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The Role of Each Player During a Claim

By January 15, 2021April 14th, 2022Blog, Claims

When a claim occurs, there is often a level of uncertainty and a layer of confusion that permeates the experience. There needn’t be.

There is a chain of command in place to ensure that your claim is being handled efficiently and professionally. As soon as a claim occurs, the first person to notify is your broker. Their role is to report the claim and to ensure that effective communication is taking place between you and the carrier.

Once the carrier is notified, they assign an adjustor, sometimes referred to as an examiner. This person is the direct line of communication to the carrier, and when it is time to pay the claim, it is the examiner who coordinates payment. The examiner very often will assign an independent adjuster, also known as a field adjuster; they are the people who actually come to inspect the insured location in most cases. It is their job to evaluate the damage, compile a report, and submit to the examiner, who will submit to the carrier, for review.

Very often, the independent adjuster will evaluate the bylaws or proprietary lease as well. A public adjuster plays a different role in that they are hired by the insured directly and work to handle the claim on their behalf. When a public adjuster is involved, the role of the broker is diminished somewhat, as the public adjuster assumes the role of representative for the insured.

Important to note is that the public adjuster is paid from the insurance proceeds for the insured. Those are the main players and their roles in the life cycle of a claim.

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