a proof of loss, or engages in soliciting
insurance adjustment business. [Cali-fornia Insurance Code § 14022.]
Like most professions, insurance adjusting requires continual learning. The more
the adjuster learns, the more effective his
or her negotiations will be. The adjuster
should consider attending courses given by
the Insurance Educational Association, the
Certified Property and Casualty Underwriters (CPCU), the Insurance Information Institute, and continuing education
seminars at colleges and various private
firms like the General Adjustment Bureau
(GAB) training or Vale Training Solutions.
Scientific principles can be applied to
the process of evaluating a claim. However, evaluating claims — particularly the
insurer’s exposure — is more an art than
a science. The more training and experience an adjuster accumulates, the more
adept he or she becomes at ascertaining
the value of a given case.
Insurance adjusters, unlike members
of other professions, must be jacks of all
trades and masters of some. For example
a property damage adjuster — working
first-party or third-party property damage losses — must know the basics of
construction, the differences between
reconstruction of damage property and
new construction, and the local costs for
labor and material. A material damage
adjuster must know the costs of repairing
automobiles while a third-party liability adjuster must know and understand
medical terms, the costs of medical and
other health care services, and the types
of verdicts that can be expected from juries in the adjuster’s territory.
The new adjuster gains this expertise in
1. By training from his employer or various continuing education providers.
2. By working in the field with an experienced adjuster.
Training and the
Business of Insurance
The business of insurance, in recent years, has attempted to reduce expenses by eliminating training programs to produce and maintain a professional claims staff. The expense reduction
efforts are a perfect example of penny wise and dollar foolish.
Insurance contracts are nothing more
than a group of promises to the insured.
The insurer promises that in the event
of a loss to the insured’s property it will
pay to repair or replace the property with
material of like kind and quality. The insurer promises that in the event a claim is
made where the insured caused someone
injury, it will protect the insured and, if
necessary, will defend the insured against
the allegations and if the insured is found
liable, it will indemnify him or her.
The standard Insurance Service Office
(ISO) policy wordings do not explain
how the promises will be kept. Insurers
learned centuries ago that an insurance
adjuster was needed to work with their
insureds to do what was necessary to ef-
fectively keep the promises.
The insurance adjuster is required to
be a person knowledgeable in insurance
retained by an insurer for the purpose
of assisting the insured in proving a loss
to the insurer. A person who expresses
to the insured the fidelity and good faith
of the insurer. In California, a statute defines the adjuster as:
A person who, for any consideration
whatsoever, engages in business or accepts employment to furnish, or agrees
to make, or makes, any investigation
for the purpose of obtaining information in the course of adjusting or otherwise participating in the disposal of
any claim under or in connection with