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Claims adjusters investigate insurance claims by interviewing the claimant and witnesses, consulting police and hospital records, and inspecting property damage to determine the extent of the company's liability.〔US Dept of Labor, Bureau of Labor Statistics, Occupational Outlook Handbook, 2008-09 Edition, Claims Adjusters, Appraisers, Examiners, and Investigators〕 In the United Kingdom, Ireland, Australia, South Africa, the Caribbean and New Zealand the term loss adjuster is used. Other claims adjusters who represent policyholders may aid in the preparation of an insurance claim. Generally, in the United States a claim adjuster duties should include the following elements: * Verify an insurance policy written by the insurance company exists for the insured person and/or property. * Investigate the circumstances and the sequence of events leading up to the claimed damages occurring as the result of someones negligence or risks of direct physical loss or damages to property, culminating in the loss of property and or bodily injury. * After obtaining the above investigation evaluate the covered injury and or damages that have been determined according to the coverage grants. * Negotiate a settlement according to the applicable law, coverage insured for following best insurance practices. In casualty insurance the main type of coverages include but may not be limited to the followings: * First party auto and other than auto coverages (sometimes referred to collision and comprehensive coverages) there are numerous types of first party insurance coverages for any kind of risk of loss or damages. * Third party liability for property damage of others property and bodily injury. (in law terms these are "tort" claims) Key words to define via a hot link. Investigation, risk of loss, negligence, third party, first party and property damages. Insurance best practices and tort. == Classes == *Claim service representatives (employed by the insurance company, or an independent adjusting company). In the two first instances, and the fourth, the adjuster operates on behalf of the insurer. Adjusters may handle "property claims" involving damage to buildings and structures, or "liability claims" involving personal injuries or third-person property damage from liability situations, such as motor vehicle accidents, slip and falls, dog bites, or alleged negligent behavior. Some adjusters handle both types of claims and are known as "Multi-Line" adjusters. Also "All Lines Adjusters" may handle "any" type of claim already identified and also include professional liability, Hospital Professional Liability, Excess Liability, Physicians and Surgeons Liability, Aircraft Liability/Hull, Inland Marine, Ocean Marine, Boiler and Machinery, as well as various types of Bond Losses. Public adjusters work exclusively for the policyholder. This means there should be no inherent conflict of interest when it comes to advocating on the policyholder's behalf to the insurance company. An independent adjuster could be working for multiple insurance companies or self-insured entities. If licensed by state authority they represent pinnacle of property loss knowledge in their field; whether it be residential, vehicular, marine, etc. An adjuster will frequently verify that coverage applies through an insurance policy, investigate liability for the damages caused, and make compensation to the injured person based on their emotional or physical property damages. Specific duties include: *Notifying the insurer of a covered loss as defined under the policy of insurance *Responding to claims in a timely manner *Filing paperwork *Communicating with policy holders *Investigate liability *Assess damages *Research, detail and substantiate each aspect of the claim, including building damage, contents, and extra living expense claims. *Prepare a detailed damages report based on monthly updated insurance cost software for the purpose of making an offer of settlement to the insured. *If needed for specialty cost coding, negotiate with product/service providers on time and cost of repairs for the purpose of making an offer of settlement to the insured. *Ensuring accurate procedures *Protect the interest of the insurance company the adjuster represents, when dealing with claimants. *Computer skills with a high degree of proficiency. Some states now require adjusters disclose to claimants whose interest specifically independent, staff and public adjuster represent, before they proceed with the policyholder. Always check your local chapter of Licensed Public insurance adjusters, or state agency, in order qualify an adjuster is properly licensed and in good standing. Some of the state chapters are AAPIA and NAPIA. In Florida, the chapter is FAPIA. IEA conducts certified online classes for people. The Insurance Institute of America also provides training leading to professional designations. Some states accept the Associate of Claims designation, and will waive the licensing examination, and grant a license by the state insurance commission. Some insurance carriers, and independent adjusting companies provide in house training certified by the state insurance commission. They must be pre-approved by the licensing division. An adjuster license is issued to those that pass the requirements. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Claims adjuster」の詳細全文を読む スポンサード リンク
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