What a claims adjuster does

Who the adjuster works for

The NAIC's licensing handbook for state regulators describes three kinds of claim adjusters. Which one calls you tells you whose interests they represent.

Licensing varies. Iowa, for example, requires licenses for independent and public adjusters, while licensing for staff adjusters there is optional. On a car claim you may also deal with an appraiser, who inspects the damage and writes the repair estimate, and with a desk adjuster who handles the file by phone and email. The California Department of Insurance notes that a qualified adjuster or appraiser usually inspects the vehicle damage, and may re-inspect if the shop finds more.

What the adjuster decides

• Coverage: whether the policy was in force, the driver and the car are covered, and which part of the policy applies, such as collision, comprehensive or medical payments.
• Fault: on a crash with another driver, who caused it and in what share, from statements, photos, the police report and the damage.
• The amount: the repair estimate, or the car's actual cash value if repairs would cost too much, plus other covered costs such as towing or a rental.
• Payment: who gets the money (you, the shop, your lender) and what is deducted, such as your deductible.

The adjuster works under your state's unfair claims practices rules. Under the NAIC model regulation that many states follow, the insurer must acknowledge the claim within 15 days, reply within 15 days when you write and expect an answer, disclose to its own customer all the benefits and coverages that may apply, and accept or deny within 21 days after proof of loss or explain why it needs more time. Your state's figures are on its page in claim rules by state, such as California claim rules, where the decision deadline is 40 days.

The repair estimate has its own rules in the model. If the insurer settles a partial loss on its own estimate, you get a copy. If a shop you chose writes a higher estimate, the insurer must either pay the difference or name at least one shop that will do the repair for its estimate, and it can't make you travel an unreasonable distance for an estimate or a repair.

Public adjusters and car claims

A public adjuster negotiates a claim with your insurer on your behalf and is paid out of the settlement. The NAIC Public Adjuster Licensing Model Act, as amended in 2025, requires a state license, a written contract, and a disclosure of the claim process before you sign, and it gives you 3 business days to rescind the contract. It also says it is not intended to apply to personal or commercial auto claims, so public adjusters are rarely part of a car claim. Whether one may handle an auto claim, and what they may charge, depends on your state's law.

Working with an adjuster

1. Get the basics on the first call: the adjuster's name, direct phone and email, the claim number, and whether they work for your insurer, the other driver's insurer or a firm hired by one of them.
2. Ask what they need to decide, and by when. Send it in one organized batch by email or the insurer's portal, and keep the receipt.
3. Give facts, not guesses. Answer what you know, say when you don't know, and correct mistakes in writing. If they ask to record the call, see giving a recorded statement.
4. Ask for copies of the repair estimate, a total loss valuation report, and any fault decision with the percentage assigned to you.
5. Confirm calls by email: a two-line note of what was said and promised gives you a record a supervisor or regulator can read.

On a claim against another driver, remember that their adjuster's job is to pay what their customer is legally responsible for and no more. That is not hostility; it is whose side they are on. How those claims work is in liability claims against the other driver.

When the answer seems wrong

• Ask for the reasons in writing. Under the NAIC model a denial must be in writing and cite the policy provision; a low offer should come with the estimate or valuation behind it.
• Answer with evidence: a second estimate from a shop, listings of comparable cars, photos or a witness statement.
• Ask for a supervisor or claims manager if the adjuster doesn't respond or won't explain the number.
• Complain to your state insurance department if deadlines pass or you get no reasons; see filing a complaint.

Questions people ask