When your home is damaged, it’s natural for most homeowners to call their insurance agent. Your agent is usually the first person who comes to mind because they sold you the policy. But insurance agents don’t handle claims. That job belongs to an adjuster.

It’s important for homeowners to understand the difference between an insurance agent and an adjuster. This blog post explains the difference between the two and answers some common questions people have about the distinction.

What Does an Insurance Agent Do?

Insurance agents sell policies. They gather information about your needs and potential risks, they recommend what types of coverage (and how much of it) would work best for your budget, and they provide ongoing customer support for questions about changing or renewing policies. Ideally, you may develop a relationship over time with your agent after years of consulting with them about your insurance needs.

But when you make a claim, the first thing an agent will do is refer you to an insurance adjuster.

What Does an Insurance Adjuster Do?

Insurance adjusters are in charge of investigating your claim and determining how much the insurance company will pay out. They inspect property damage, interview claimants and witnesses, and review your supporting documentation. In general, there are two types of adjusters: Field adjusters, who visit the location to assess damage, and desk adjusters, who work on your claim from an office.

When Do You Interact With an Insurance Agent Versus an Adjuster?

Here’s when you’re likely to interact with an insurance agent:

  • When you’re shopping for insurance, comparing quotes, and selecting coverage.
  • When you need to make changes to your policy, such as updating coverage limits, or changing your address.
  • When you have questions about your policy or need help understanding your options.

Here’s when you’re likely to interact with an insurance adjuster:

  • When you file a claim after experiencing a loss and you’re requesting compensation from the company.
  • During the claims process, when the adjuster is your primary point of contact for the investigation, evaluation, and negotiation of your claim.
  • When you’re presented with a settlement (or when your claim is denied).

Not to be cynical, but it’s good to keep the following in mind about agents and adjusters: As employees of the insurance company, it’s in the agent’s best interest to sell you the most expensive coverage they can, and it’s in the adjuster’s best interest to limit the payout you get for a claim as much as possible.

When interacting with either of these company representatives, you need to diligently defend your own interests, and working with an insurance attorney is one of the best ways to do that.

FAQs About Insurance Agents Versus Adjusters

Can an Insurance Agent Help With a Claim?

It’s important to remember that insurance agents don’t investigate claims or make determinations about payouts. However, agents can:

  • Answer basic questions about your policy’s coverage
  • Explain how the claims process works
  • Help you track the progress of your claim
  • Provide contact information for adjusters during the claims process

When Should You Hire a Public Adjuster?

Public adjusters are independent insurance professionals that policyholders can hire to work for them during the claims process. They typically charge between 5 and 15% of the claim settlement. Public adjusters can be useful when you’re dealing with a complex or large-scale claim, you’re trying to navigate complicated policy language, or you’re overwhelmed by the claims process and need assistance. However, public adjusters can’t provide you with legal advice, file bad faith claims against insurers, or represent you in court if you need to sue or appeal a decision.

Further Resources on Insurance Coverage Law

Navigating the complexities of insurance claims can feel overwhelming. Whether you’re facing unpaid claims or simply filing for the first time, our eBooks equip you with the crucial information you need to advocate for yourself with confidence.

Why Merlin?

Are you fighting an insurance company that won’t pay up on claims? With nearly 40 years of practice and $2 billion in recovered claims, our team stands by your side to ensure you can face any insurance challenge with confidence. Contact us today for a consultation, or read more about how we’re your trusted advocate.