Public adjusters act as mediators before the dispute resolution team meets with an insured/Policyholder to reach a final claim settlement. Some insurers/carriers do not provide their agents with public adjusters. The agents of these non-employees rely on their own internal adjusters in adjusting their insurance policy. In some cases, the agents have to refer their careless case to a third party company called a public adjuster.
The main objective of public adjusters is to resolve insurance disputes, claims, impasses between insurance companies and their insureds in a timely manner. With their expertise, public adjusters are trained to negotiate among the parties for a claim settlement. The settlement can be an amount that the policyholder pays, accepts the terms of the policyholder’s coverage or opts to go to court for a judicial adjustment.
A public adjuster may present an insurance claim to the carrier’s dispute resolution department for adjudication. If the adjudication is denied, the claim can be appealed to the carrier’s court system for a judicial adjustment. In this case, the public adjuster will present the case to the carrier’s court administration department and the court will decide on the carrier’s final determination.
For the purpose of insurance claim settlement, public adjusters act as a mediator between the insurers and the policyholders. They provide opinions and recommendations to the court administration department and the court decides the claim settlement, on the basis of all parties’ opinions and recommendations.
Although insurance agents typically are responsible for the settlement of the claims they filed with the carrier and submitted to the court, as long as the agent is authorized by the policyholder to settle the claim, this role will usually be performed by a public adjuster. This is the main reason why most judges will accept the public adjuster’s recommendations. It is the public adjusters role to present the opinion of his office to the court administration department on behalf of the policyholder, during the court hearing. If the opinion is denied, it is the public adjuster’s duty to explain why his office has the competence to offer the opinion. The court administration department will usually accept the recommendation as valid unless an objection is raised.
The role of public adjusters is to settle claims filed by the policyholder against his insurance carrier. They do not settle claims filed by the policyholder against the carrier or its agents. In these cases, the role of the carrier is to defend the rights of the insurer or its agents.
Public adjusters and their case files will often have a defense strategy. Make sure that your defense strategy contains no allegation of wrongdoing on the adjuster’s part. The burden is on claims assistance to make the case. You only have the burden to disprove the charge. This is not a slam dunk. It does not prove the charge. If you prevail, you win. If the adjuster prevails, you lose.
As a public adjuster, you will use legal research, find experts, and research medical precedent. As a public adjuster, you should be prepared to call witnesses, present evidence, and receive testimony. The law requires public adjusters to be objective and make decisions based on legal, professional and factual evidence. You are the neutral party in court, and your job is to keep all parties in their place by working with them until they reach a settlement. The best public adjuster will be able to provide insurance companies or any party with medical precedent, references, and professional opinions.