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Dealing With Car Insurance Claim Adjusters

A car insurance claim adjuster works directly for the insurance company whether they are hired as an independent adjuster or they are an employee of the company. A claims adjuster may also be referred to as a customer service representative or a claims representative.  Many people are under the misconception that the insurance adjuster is working for them. Since the claim adjuster works for the insurer, it is their job to settle claims as cheaply as possible. 

How Do I Deal With An Insurance Adjuster After An Accident?

accident report

Following an accident involving property damage or personal injury, you must report it to your insurance provider. An insurance adjuster will be assigned to your file. You will be required to provide the adjuster with all the information pertaining to the accident, you must be 100% honest. 

What Should You Say And Not Say To An Insurance Adjuster?

There are several things you should never say to your insurance adjuster. Some of these include:

  • Never admit fault
  • Never use apologetic language during a conversation
  • Never speculate what happened
  • Never say I’m not injured
  • Never give a recorded statement

Things that you can say to your insurance adjuster include:

  • When the accident occurred
  • Where the accident occurred
  • What vehicles were involved in the accident
  • Provide the other drivers basic information and  insurance information 

How Do Insurance Adjusters Investigate?

payment-for-accident

Insurance adjusters collect all the information pertaining to the accident. This allows them to assess all property damage and personal injury, as well as determine the extent of coverage you have. They must determine fault by complying with The Insurance Act and the Fault Determination Rules.

What does the adjuster do for auto insurance?

The adjuster works directly for the insurance company, not for the insuree. The adjuster will settle the claim as cheaply as possible. The claims adjuster will also guide you through the claims process. 

What Does an Insurance Adjuster Do Following An Accident?

The insurance adjuster assigned to your file will contact you. He/she may want to meet with you in person or the entire claim can be handled over the phone. The insurance adjuster will collect all the necessary information pertaining to the accident. The claims adjuster will advise you on the extent of coverage that you have. The claims adjuster will instruct you about obtaining a quote for damage to your car from one of their preferred repair shops in your area, or another approved repair shop of your choice. The claims adjuster will also arrange for a rental vehicle (if included in your policy) for the period of time your own vehicle is being repaired. The claims adjuster will assess fault by all the information pertaining to the accident following the Fault Determination Rules. The claims adjuster will guide you through the entire claims process. 

What To Do If You Have A Complaint About How Your Claim is Being Handled

If you are not happy with the way your auto insurance claim is being handled there are certain steps you can take. The government has established a Complaint-Handling Protocol for insurance companies. The complaint-handling protocol may vary from insurance company to insurance company. Your insurance company will be able to provide you with the steps you need to take when you have a complaint. 

How To Become An Insurance Adjuster

In Ontario, you must follow a licensing process to become a fully licensed insurance adjuster. There are 3 stages to obtaining your full adjuster’s license which are:

  • Letter of Authority
  • Probationary Adjusters Licence
  • Full Adjusters Licence

Letter of Authority

Writing letter

The first stage to becoming an insurance adjuster is referred to as a letter of authority. In order to obtain a letter of authority, you must meet certain requirements. These requirements include:

  • Completing an insurance adjuster application, pay the required fees, and provide supporting documentation.
  • Have knowledge of the Ontario laws pertaining to the licensing of adjusters.
  • Must be sponsored by a fully licensed adjuster, adjusting company, or adjusting partnership.

During 30 months of holding the letter of authority, a person must successfully complete the following IIC courses:

C11 – Principles and Practices of Insurance OR both C-81 and C-82 (GIE) courses

C12 – Insurance on Property

C14 – Automobile Insurance Part 1

C110 – Essentials of Loss Adjusting

Once all these steps are completed you will receive a Probationary Adjusters Licence.

Restrictions – When holding a Letter of Authority, a person cannot:

  • Sign any communication or report addressed to an insurer.
  • Sign any other correspondence without the permission of the employer.
  • Authorize repairs to the property or agree to accept any bill regarding a claim without the consent of the employer.
  • Negotiate the settlement of any bodily injury claim.

Probationary Adjusters Licence

The following 4 courses must be completed within 30 months of receiving a probationary adjusters licence:

C13 – Insurance Against Liability

C32 – Bodily Injury Claims

C111 – Advanced Loss Adjusting

C112 – Practical Issues in Claims Management

Restrictions – When holding a Probationary Adjusters Licence, a person cannot:

  • Sign any communication or report addressed to an insurer.
  • Sign any other correspondence without the permission of the employer.
  • Authorize repairs to the property or agree to accept any bill regarding a claim without the consent of the employer.
  • Negotiate the settlement of any bodily injury claim.

Full Adjusters Licence

In order to achieve a Full Adjusters Licence the participant must:

  • Successfully complete all 8 courses as outlined in the Letter of Authority and the Probationary Adjusters Licence stages.
  • Register and pay no later than 6 weeks in advance of the examination date, the required fee through CIAA.
  • Successfully pass with a mark no less than 70% a computer-based exam in automobile, liability, and property insurance.
  • Be employed full-time by an independent adjusting firm.

Exceptions:

Individuals which have a Chartered Insurance Professional designation or Fellow Chartered Insurance Professional designation may take the computer-based exam without having to complete the 8 courses as listed above. 

Those that do not pass all three requirements on the exam, automobile, liability, and property,  may be eligible to complete an oral exam before a Qualification Panel on the requirements they are required to pass.

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