How to Be Commercial Insurance Claims Adjuster - Job Description, Skills, and Interview Questions

The role of a Commercial Insurance Claims Adjuster is to investigate, analyze, evaluate and settle complex insurance claims in a timely manner. They must analyze the cause of the loss and assess the damages for a fair settlement. The adjuster will often review the policy language, contact witnesses and conduct research in order to accurately assess the claim.

Their work is critical in ensuring that an insurance company pays out the right amount to its policyholders. This role requires strong problem-solving skills and an aptitude for understanding insurance policies, as well as excellent communication and negotiation skills. A successful adjuster must be able to work both independently and collaboratively, as well as remain organized and detail-oriented throughout the process.

Steps How to Become

1. Earn a Bachelor's Degree. Most employers prefer to hire Commercial Insurance Claims Adjusters with a bachelor's degree. You should pursue a degree in business, finance, accounting, or a related field.
2. Gain Experience. Many employers prefer to hire Commercial Insurance Claims Adjusters with at least two years of experience in the insurance field. Consider working as an insurance agent, customer service representative, or claims analyst to gain the needed experience.
3. Obtain Licensure. In order to become a Commercial Insurance Claims Adjuster, you must obtain licensure from your state's insurance department. Requirements vary by state, but typically include an exam and a background check.
4. Complete an Apprenticeship. Many employers require Commercial Insurance Claims Adjusters to complete an apprenticeship program. During this program, you will gain hands-on experience and learn the skills necessary to become successful in the field.
5. Take Continuing Education Courses. Most states require Commercial Insurance Claims Adjusters to take continuing education courses in order to maintain their licensure. Be sure to stay up-to-date on industry changes and regulations in order to remain competitive in the field.

The role of a Commercial Insurance Claims Adjuster is critically important in helping businesses mitigate the financial losses associated with unexpected events. In order to be successful, an adjuster must have a combination of key skills and abilities. These include excellent analytical and problem solving skills, strong communication and interpersonal skills, the ability to manage multiple tasks and prioritize workloads, and a high level of attention to detail.

Furthermore, it is essential for a Commercial Insurance Claims Adjuster to have a thorough understanding of insurance policy language and the claims process, as well as a deep knowledge of the relevant laws and regulations. By possessing all of these qualities, an ideal and capable adjuster can help businesses receive the financial compensation they need in order to move forward following a loss.

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Job Description

1. Assess the insurance policy coverage for claims and determine the extent of the insurer’s liability.
2. Investigate the claim to determine the cause and extent of loss or damage.
3. Evaluate the extent of the insured’s loss or damage and negotiate settlements.
4. Analyze claims data, investigate complex cases, and prepare reports.
5. Review medical records, legal documents, property appraisals, and other relevant information to assess claims.
6. Work with attorneys, engineers, and other experts on various types of claims.
7. Maintain accurate records of claims activities and decisions.
8. Monitor progress of claims and ensure timely resolution of claims.
9. Provide timely and accurate information to policyholders on the status of their claims.
10. Prepare complex reports for management review and make recommendations for improvement.

Skills and Competencies to Have

1. Knowledge of insurance industry regulations and best practices
2. Ability to analyze complex claims data
3. Strong research and investigative skills
4. Excellent communication and interpersonal skills
5. Ability to negotiate and mediate resolution of claims
6. Proficiency in computer applications related to claims processing
7. Excellent organizational, time management, and problem-solving skills
8. Ability to handle high levels of stress
9. Excellent customer service skills
10. Ability to work independently and as part of a team

A successful Commercial Insurance Claims Adjuster must have strong analytical, problem-solving and communication skills. The ability to interpret complex policies and regulations, analyze data, and effectively communicate with policyholders, claimants and other stakeholders is essential for success. Good organization and decision-making skills are also important for processing claims in a timely and accurate manner.

The adjuster must be able to review the facts of a claim, determine the cause of the loss, and evaluate the damages. They must then calculate the cost of the loss, communicate the results of their investigation to the policyholder, and negotiate a settlement that is fair to both parties. In order to do this, they must have a thorough understanding of the insurance policy, legal documents, contract language and financial calculations.

This requires an in-depth knowledge of business and financial regulations, as well as an ability to think critically and apply sound judgement.

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Frequent Interview Questions

• What experience do you have in commercial insurance claim adjusting?
• How have you handled difficult or complex claims in the past?
• What strategies do you use to investigate and evaluate commercial insurance claims?
• What is your approach to effectively managing multiple claims at once?
• What tools or software do you use to manage and update information on commercial insurance claims?
• How have you stayed current on regulations and policy updates in the commercial insurance industry?
• How do you handle disputes between policyholders and insurers?
• How do you handle difficult conversations with policyholders and insurance companies?
• Describe a time when you had to identify and analyze complex evidence for a commercial insurance claim.
• How do you ensure accuracy and fairness in the claims process?

Common Tools in Industry

1. Claims Software. A computer program used to manage, document, and analyze the details of an insurance claim. (e. g. Xactimate)
2. Estimating Software. A computer program used to estimate the cost of repairing or replacing damaged property. (e. g. CCC ONE Estimator)
3. Digital Camera. A device used to take photographs for documenting property damage. (e. g. Canon EOS Rebel)
4. Calculations Software. A computer program used to calculate the amount of coverage needed and the cost of the claim for a policyholder. (e. g. Microsoft Excel)
5. Estimating App. A mobile application used to estimate the cost of repairing or replacing damaged property on the spot. (e. g. Mitchell Estimator App)
6. Legal Research Software. A computer program used to research relevant laws or regulations related to an insurance claim. (e. g LexisNexis)
7. Claim Management System. A computer program used to manage the entire claims process from start to finish, including tracking and assigning tasks to adjusters. (e. g. Guidewire ClaimCenter)

Professional Organizations to Know

1. International Association of Claim Professionals (IACP)
2. Chartered Institute of Loss Adjusters (CILA)
3. National Association of Independent Insurance Adjusters (NAIIA)
4. American Association of Professional Insurance Adjusters (AAPIA)
5. National Association of Professional Insurance Agents (NAPIA)
6. National Association of Public Insurance Adjusters (NAPIA)
7. International Association of Arson Investigators (IAAI)
8. National Fire Protection Association (NFPA)
9. The National Society of Professional Insurance Investigators (NSPII)
10. The International Association of Special Investigation Units (IASIU)

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Common Important Terms

1. Loss Adjuster. A professional who evaluates and settles insurance claims, usually on behalf of an insurance company.
2. Claims Examiner. An individual who evaluates, investigates and processes insurance claims to ensure accuracy and compliance.
3. Subrogation. The process whereby an insurance company, upon payment of a claim, pursues another party for recovery of the monies paid out in the claim.
4. Liability Claims. Claims made against an individual or company for a wrongful act resulting in injury or damage to another party.
5. Property Damage Claims. Claims made against an individual or company for damages caused to property resulting from a negligent act or omission.
6. Negligence. The failure to exercise the standard of care that a reasonably prudent person would exercise in similar circumstances.
7. Reserves. An estimate of the amount of money that may be required to cover future losses related to a particular claim.
8. Litigation. The process of resolving legal disputes in court.
9. Arbitration. A dispute resolution process in which a neutral third party hears both sides of a dispute and renders a binding decision.
10. Coverage Analysis. The evaluation of an insurance policy to determine the scope of coverage available under the policy.

Frequently Asked Questions

What is a Commercial Insurance Claims Adjuster?

A Commercial Insurance Claims Adjuster is a professional who investigates and evaluates insurance claims to determine the amount of compensation that should be paid to policyholders.

What qualifications do I need to become a Commercial Insurance Claims Adjuster?

Generally, a Commercial Insurance Claims Adjuster must have a high school diploma or equivalent, experience in the insurance industry, and must pass a licensing exam.

What is the job outlook for Commercial Insurance Claims Adjusters?

The job outlook for Commercial Insurance Claims Adjusters is expected to grow by 6% from 2020-2030.

What are some common duties of a Commercial Insurance Claims Adjuster?

Common duties of a Commercial Insurance Claims Adjuster include gathering and evaluating evidence, estimating costs of damages, and negotiating settlements.

What is the average salary for a Commercial Insurance Claims Adjuster?

The average salary for a Commercial Insurance Claims Adjuster is $60,000 per year.

What are jobs related with Commercial Insurance Claims Adjuster?

• Commercial Real Estate Agent
• Commercial HVAC Installer
• Commercial Security Technician
• Commercial Litigation Attorney
• Commercial Collection Specialist
• Commercial Sales Manager
• Commercial Account Manager
• Commercial Lender
• Commercial Production Manager
• Commercial Building Maintenance Supervisor

Web Resources

• Insurance Claims Adjuster - Florida State College at Jacksonville www.fscj.edu
• Insurance Claims Adjuster Training Online | USCI www.uscareerinstitute.edu
• Online Insurance Claims Adjuster Course - U.S. Career Institute www.uscareerinstitute.edu