by Guest » Mon Jan 18, 2010 12:21 pm
I do come across the terms adjusters, investigators, examiners and appraisers whenever I come across threads clarifying insurance claims. Now, how do we distinguish between these claims professionals?
Posted: Tue Jan 19, 2010 06:01 am Post Subject:
A claims examiner's primary job is to review claims. They're also known to help adjusters at evaluating complicated claims. Examiners are of great help when a natural disaster turns up suddenly.
Posted: Wed Jan 20, 2010 06:30 am Post Subject:
An adjuster has to arrive at a settlement proposal after going through the following processes-
* Investigation of claims through interviews conducted on the claimant as well as the associated witnesses.
* Checking with the associated medical records and police records
* Visiting the accident site and investigating the damages caused to the property.
All of these factors would help him determine a possible worth of the settlement offer.
Posted: Thu Jan 21, 2010 09:32 am Post Subject:
Whenever a claims application reaches an examiner, his job is to check out the accuracy of the application, discuss with the medical professionals and go through the policy files.
They'd need to verify if the policy files depict the correct information regarding the claim.
Once an examiner is done with his verification, he might either cancel, authorize a settlement or get the claim reviewed by an investigator.
Posted: Fri Jan 22, 2010 07:49 am Post Subject:
If a claims examiner or an adjuster identifies a fraud, he might convey the claim to the investigator. Any kind of fraudulent activity or criminal act could be conveyed to the investigator.
Such activities may involve staged accidents, false claims or even unnecessary hospitalization. Such fraudulent activities may involve a single person who's exaggerating damages or even a group of attorneys, doctors and insurance professionals.
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