Glossary

Claims adjuster

The insurance company employee or contractor who investigates a claim, decides what the policy covers and sets how much is paid.

Also called: adjuster, insurance adjuster, claims representative, appraiser

A claims adjuster investigates an insurance claim and decides, or recommends, what the insurer will pay. On an auto claim the adjuster reviews the police report and statements, determines fault on liability claims, inspects or arranges an inspection of the damage, writes or approves the repair estimate, and negotiates the settlement. Many insurers call the role a claims representative; the person who inspects cars may be called an appraiser.

Three kinds handle claims. Staff adjusters work for the insurer. Independent adjusters are contractors the insurer hires, often after storms when claim volume spikes. Public adjusters work for policyholders for a percentage of the settlement, though they mostly handle property claims and are uncommon in auto.

Whatever the title, the insurer's adjuster represents the insurer. On a third-party claim against another driver's policy, the adjuster owes you fair dealing under state law but is not your advocate. Keep notes of every call, ask for estimates and decisions in writing, and know that state rules set deadlines; an NAIC model regulation, adopted in some form by many states, calls for claims to be acknowledged within 15 days. If you disagree on value, your policy's appraisal clause or your state state department of insurance may help.

Last reviewed October 4, 2026

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Related terms

First notice of loss The first report to your insurer that a crash, theft or other loss has happened, which opens the claim and starts the clock on handling it. Claim number The unique reference an insurer assigns when a loss is reported, used to track every call, document and payment on that claim. Claim reserve Money an insurer sets aside on its books to pay a claim it expects to settle, based on its estimate of the eventual cost. Appraisal clause A policy provision letting you or the insurer call in independent appraisers, plus an umpire if needed, to settle a dispute over the amount of a loss. First-party claim A claim you make under your own insurance policy, such as collision, comprehensive, PIP or uninsured motorist coverage. Third-party claim A claim you make against another driver's insurance for damage or injuries that driver caused, rather than against your own policy.

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