What is the Difference between an Insurance Company’s Claims Adjuster and a Public Adjuster

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What is the Difference between an Insurance Company’s Claims Adjuster and a Public Adjuster

The Insurance Adjuster aka The Claims Adjuster

(Hired by the Insurance Company – “The Insurer”.)

Types of Adjusters

All insurance claims have a claims handler (insurance adjuster.)  There are many types of insurance adjusters.  There are (in-house) Telephone Adjusters, Senior Adjusters, and Field Adjusters.
The adjuster may be directly employed by the Insurance Company, or they may be and independent contractor working for the Insurance Company. 

On larger losses, or when there are more insurance claims than an insurance company’s staff can manage, an insurance company might hire an “independent adjuster” to manage the file for the Insurer. Independent adjusters work for almost every insurance company who writes business in the province where the loss occurred.

An independent adjuster must report their recommendations up to the Insurance Company’ “Examiner.”   The independent adjuster cannot confirm coverage or guarantee payments before the adjuster receives those instructions from the Insurance Company (there are exceptions; those are rare.)

Licensing

The Insurance Company’s staff adjusters are unlicensed.

The Insurance Council of the province where a loss took place requires that all independent (and public) adjusters must hold a valid adjuster’s license for that province before they can adjust any loss within that province.

Before adjusting any loss, an “out-of-province” independent adjuster a/o public adjuster must first produce licensing that is valid in the province where the loss took place.

Loss Types and Assignment of Adjusters

Small Property Losses
Smaller claims are generally handled by junior adjusters who have recently entered the industry.  These telephone adjusters rarely leave their office; you will see them on site on an insurance claim if the claim is anything that is significant in size or complexity.

Larger Losses (non-complex / non-specialty)
Generally, insurance companies will engage a senior adjuster for this task.  In almost every instance, the adjuster will attend to the insurance claim location to view the circumstances of the loss.  Some insurance companies are relying on their contractors and appraisers to do this work.  We are starting to insurance claims valued at up to 7 figures where the Insurance Company’s Adjuster no longer visits the site, nor do they meet the client (the “Insured”.)

Specialized or Complex Losses
Specialists are brought in by the Insurance Company for these losses.  They are often flown in from across the country.  These persons are rarely employees of the Insurance Company.

The Public Adjuster

(Hired by the individual – referred to as “The Insured”.)
These adjusters usually work exclusively for the public (on the “client-side”.)  Some adjusters split their time; they will do work for both 1) the public, as well as 2) for the insurance companies.  The Public Adjuster must be licensed in the Province where the loss took place.
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