If so, they check out the truth of the claim, the value of the loss, and the amount the company will pay. Property and liability representatives are generally known as Insurance Adjusters or Claims Adjusters, and they read police reports and medical records, get diagrams and photos of the scene of the loss, talk with lawyers, and take statements from claimants and witnesses. They may inspect damaged property and estimate the cost of repair or replacement, or they may get an outside appraisal. Depending on how their investigation turns out, adjusters accept the claim, deny it, or try to negotiate a settlement. Adjusters have to protect the company from false or inflated claims but also have to settle valid claims fairly and quickly.
Adjusters usually have the authority to make settlements up to a specific amount.
Representatives of life, medical and disability insurance companies are called Claims Examiners. Most benefits are paid routinely and with no delay if claim forms and the necessary documents, such as the hospital records or death certificates, are in order. In some circumstances, such as accidental death or long-term disability, Examiners may contact claimants, doctors or employers for more information. Because long-term disability cases need review, some companies use their own field disability claims representatives for this purpose. Others use outside investigating services.