A person who investigates and settles losses for an insurance carrier.
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1. Employed representative of the insurance company who is responsible for handling insurance claims as they are received from patients and medical practices and who determines the dollar amount of a claim or debt. 2. In industrial cases, a representative of the insurer who investigates, evaluates, and negotiates the patient’s insurance claim and acts for the company in the settlement of claims. Adjusters may be employees of the insurance company or an individual operating independently and hired by a company to adjust a particular loss. Also called claims administrator, claims examiner, claims processor, claim representative, or health insurance adjuster.
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A person who may act either on behalf of the insurance company or the insured in the settling of a claim. Employee adjusters work for an insurer, while independent adjusters represent the insurance company on a fee basis and public adjusters represent the insured on a fee basis.
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Individual at the workers’ compensation insurance carrier overseeing an industrial case, authorizing diagnostic testing and medical treatment, and communicating with the provider of medical care.
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One who settles insurance claims. This typically involves investigation of the loss and a determination of the extent of coverage. In the context of first-party (e.g., property) insurance, the adjuster negotiates a settlement with the insured. In liability insurance, the adjuster coordinates the insured’s defense and participates in settlement negotiations. Adjusters may be employees of the insurer (staff adjusters) or of independent adjusting bureaus (independent adjusters) that represent insurers and self-insureds on a contract basis. Public adjusters are consultants who specialize in assisting insureds in presenting claims to insurance companies in a manner that will maximize their recovery.
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Person responsible for the evaluation and settlement of an insured claim. An adjuster may be an employee of an Insurer, or an individual operating independently and engaged by an Insurer or insured to adjust a particular loss or claim. Insurance Company adjuster -Adjuster who is a full time employee of an Insurer, adjusting only losses and claims covered by that Insurer. Public adjuster -Independent adjuster hired by any Insurer or insured to represent that client’s interest in the adjustment of a specific, often complex insured loss or claim.Adjuster Average : An adjuster who specializes in adjusting marine losses.
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See LOSS ADJUSTER.