Public Adjuster - The Role of an Insurance Adjuster
A public adjuster is a claims adjuster/ claims specialist who advises on the policyholder's insurance claim in helping and assisting with the insurance company. A public adjuster works for a large insurance company or insurer and works under the supervision of the company's compensation department. The primary responsibility of a public adjuster is to assist in the claim process and to ensure that the client has been given the proper medical care and compensation due to his accident, illness or injury, regardless of who was at fault. The adjusters also assists the claimant with finding and paying for any medical bills resulting from the accident, or to cover funeral expenses or burial expenses.
Public adjusters work closely with their peers as well as their insurance claims specialists to help clients find compensation for their injury, medical bills and other related costs. They assist their colleagues in making sure that the client receives the proper compensation he/she is entitled to as a policyholder, read more now.
A public adjuster's job may include reviewing the claimant's case and making sure that all claims made are correct, as well as checking the information provided by the claimant for a claim to be valid. The adjustor will also review the claims information provided by the company's claims department. A public adjuster is responsible for maintaining the confidentiality of all medical records related to a client's claim. He/she may also discuss the client's case with their peers, insurance company representatives or other companies, if they are in need of legal advice. If the client chooses to work with another company, then they must inform the adjustor of any such agreement, prior to beginning.
An adjustor performs the following responsibilities: maintaining the confidentiality of all medical records pertaining to a client's claim; assisting the claims department with the client's case; communicating with the claimant's peers and insurance company reps; working closely with medical professionals on the claim; keeping client records confidential; and providing the client with a written compensation amount. The adjustor may also refer to other companies for any additional information they have relating to the case or refer a client to an attorney or claims specialist.
Claims adjusters are required to file a certificate of compensation (COA) when the claimant files his/her claim, so that an insurance adjustor can be paid, and the claimant and/or adjustor's insurance company can be paid. The COA helps an insurance company to determine how much money has been paid out as compensation, and what the actual pay out will be. Once the claim is approved by the claims department of an insurance company, the adjuster files an amended claim form to the insurance company, which details all changes or additions to the original claims form to reflect the client's injury and any new medical bills received and the amounts paid.
The duties of the adjustor are performed at the time of the accident or claim, or upon receipt of the claim forms, or a reasonable interval later. When an adjuster receives a claim form, he/she must review the claim and make sure it is accurate and complete. If the adjusted feels there may be any errors or omissions, the adjuster must correct the claims information immediately. The adjuster must notify the claims department of the mistake and resubmit the claim form, or issue a new claim form, whichever happens first, before submitting the claim to the insurance company. If you probably want to get more enlightened on this topic, then click on this related post: https://en.wikipedia.org/wiki/Public_adjuster.
