The Claims Adjuster

When you have reported an auto accident to the insurance company, whether it is your own insurance company or the other party's insurance company, it will be assigned to a Claims Adjuster to handle your claim. The Claims Adjuster has a high volume of responsibilities and the following information will help you understand what you should expect.

New claims are assigned to the Adjuster everyday and they contact the insured, claimant and any witnesses to obtain a statement of the facts of loss. In addition, they will assign an Appraiser to each vehicle, order a police report if they responded and send out all required forms including House Bill 2 Texas Dept. of Insurance requirements.

A coverage investigation is completed to determine if coverage will be afforded for the loss or not. They are looking at things like was the insured vehicle considered a covered auto and listed on the policy, was the driver considered covered and listed as a named driver on the policy, was there an excluded driver driving at the time of loss, was the policy in force at the time of loss with no lapse, does the insured have specific coverage to cover the loss and a review of the Texas Auto Policy to determine if there are any factors or exclusions that prohibit and prevent coverage form being afforded. A claim denial must be put in writing stating the exact reason for the denial.

A liability investigation is initiated to determine who was the at fault party and what damages are owed. Any claim denials must be put in writing stating the reasons. (See Determining Liability)

The Claims Adjuster facilitates an active relationship with the insured, Claimant, Agent, repair shop, Appraiser, rental car company, Attorney, Doctor, Lien Holders, insurance companies and others for each claim. Their phone call volume is very high.

Evaluates and negotiates the settlement of collision, comprehensive, property damage and bodily injury claims.

If you feel you are not being treated fairly then you should speak with the Claims Supervisor. They can usually resolve your problem fairly, accurately and timely. If you wish to make a complaint regarding the handling of your claim, contact the Texas Dept. of Insurance at 512-463-6464.