cautious if the adjuster pressures you to sign documents quickly, refuses to provide a written report, or discourages you from getting your own estimates. Legitimate adjusters expect you to gather documentation and may take weeks to complete their investigation. They should be willing to answer your questions and explain their findings.
If the adjuster seems to minimize damage you know exists, ignores items you point out, or dismisses your concerns without explanation, ask for clarification in writing. Request a copy of their photos and measurements. If you remain unsatisfied, hiring a public adjuster or getting a second opinion from a contractor is reasonable.
Also be aware that some adjusters work faster than others. A quick inspection does not necessarily mean a thorough one. Complex claims—especially those involving structural damage, multiple types of loss, or business interruption—should take longer to investigate properly.
How to prepare for the adjuster's visit
Before the adjuster arrives, document the damage yourself with clear photographs and video from multiple angles. Write down what happened, when it happened, and what you've done so far. Gather receipts, warranties, and proof of ownership for damaged items. If you've obtained contractor estimates, have those ready.
During the visit, be honest and thorough in answering questions. Point out all damage, including items the adjuster might miss. If you disagree with something the adjuster says or observes, say so politely and explain why. Ask the adjuster to explain their findings and take notes on what they tell you.
After the visit, follow up in writing with any additional information or clarifications. Keep copies of everything you send to the insurance company. If the adjuster said they would contact you with next steps, follow up if you don't hear from them within the timeframe they mentioned.
Frequently Asked Questions
Can I be present when the adjuster inspects my property?
Yes. You should be present so you can point out damage, answer questions, and hear the adjuster's observations firsthand. If you cannot be there, arrange for someone you trust to represent you. Do not rely solely on the adjuster to find all damage—they may miss items or underestimate severity.
What if the adjuster and I disagree about the cost of repairs?
Get your own estimates from licensed contractors in your area. Submit these to the insurance company in writing. If the disagreement is significant, request an appraisal (if your policy includes one) or hire a public adjuster to negotiate on your behalf.
How long does the adjuster have to complete their investigation?
This varies by state and policy, but most states require the insurance company to investigate and respond within 30 to 45 days of receiving the claim. Complex claims may take longer. Check your state's insurance commissioner's office for the specific timeline in your area.
Do I have to use the contractor the adjuster recommends?
No. The insurance company cannot require you to use a specific contractor. You can hire any licensed, insured contractor you choose. However, if you hire someone significantly more expensive than the adjuster's estimate, the company may only pay up to their estimate amount.
What if I think the adjuster made a mistake in their report?
Request a copy of the full report and review it carefully. If you find errors, submit a written correction with supporting evidence to the claims department. You can also request that a supervisor review the adjuster's work or ask for a second adjuster to investigate.