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Role of the Claims Examiner

The Insurance industry is well-structured with many companies offering to insure homes and businesses; every property damage claim that is filed must be reviewed by a claims examiner that works for the insurance company. Every year Insurance Companies pay out a large amount of claims filed by policy holders, and that is why they employ professional examiners to check whether all details and paper work of the claims are accurate. As a policy holder, you should also hire a claims examiner, also known as a Public Adjuster, to make sure the insurance company pays all the money to put your home or business back to pre-loss condition. The insurance company claims examiner will only pay what the insurer will allow, and without anyone on your side, they will pay as little as possible.

Evaluation of Insurance Claims and Applications

As an individual, it is not in your best interest to deal directly with the Insurance Claims Examiner, because they have a great deal of influence on whether the insurer cover loses or not. They do the work of evaluation and examining of the applications that are submitted on a daily basis, they also follow up on what insurance adjusters have done to verify the accuracy of each claim. They work round the clock to ensure that Insurers don’t lose money to claims that aren’t justified, and they attempt to save money for the insurance company by paying as little as possible for each claim. It should be obvious that the insurance company claims examiner does not protect the best interest of the policy holder, so make sure you call Atlanta Public Adjusters and let one of our top claims examiner come and work for you. The only cost you will ever pay for Atlanta Public Adjusters to work for you is your deductible. Our fee comes from the insurance proceeds, never from the policy holder.

Findings Review

Another role of a Public Adjuster is reviewing of findings, and results from the insurance claims examiner in a given Insurance Company. A Public Adjuster ensures that all findings and filings by insurance adjusters are correct done, Public Adjusters ensure that the process is followed within the Insurance Company’s guidelines. The documentation has to reflect the entire loss as well and adhere to the Insurance Company’s rules; Public Adjusters as well as Insurance Company Examiners are senior as far as claims are concerned. Public Adjusters are called upon in complex claims that involve hefty payouts and tough cases; they also come in handy where questionable claims that might be denied.

Examiners in Different Insurance Classes

Although all Examiners do the same kind of work no matter if they work for the Insurance Companies or the policy holders, they differ depending on the class of insurance they work on. Medical insurance examiners only deals with medical claims where they verify medication and the treatment, they also visit health institutions to ensure that claims filed are accurate. Life insurance Examiners mostly deal with causes of death, and or related life matters before a claim is settled. Auto insurance Examiners only reviews and evaluate damages on vehicles, and how accidents have occurred. Examiners are specialized depending on the kind of insurance examination they are involved with. Public Adjuster claims examiners work for you, the policy holder, as a way to ensure you are represented at the same level the Insurance Company is represented by the claims examiner that works for them. Why would you let the insurance company claims examiner determine how much you should get paid?

Payment Policies

An Insurance Company claims examiner has a sole discretion to decide whether a case is genuine or in need further investigation and if the claim is going to be paid by the Insurance Company. He clears the case and will process the payment on the claim. But if an Insurance Company Claims Examiner decides that the claim isn’t covered he can immediately deny the claim.

Make Recommendations on Cash Reserves

Insurance Company Claims Examiners also study and analyze Companies cash reserves to make sure that there is enough cash to settle claims. They can adjust and recommend how the cash reserve is utilized, they also do further examination about coverage to find out cases of serious illnesses that pose serious threats to an insurer. This they do in order to come up with recommendations on the cash reserves.

Claims Administrations

The functions of Claims Examiner are not limited only during the time of settling claims, but they also play a day to day role of filing and entering data on the Insurance Company’s IT systems. They organize all aspects of claims for the claims department and ensure that all records are kept in order. They also keep inventories of claims that require further investigations and analysis.

The Insurance Company Claims Examiner works exclusively for the insurance company, not for the policy holder. Don’t make the mistake of handling your property insurance claim on your own. Call 404-445-4561 and let an Atlanta Public Adjuster become your personal Claims Examiner.

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