Insurance 101 – Chapter 7 – Volume 43 – Exercise Claims Judgment

Exercise Claims Judgment

The adjuster must determine if the facts recited by the insured as repeated in the adjuster’s report are credible. The adjuster must evaluate the insured to determine if his or her demeanor (like body language) coupled with the statements of fact are believable. If the statements of the insured do not appear credible or the physical evidence does not support the insured’s rendition of the facts, a thorough investigation will either prove or disprove the insured’s statements. Every statement of fact should, if possible, be corroborated. Some adjusters, when faced with what they consider a “small loss” will close the file as quickly as possible and ignore incredible facts, overvalued property, or facts that would take the claim outside coverage. Fraudulent claims or claims that are excluded are not necessarily large.

The following video was adapted from my book, “Insurance Claims A Comprehensive Guide” Published by the National Underwriter Company and is available at the Zalma Insurance Claims Library

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The author and publisher disclaim any liability, loss, or risk incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this blog. The information provided is not a substitute for the advice of a competent insurance, legal, or other professional. The Information provided at this site should not be relied on as legal advice. Legal advice cannot be given without full consideration of all relevant information relating to an individual situation.

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