What is an insurance Claims Adjuster?

An insurance claims adjuster is a person who handles claims for an insurance company that come from damage to your property covered by an insurance policy. Normally these claims arise from damage to your property under your homeowners or renters’ policy or due to an accident under your auto policy. Adjusters also handle claims when you have injured someone else or damaged their goods due to some negligence on your part and that person or persons file a claim or lawsuit against you.

What types of claims are typically covered by insurance policies?

As mentioned above, claims generally fall into two areas – property damage and liability. Most homeowners and renters policies will cover both types of claims. Auto policies always cover liability claims and may cover property claims if you request it.

What is a property claim?

Homeowners policies and renters policies normally cover damage to your covered property such as your house, which is usually called “real property,” or your stuff, which is referred to as “personal property.” Of course, a renters policy only covers your personal property since you do not own the building you are renting.

Damage to your property is normally covered if they are caused by such things as fire, wind, hail, falling objects, collapse, or theft. These are called “covered perils.” Every insurance policy will contain either a list of these covered perils, or in the better policies, the policy will not list the covered perils but instead state that it will cover all causes of loss except for a few exclusions specifically listed in the policy. Your insurance agent should go over with you the covered perils when you buy the policy.

As long as the damage to your property is accidental and not intentional and is due to a covered peril, it will be covered by the policy. When you buy your policy, there will be a limit listed as to how much will be paid per loss for your house and for your personal property. There may also be limits as to how much the policy will pay for certain specific types of losses, such as money. All this will be spelled out in the policy.

Property damage claims under an automobile policy is an optional coverage which covers several types of damage to your care. There are two types of physical property damage coverage. The first coverage is referred to as “collision” which as the name suggests covers damage to your car if it hits or is hit by another car or object, such as maybe a guardrail on a highway.

The second type of property damage coverage in your auto policy covers most other types of damage except collision, this is called “Other Than Collision” or sometimes “Comprehensive.” This covers things like wind, hail, fire, flood, vandalism, or glass breakage.

What is a liability claim?

A liability claim occurs when you, the policyowner, cause damage to others – either damage to their property or bodily injury to them, due to either an accident you caused, or if they are injured on your property due to poor upkeep of your property or a condition of your property which causes them to be hurt or damage their property. In these cases, you may be held responsible or “liable” for the damages you caused. Your liability insurance coverage protects you in case you are sued for the damage caused up to the dollar limit in your policy. For example, you have neglected to maintain the walkway up to your house and it has big holes and is uneven. Someone walking up to your house trips on your walkway and falls and is hurt and sues you for their injuries.

The most common liability claims occur due to an automobile accident when you cause damage to others due to the operation of your motor vehicle. As a matter of fact, when you buy an automobile insurance policy, the most important coverage you buy is coverage for damage to others caused by you. This liability protection is required by law in both North and South Carolina. So, if you cause an automobile accident and damage someone else’s car or hurt them, you may be held liable for the damage. Auto liability insurance covers you up to the limits you have purchased.

What does a claims adjuster do?

A claims adjuster’s job is to determine first if the loss was due to a covered peril, and then to determine the amount of the loss, which is usually the cost to repair or replace the property based on its current value. Some more comprehensive and more expensive policies will cover the cost of replacing the property with new property of the same type that you have lost.

Some adjusters will also handle liability claims when you have caused damage or injury to others. Here, the adjuster’s job is to determine if you have coverage, and then to determine the extent of the damages and injuries you have caused and to pay accordingly.

There is another type of claims adjuster who works for you, the property owner, called a public adjuster. A public adjuster works on your behalf and negotiates with the company’s adjuster to obtain a “fair settlement” with the insurance company for the damage to your covered property.  They handle property claims only, not liability claims.

What are the types of claims adjusters?

There are three types of claims adjusters, the staff adjuster and the independent adjuster, both of whom work for the insurance company, and the public adjuster, who we just mentioned, who works for you.

Most of us will only interact with the company’s staff adjuster, who as the name implies, is employed by and on the staff of the insurance company.

Sometimes the insurance company will hire outside independent adjusters for large and complicated claims or when there is a need for special expertise in handling a particular type of claim. These independent adjusters are independent firms who are hired by insurance companies on a contract basis. Some smaller insurance companies do not have staff adjusters and only use independent adjusters to handle their claims.

Some adjusters, both staff and independent, specialize in handling what are called “catastrophe” or “cat” claims. These are claims which arise after some sort of natural disaster such as a flood or hurricane or tornado, a catastrophic event where there is widespread devastation and a lot of total losses to property. The adjuster’s job then is helping the policyowner who has suffered a huge loss by adjusting the loss as quickly as possible in order to get the policyowner paid as soon as possible. Many insurance companies have dedicated “cat teams” ready to be deployed whenever necessary. This is another area where independent adjusters are used.

What do I need to do to become a claims adjuster?

In most states, including North and South Carolina, in order to adjust claims, you must obtain a claims adjusters license. A public adjuster also needs a license, which is slightly different than a normal adjusters license.

This requires passing a test to ensure you have a basic understanding of insurance and the policies you will be working with as well as any state laws which may apply to licensing and your dealings with the public.

You must then meet the general licensing requirements, such as being an adult, i.e. at least 18 years of age, and not having been convicted of a felony, be a resident of the state, and then apply and pay the fee for your license.

What are the requirements to become an adjuster in South Carolina?

In South Carolina you must be at least 18 years of age, not been convicted of a felony, be of good moral character, and be a resident of the state.

You must then pass a multiple-choice exam consisting of 100 questions covering the insurance and licensing laws of the state, insurance generally, the standard insurance policies covering property and liability, both personal and commercial, and also some specialized policies, such as flood insurance. The public adjuster’s exam has 60 questions as it covers property insurance only. A passing score is 70%. The cost of either exam is $59.

One you have passed the exam, you must obtain a SLED background check to prove you have not been convicted of any felonies in South Carolina. This costs $25.

Finally, you must apply for your license at NIPR.com and pay an application fee of $80. 

For more specific information on the South Carolina adjusters license, here is a link to the South Carolina Department of Insurance. https://doi.sc.gov/355/Adjuster

What are the requirements to become an adjuster in North Carolina?

The requirements are similar to South Carolina. You must be at least 18 years of age, have not been convicted of a felony, be of good moral character, and be a resident of North Carolina.

The licensing exam is similar to the South Carolina exam, in that it covers insurance generally, as well as the standard insurance policies you will be working with, both personal and commercial, as well as the specialized policies available in North Carolina. It also covers North Carolina insurance and licensing laws. The exam consists of 100 questions, and a passing score is 70%. The cost is $45.

Public adjusters in North Carolina must also be fingerprinted by local law enforcement and post a $20,000 surety bond.

Finally, you must apply for your adjuster’s license online at NIPR.com and pay the licensing fee of $75 along with a $50 registration fee and a $44 application fee for a total of $169.

For more specific information on the North Carolina adjusters license, here is a link to the North Carolina Department of Insurance. https://www.ncdoi.gov/licensees/insurance-producer-and-adjuster-licensing.

Do I need a pre-licensing class to get my license?

Although adjusters are not required to take a pre-licensing course in order to take the adjusters exam, most candidates do attend a pre-licensing course to learn the information necessary to pass the licensing exam. It is possible to study on your own, but most people find it is easier to attend a class so they can be sure that they learn what is necessary to pass the exam.

Brewer Insurance School has pre-licensing classes for Adjusters as well as Agents in both North and South Carolina. We have classes every month in Columbia for South Carolina adjusters, and also via a Zoom meeting in both North Carolina and South Carolina. Check our schedule [here].

What if I want to work in more than one state?

Once you have gotten your state insurance adjusters license in either North or South Carolina, you can then be licensed in other states as well in order to adjust claims in those states. This is called a nonresident license, as you do not reside there.  There are a few states where an adjuster’s license is not required, although most states do require a license to adjust claims in that state. The good news is no new exams are required. All that is necessary is to go to NIPR.com again, choose the states you wish to be licensed in, and pay each state’s licensing fee. Some states may have additional requirements as well.

Following a large natural disaster, such as a hurricane or tornado, most states will allow adjusters to enter the state to adjust claims arising from the catastrophe without being licensed in that state. This is done typically through what is called an emergency adjuster permit, which allows you to adjust claims arising from that emergency only with the requirement that once the state of emergency ends, you must leave the state and go home.

What must I do in order to keep my adjusters license?

In South Carolina, an adjuster’s license is valid indefinitely. However, it must be renewed every odd-numbered year by August 31, and an $80 renewal fee paid.

Public Adjusters licenses renew by October 31 every even-numbered year.

In North Carolina, an adjusters licensed is also valid indefinitely. However, to maintain your license, every licensed adjuster is required to complete 24 hours of Continuing Insurance Education every other year, by the last day of your birth month in either the even or odd year, depending on your year of birth. So, if you were born May 23, 2000, you must renew by May 31st every even-numbered year. The 24 hours must include at least 3 hours of ethics. Every other compliance period (every 4 years), you must also take a department-approved 4-hour flood insurance class.

Where can I find a North Carolina approved continuing education provider?

The North Carolina Department of Insurance maintains a list of all approved CE providers on its website. Brewer Insurance School is a North Carolina-approved CE provider and we hold classes online via Zoom meeting two weeks a month. You can look for upcoming CE classes on our website [here].